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EMBARGOED UNTIL DATE OF MEETING

Renfrewshire Community Health Partnership CommitteeDate: 19th September 2008 (Paper No. – 08/28)Author: CHP Director

Agenda Item Description – Renfrewshire CHP Workforce Plan 2008 - 2011

1. Introduction and Background

1.1 This is the first Workforce Plan published by Renfrewshire CHP since it’s formation in 2006.

1.2 Workforce planning work in relation to the Renfrewshire CHP workforce was prompted by the anticipation of a range of service changes over the next three years (and beyond) which have significant workforce implications.

2. Brief Summary

2.1 The methodology used in the development of this workforce plan has been developed within NHS Greater Glasgow and Clyde and has been accepted by all NHS Boards in the West of Scotland to provide a logical and chronological process which is easily understood by participants and which suits a project management approach.

2.2 The scope of the document is to cover the workforce directly employed by Renfrewshire CHP at this time.

2.3 It is anticipated that the plan will cover the period from 2008 to 2011 to align with the CHP Development Planning process. The context of this plan is set against a time of increasing financial constraints and increased competition in the labour market.

2.4 The document and plan will link to the NHS Board, regional and national workforce planning processes as well as workforce plans for service area and profession specific plans.

Recommendations:

The Committee is asked to:

Note the content of the paper and work undertaken to date.

Renfrewshire CHP Workforce Plan 2008-2011Consultation Draft

Renfrewshire CHP

Workforce Plan

2008-2011

2


Chapter Contents Page

Executive Summary 3

1 Introduction 4

2 Workforce Demand:

- Background and Local Service Drivers

9

3 Workforce Supply:

- Current Workforce- Workforce Trends

14

4 The Future Workforce:

- The NHS Career Framework- The Future Workforce- Affordability- Availability- Adaptability

28

5 National, Regional and Local Actions:

Challenges and Actions:

- Recruitment and Retention- Service and Role Redesign- Education and Development

39

6 Action Plan

Implementation and Monitoring

44

Appendices:

1 Project Team Membership

2 References

3


Executive SummaryThis is the first Workforce Plan published by Renfrewshire CHP since it’s formation in 2006.

The CHP has an experienced and stable workforce which exhibits a relatively low leavers rate of 5.42% over the last year. This is encouraging in relation to retaining an experienced workforce however, it may limit the opportunity for service redesign initiatives using turnover as a driver.

The CHP workforce displays a slightly older than average workforce (if median age is taken as 42 years old). There are no immediate concerns regarding staff losses through retirals in the majority of staff groups although there is are two groups Untrained Nursing Staff and Administration Staff where a cohort of existing staff members are approaching retiral age. Appropriate recruitment or retention strategies may have to be considered for these groups in the near future depending on forecasted need.

The Renfrewshire CHP staff work on average 0.80 wtes. Part time staff display an average wte input of 0.62 wte

The CHP workforce is predominantly female with an 88% Female to 12% Male split. This is consistent with the pattern displayed in other CHCPs/CHPs.

The CHP has a large staff component working within Elderly Inpatient Mental Health services. The majority of these staff will have Mental Health Officer Status and as such may display a trend towards earlier retiral age Retiral and leavers rates will be closely monitored and reviewed to identify any changing trends within the CHP which may present opportunities for service and role redesign.

The CHP works closely with General Medical Practices and estimated workforce and retiral projections are included in this plan within chapter 3.

Detailed workforce information for other Independent Contractors Groups such as Dental Practice staff, Community Pharmacists and Optometrists is limited at present. NHSScotland is currently reviewing data collection options for these groups and the CHP will implement any recommendations arising from this review.

A number of generic workforce challenges have been identified in Chapter 5 under the headings

Recruitment and Retention Education and Learning Service and Role Redesign

An action plan containing a series of detailed action points has been developed and is included in this in this workforce plan under Chapter 5.

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1 Introduction

Workforce Planning Methodology

The methodology used in the development of this workforce plan has been developed within NHS Greater Glasgow & Clyde and has been accepted by all NHS Boards in the West of Scotland to provide a logical and chronological process which is easily understood by participants and which suits a project management approach with delegation of tasks to project team members and others. The methodology is outlined below.

Workforce planning work in relation to the Renfrewshire CHP workforce was prompted by the anticipation of a range of service changes over the next three years (and beyond) which have significant workforce implications.

Chapter 2 focuses on the service changes and workforce implications. At the same time, the CHP workforce in five years time will be shaped by, and will evolve from, the current workforce. The dynamics of the current workforce, turnover, age, etc. are examined in Chapter 3.

Chapter 4 gives a picture of what the future workforce will look like five years ahead.

A series of challenges to bring about the required future workforce is identified under the headings of recruitment and retention; service and role redesign; and education and development. Actions are derived to meet these challenges. The challenges and resulting actions are set out in Chapter 5.

Actions developed to meet these challenges are brought together in an action plan in Chapter 6 with arrangements for implementation and monitoring.

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Scope

The scope of the document at this time is to cover the workforce directly employed by Renfrewshire CHP as shown in Figure 1.1.

Figure 1.1

Discipline Headcount WTEADMINISTRATIVE 103 81.28ALLIED HEALTH PROFESSIONS 113 91.73ANCILLARY 26 12.45MEDICAL & DENTAL 37 33.40NURSING (TRAINED) 295 238.28NURSING (UNTRAINED) 137 111.47PSYCHOLOGY 9 8.24TECHNICIANS 3 2.19

Total 723 579.05

RENFREWSHIRE CHPCURRENT WORKFORCE (as at September 2007)

The CHP has close links with a number of independent contractor groups providing healthcare services within the CHPs geographical area. Theses groups include

General Medical Practitioners General Dental Practices Community Pharmacists Community Optometrists

Following the introduction of new contractual arrangements for independent contractors the CHP has limited information on the workforce within these specific groups. While this may be the case a number of actions detailing support for independent contractors are noted within the action plan chapter

It is anticipated that the plan will cover the period from 2008 to 2011 to align with the CHP Development Planning process. The context of this plan is set against a time of increasing financial constraints and increased competition in the labour market. Our core services face continuing and growing demands from service users.

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Links to Other Plans

The CHP Workforce Plan cannot stand alone as a piece of isolated work. The document and plan will link to the NHS board, regional and national workforce planning processes as well workforce plans for service area and profession specific plans. A diagram showing the expected linkages is shown below

National Workforce Plan

West of Scotland

Workforce Plan

NHS Board Workforce Plan

Acute Services Workforce Plan

CH[C]Ps Workforce Plan

Directorates Workforce Plan

Staff Group Workforce Plans

Partnership

Involvement

Learning and Education

Workforce Planning - levels and linkages

Relationships with other parts of the NHS system are being developed. Renfrewshire CHP has been ‘twinned’ with Clyde Acute Directorate and the two management teams will come together over the next 12 months to ensure that interface issues are addressed. – check current arrangements for this!!

Historically, the primary/secondary care interface in Renfrewshire with the Royal Alexandra Hospital has been strong, and we will build on this. This plan has been developed in partnership with acute planning colleagues, and we have ensured that areas of joint work are highlighted in both plans.

Other CH(C)Ps have been twinned with other Directorates within the Acute Operating Division to ensure a primary care perspective is present within the management of acute services. To complement this, CH(C)Ps have agreed representation at the Collaboratives for Diagnostics, Planned Care and Unscheduled Care. CH(C)P Directors will form a network to share information from the twinning arrangements and from representation at the Collaboratives

Communication Policy and Process

This document is only one method of sharing the message and the plan.

The focus for approving the detail and plan lies with the CHP Committee. This group will be central to taking forward the key messages and actions contained within the

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plan. It has been recommended that responsibility for workforce planning in future be integrated with learning and education at a corporate level.

It is planned that an executive summary and standard version of this report, will be made available and shared in a variety of meetings, groups and forums over the coming months.

Vital to the success and relevance of this process and document is ownership of the plan by the relevant manager / group or area. Implementation and success around the plan will have to be monitored on a regular, ongoing basis. This document is not a “one off”; it should be used as a supportive tool to help plan and develop new services and service changes in the future.

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2. Workforce DemandService Planning and Priorities

Renfrewshire CHP covers the entire population of the local authority of Renfrewshire Council. The total population of the Council area is approximately 170,000 and the main population centres within the Council area are Paisley, Renfrew, Johnstone, Linwood, Erskine, Bridge of Weir and Elderslie along with a collection of smaller, more rural villages, such as Bishopton, Lochwinnoch, Houston, Howwood and Kilbarchan.

The CHP has 30 GP practices – practice population 177,000, 30 Dental practices, 44 Pharmacies and 20 Optometry practices. We have approximately 800 members of staff and an annual revenue budget approaching £85 million.

We directly manage health visitors, school nurses, district nurses, allied health professionals, health improvement staff and the relationship with primary care contractors. We jointly manage teams for learning disabilities and older people with Renfrewshire Council and we host specialist children’s services for Clyde (south of river).

Our vision is that Renfrewshire CHP will:

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Ensure patients and a broad range of health care professionals are fully involved in planning and delivering services

Establish substantive and productive working relationships with Renfrewshire Council.

Have responsibility and influence in the designing of services at a local level. Play a central role in designing services at a local level. Act as a focus for integrating primary/community health services and

specialist/hospital services. Play a pivotal role in delivering health improvement for Renfrewshire.

The current Renfrewshire CHP Development Plan [April 2007] 1 describes the detailed planning priorities for the CHP for the period 2007-2008 and looks forward look at priorities for the next three years.

The Development Plan for 2007/2010 has been shaped and influenced by the NHS Greater Glasgow and Clyde wide corporate themes, which underpin both our personal and organisational objectives. The action plan resulting from this plan demonstrates how we will deliver against these themes, and we will use this as a basis for performance management and related reporting. The corporate themes are:

Improve resource utilisation Shift the balance of care Focus resources on greatest need Improve access Modernise services Improve individual health status Effective organisation

Achieving the corporate themes and priorities requires continuing change to our organisation and staff. The nine transformational themes have set the framework for driving that reformation and continue to be an explicit element of planning:

Achieving an organisation in which the component parts work together to shared aspirations and objectives, not competing ones, and managers and clinical leaders work in teams with shared values and priorities

The whole top team and organisation contributing to leadership on health improvement and tackling inequalities.

Focusing on service improvement and equipping and supporting frontline staff and first line managers to help us deliver it.

Moving away from functional systems of management to general management with managers at all levels responsible for the quality of service delivered to patients and professional staff developed into management and leadership roles.

An organisation where people take responsibility for their area of work and for the wider performance of the organisation

An organisation focused on learning and development, as individuals and collectively, to improve our performance.

A culture of clear objectives, accountability and performance management at all levels.

1 Renfrewshire CHP Development Plan

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Driving integration of acute and community and health and social care services to improve the experience of patients.

Leaders and managers who have a value base of public services, acting in the interests of patients and the communities we service, behave in a collaborative not competitive way but constructively challenge each other

NHS Greater Glasgow & Clyde has established a ten element approach to become a more inequalities sensitive NHS as follows:

1. Knows and understands its diverse population and the nature of inequality and discrimination it experiences.

2. Develops and delivers meaningful engagement with those experiencing inequality and discrimination in order to design services and empower patients.

3. Recognises that positive behaviours for health will be more likely to be enacted if strategies for support are specifically designed to take the experience of social class, gender, race, disability, age, sexual orientation and faith into account.

4. Understands and removes the obstacles to accessing frontline services and health information.

5. Creates services that have the ability to support patients in the context of their lives and gives practitioners support to address the causes as well as the consequences of inequality and discrimination.

6. Recruits and retains a workforce that represents, at all levels of the organisation, the diversity of the population.

7. Creates a working environment which is responsive to all dimensions of health and social inequalities, and prevents discrimination and prejudice from affecting patient care and staff relations by developing the competency of and support for staff leading and implementing an inequalities sensitive health service.

8. Reallocates available resources and manages performance in favour of the elements of an inequalities sensitive health service.

9. Procures its goods and services to impact positively on health and social inequality.

10. Advocates for and contributes to the implementation of economic and social policy which addresses income inequality, geographic and social class inequality, gender inequality, racism, disability discrimination and homophobia, as pre-requisites for good health.

We will use the 10 goals framework to develop inequalities sensitive health services in Renfrewshire as follows:

Expand the training offered to staff groups to embed equality into practice Implement the new Language Plan, Gender Based Violence and

Communication support policy Use the Equality Impact Assessment tool to assess CHP plans and

services

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Check plans and documents to meet requirements of the Equality Scheme

Involve services users in services changes and redesigns Improve the collection of patient data Implement processes on Human Resource data collection and indicators

for performance reporting

Improving health and wellbeing is a key priority for Renfrewshire CHP. In order to achieve significant health gain, health improvement as well as inequalities need to be reflected in all the policies and activities of the CHP and Community Planning partners. This section describes the services, challenges and priorities for 2007/08 in the following areas:

Smoking/tobacco control Obesity/weight management Older people Physical disabilities and long term illness Palliative care and cancer Mental health Addictions Learning disabilities Children Sexual health Carers

Smoking/Tobacco Control Service Priorities

Smoking prevalence is around 35% among people aged 16-74 in both Scotland and Renfrewshire. However this figure belies the true picture and there is evidence of large disparities in smoking prevalence at postcode or neighbourhood level.

In terms of success, Renfrewshire has demonstrated the highest reduction in smoking by region from 2003 to 2005. The Scottish Household survey shows a 5% decrease from 27% to 22% thus achieving the SE 2010 target.

Workforce issues may arise from the potential integration of the Clyde smoking cessation service with the wider NHSGG&C smoking cessation services.

Obesity/Weight Management Service Priorities

The Nutrition and Dietetic service is the main specialist service for both adults and children, receiving referrals from General Practitioners, medical consultants and other NHS professionals. Patients attending this service are seen initially by the Dietitian and where appropriate are followed up in a group session. Dietitians also deliver services in specialised fields, such as mental health & learning disabilities, and provide appropriately tailored weight management advice to specific client groups.Workforce implications include

Reviewing current level of service provision (including patient pathways) and compare with patient need.

The Nutrition and Dietetic Service will work with Paisley Partnership in developing and delivering training on the use of a weight management lay support package for community workers.

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Identify training and development needs for NHS staff involved in delivering weight management services across the CHP.

Older People’s Services Priorities

By 2013, we anticipate we will need to support at least 230 additional older people per year who require the level of care that a care home currently provides. 160 of these people are likely to have mental health needs and 70 will have complete physical care needs. We expect that as people live longer following retirement on fixed/limited pension incomes,

Our current District Nursing, Podiatry, Physiotherapy and Dietetics Services are under pressure to meet the needs of our population. This has resulted in increased waiting times for routine cases within AHP Services. Although redesign work is planned to commence in 2007/8, early analysis of existing resources in these services suggests consideration of options to meet the needs of our populations’ changing demographics which could include the need for additional resources and/or delivering services that are targeted to the greatest need. These resource requirements will require to be considered and prioritised within the overall CHP Development Plan.

Physical Disabilities and Long Term Illness Priorities

Issues for the CHP include understanding our current activity and caseload and optimising how frontline services provide interventions to people with disabilities and long term illness. In addition we need to explore how the new GP contract can enable us to improve our service response.

Palliative Care and Cancer Service Priorities

Renfrewshire has an above average amount of cancer and concomitant palliative care which covers other terminal illnesses apart from cancer (e.g. COPD, heart failure and MS). Approximately 20 people with a terminal illness will be receiving speech and language therapy at any time. The use of oral nutritional supplements is increasing. The challenge is to understand how patients access services and if services are comprehensive and responsive.

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Mental Health Service Priorities

Community based Mental Health services are provided via two joint Community Mental Health Teams (CMHTs), with staff from both health and social work making up the membership of the teams. The "Doing Well by People with Depression" project provides a primary care based service for all people presenting with low mood or depression to 14 GP practices in West Renfrewshire. Adult Acute in-patient care is at Dykebar Hospital and 30 acute assessment beds based at Dykebar and the Royal Alexandra Hospital.

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Estimates suggests that one third of all consultations between GPs and patients in Scotland are in relation to Mental Health Problems. The scale of time is clearly a major driver in demand for services.

The key service priorities in mental health will be identifed as part of the development of a comprehensive Mental Health Strategy. The workforce implications of this will include developments such as:

A Crisis Resolution Team An Assertive Outreach Team Primary Care Mental Health Team Reduction in the number of adult continuing care beds

Addictions Services Priorities

There are a number of challenges confronting services based on population analysis:

Alcohol -In the former Argyll and Clyde area, the number exceeding recommended weekly limits was higher among both males and females in comparison to the rest of Scotland.

Drugs -The national prevalence study of 2003 showed the overall prevalence of problem drug use in Renfrewshire was estimated at 2.41%, Scotland was 1.84%.

A more comprehensive set of priorities will emerge with the Addiction Services Strategy but these will include workforce issues around

Drugs - Identify member of nursing team to provide additional shared care clinic

Alcohol - To further develop Acute Alcohol Liaison Service by extending it into Accident and Emergency Dept at RAH.

Learning Disabilities Service Priorities

A Joint Manager for Learning Disabilities has been appointed to develop an integrated learning disability service in Renfrewshire and it is planned that health and social work services will become part of the redesigned joint learning disability service for Renfrewshire.

Based on national research, Renfrewshire is likely to have around 600 people with a profound or multiple learning disability and around 3,400 with a mild or moderate disability. As these figures are based on total population, and Renfrewshire’s population is predicted to fall in the next 10 years, the number of people with learning disabilities may fall over this period. However, this is likely to be offset by increased survival through medical advances, people living longer and local information

Service priorities leading from National policy and Renfrewshire’s workforce implications:

The closure of learning disability beds at Merchiston Hospital Better met needs of people with Autistic Spectrum Disorder. Development of the and additional input role of the Allied Health

Professionals (AHPs) within the Community Learning Disability Team (CLDTs) across Renfrewshire CHP.

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In dietetics, develop and deliver training packages on identified nutrition topics for staff and carers working with adults with Learning Disabilities.

Children’s Services Priorities

Renfrewshire CHP is the lead CHP for Clyde Specialist Children’s Services and hosts Specialist Children’s Services for Inverclyde and part of East Renfrewshire. Services are planned jointly with local authorities.

NHS Greater Glasgow and Clyde have established a prime objective for 2007 to continue to do more to address the needs of vulnerable children and their families. It recognises that the development and deployment of Renfrewshire CHP’s skilled and experienced Health Visiting and School Nursing resource is key to the NHS contribution to addressing those needs, as are staff within Specialist Children’s Services.

Child Protection - ‘Getting our Priorities Right’ training has been extended for another year

Specialist Children’s Services - Actively participate in the redesign of children’s hospital services.

Dietetic Priorities - In relation to paediatrics we need to identify training needs of all community dietitians and agree appropriate, cost effective ways to address this need.

Sexual Health Service Priorities

In terms of sexual health services, we will work closely with Sandyford to develop the hub model.

Workforce impacts will revolve around the development of a hub in Paisley, supported by a number of smaller satellite clinics.

Carer’s Service Priorities

It is predicted that 3 in 5 people will care for a family member or friend who is unable to manage without assistance due to illness, frailty or disability. Estimates for Renfrewshire suggest that there are approximately 22,000 carers in the area of whom 7,000 are caring for someone for more than 20 hours per week. Approximately 1,800 are young carers.

The CHP has established the Carers Joint Planning, Performance and Implementation Group in partnership with Renfrewshire Council and priorities with specific workforce implications will be to develop education and awareness raising programmes for staff and carers.

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3 Workforce Supply

Using NHS Greater Glasgow & Clyde payroll data as at 30th September 2007 the Renfrewshire CHP Workforce was comprised of 723 directly employed headcount staff working 579.05 whole time equivalents. The workforce is augmented by a “bank” of 332 staff providing services across the “Clyde” area.

Figure 3.1

Renfrewshire CHPStaff by Employment Category

(Headcount & WTE)

332

723579.05

2.210

100

200

300

400

500

600

700

800

Headcount W.T.E Headcount W.T.E

Bank Staff Directly Employed Staff

Hea

dcou

nt/W

TE

Note that all future data expressed within this plan will relate to in-post as at 30 th

September 2007 unless stated otherwise.

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Figure 3.2

Renfrewshire CHPStaff by Discipline

(Headcount & WTE)

137

238.28295

33.43726

110103 111.47

12.45

88.8381.28

0

50

100

150

200

250

300

350

HC

W.T.E

HC

W.T.E

HC

W.T.E

HC

W.T.E

HC

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W.T.E

ADMIN AHP ANCILLARY MEDICAL &DENTAL

NURSING (TR.) NURSING(UNTR.)

Directly Employed Staff

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TE

Figure 3.2 shows the workforce broken into traditional Whitley staff groups. Trained Nurses account for the largest single group of 295 headcount (238.28 wte). “Untrained” Nursing staff are the second largest discipline with 137 headcount (111.47 wte). The third largest staff group are Allied Health Professionals (AHPs) with 110 headcount (88.83 wte).

Figure 3.3 shows the component parts of the workforce expressed as a percentage of the overall total

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Figure 3.3

Renfrewshire CHP WTE as a % of CHP Total

by Discipline

NURSING (TR.)42%

MEDICAL & DENTAL6%

ANCILLARY2%

AHP16%

ADMIN14%

PSYCHOLOGY1%NURSING (UNTR.)

19%

Overall Trained Nursing staff accounts for 42% of the Renfrewshire CHP workforce (WTE). The rest of the workforce is comprised of 16% Allied Health Professions, 19% Untrained Nursing staff and a further 14% of staff on Administrative grades. Note that the A&C group will include staff will delivering primary healthcare services such as Counsellors, Health Improvement staff.

Figure 3.4 shows a further breakdown of the AHP staff group into relevant professional groups.

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Figure 3.4

Renfrewshire CHP AHP Staff (Headcount & WTE)

by Profession

31

19

2726

8

27.37

16.62

18.8421.48

5.42

0

5

10

15

20

25

30

35

HC W.T.E HC W.T.E HC W.T.E HC W.T.E HC W.T.E

DIETETICS OCCUPATIONAL THERAPY PHYSIOTHERAPY PODIATRY SPEECH THERAPY

AHP

Hea

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nt/W

TE

Figure 3.5

Renfrewshire CHPStaff by Service Area(Headcount & WTE)

27

224

174

56

18

133

91

21.08

174.58149.68

50.18

15.23

103.07

65.22

0

50

100

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200

250

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.E

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W.T

.E

Administrative &Other Support

Staff

Children &Families Services

CommunityLearning Disability

Services

Community MentalHealth Services

Elderly InpatientMental Health

Services

Health &Community Care

Services

Planning & HealthImprovement

Hea

dcou

nt/W

TE

The workforce has also been split into the service areas covered by the CHP. The largest service group within the CHP is Health & Community Care which has 224 headcount staff 174.58 wte. Note, for the purposes of this service area breakdown staff providing Inpatient Elderly Mental Health support have been shown separately although they would normally appear in the figures for Health & Community Care Services.

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Children and Families Services are the second largest service group with 133 staff followed by Community Mental Health Services with 56 headcount staff. There are 91 Administrative staff (65.22 wte) employed by the CHP and while they have been shown separately these staff will provide support to the other service areas.

Figure 3.6

Renfrewshire CHPWTE as a % of CHP Total

by Service Area

Inpatient Eldely Mental Health Services

26%

Community Mental Health Services

9%

Community Learning Disability Services

3%

Children & Families Services

18%

Administrative & Other Support Staff

11%

Planning & Health Improvement

4%

Health & Community Care Services

29%

Overall the Health & Community Care service group constitutes approximately half of the CHPs workforce (note that this includes a sizeable Elderly Inpatient Mental health workforce component shown separately). Children & Families Services and Mental Health Services make up 18% and 9% respectively. Again while the administrative component of the workforce have been shown separately it is important to note that these staff will provide support to the other service area and also will include staff on administrative grades providing patient care.

Gender Profile

Figure 3.7 shows the age profile for Renfrewshire CHP by gender. Note the small male staff component within the CHP. There is a 88/12% female to male split within the workforce.

Figure 3.7

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Renfrewshire CHP Gender Profile (by Headcount)

Male12%

Female88%

Age Profile

Figure 3.8 shows to overall age profile by individual age and gender.

Renfrewshire CHPAge Profile

0

5

10

15

20

25

30

35

40

45

23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64


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The distribution shown is consistent with other services displaying “dips” in the female element of the workforce during mid 20’s to mid 30’s. This is usually associated with breaks in service for maternity leave.

Figure 3.9 displays the CHPs workforce age (by gender) in 5 year age bands and gives a clearer picture of the overall age trend within the CHP. The median age of a workforce (based on 20 to 65 year old workforce) occurs at 42 years old. From the

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table we can clearly see that the majority of the Renfrewshire CHP workforce is older than the median figure of 42 years. Consequently the CHP workforce displays a tendency towards older staff members.

Figure 3.9

Renfrewshire CHPAge Profile

(5 Year Age Bands)

0

20

40

60

80

100

120

140

160

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64


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The older age profile displayed within the CHP does not necessarily present an immediate problem however as shown in Figures 3.10 below show the impact of the older workforce will become more apparent over the next 10 years when a greater proportion of the workforce reaches potential retiral age (which for nursing staff can be as low as 55 years old).

The projections within figures are based on the current workforce and will, to some degree be offset by new employees. There is, however, a recognition that there is an increasing trend towards retraining and second careers and we cannot therefore assume that in future new employees will always be at the younger end of the age spectrum.

Figure 3.10

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Renfrewshire CHPAge Profile + 10 Years

(5 Year Age Bands)

0

20

40

60

80

100

120

140

160

30-34 35-39 40-44 45-49 50-54 55-59 60-64


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Within the CHP the impact of an ageing workforce may be more apparent within individual staff groups. Figure 3.11 shows the age profile for trained nursing staff. Given that this group are the largest within the CHP the profile closely resembles that of the CHP as a whole. There is not an immediate problem within this staff group as there are relatively small numbers of staff approaching statutory retiral age in the next 5 years.

Given the high proportion of female staff and the potential for retiral at age 55 for female nursing staff it is important that trends within this particular staff group are closely monitored.

Figure 3.11

Renfrewshire CHPTrained Nursing Staff (Excluding Bank)

Age Profile by Gender

10 12

40

74 74

39

11

5

8 8

1 3

3

4

1 2

0

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20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64

NURSING (Trained)

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Figure 3.12 shows the age profile for untrained nursing staff within the CHP. There is a group a staff approaching statutory retiral age. The number of staff involved may

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not present an immediate problem however there are larger numbers of staff approaching retiral age in the next 5 to 10 years.

Figure 3.12

Renfrewshire CHPUntrained Nursing Staff (Excluding Bank)


26

12

2427

23 21

11

3

32

2

1

0

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10

15

20

25

30

35

25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64

NURSING (Untrained)

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Allied Health Professions (shown in Figure 3.13) displays a clear tendency towards younger staff which while positive in relation to retiral issues may present issues for career progression in future.

Figure 3.13

Renfrewshire CHPAllied Health Professions Staff


5

1620

23

14

7 8 8

2

2

3

11

0

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20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64

Allied Health Professions

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The profile displayed by Administrative staff in Figure 3.14 shows that there are a significant number of staff within this staff group approaching retiral age. The CHP recognises the important role that administrative staff play in supporting the delivery of clinical care and also notes that a number of staff paid on administrative grades deliver care to patients (e.g. Counsellors etc). Given the potential number of retirals in the relatively near future it will be important that the CHP assesses, as part of the workforce planning process, the availability of administrative skills within the local community and as such the potential to recruit to future vacancies.

Figure 3.14

Renfrewshire CHPAdministrative Staff


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Historically recruitment initiatives within the CHP have been successful in meeting current staffing needs however, the CHP recognises that, in future, the shrinking labour market allied to increased competition from both the public sector and private industry will mean recruitment will become more difficult.

This may be offset by more staff working beyond retiral age as a result of social changes such as increased living costs. The CHP will monitor turnover trends including starter and leaver age profile and use this information to inform future workforce plans.

Whole Time Equivalent Trends

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Figure 3.15 shows the current trends in whole time equivalent input displayed by the workforce. There is a relatively even distribution in hours worked as shown by the 377 part time workers providing a 233.05 wte input (an average of 0.62 wte). The overall average wte across the entire workforce is 0.80 wte.

Figure 2.15

Renfrewshire CHPAll Staff (Excluding Bank)

WTE Input

346 346 377

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Length of Service Profiles

Figure 3.16 shows the overall length of service profile for the CHP. The graph shows a large concentration of staff towards the lower end of service length (between 0 and 5 years service. This pattern is consistent with that shown in other CHCPs and CHPs and can be explained by normal staff replacement through the recruitment process.

Figure 3.16


NHS Service Length

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Figure 3.17 shows the overall CHP length of service profile broken into a series of 5 year age bands. This categorisation goes some way to evening the distribution of service lengths and gives an indication that retention is not a significant issue within Renfrewshire CHP as 53% of the workforce has over 10 years service and 74% have more than 5 years service. Note that the information detail is for length of NHS service rather than service solely within Renfrewshire CHP.

Figure 3.17


NHS Service Length (5 Year Bands)

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Leavers Profile

During the last financial year (March 2007 – Dec 07) a leavers rate of 5.42% was noted for the CHP. The figure augers well in relation to the CHPs ability to retain experience staff. Conversely a relatively low leavers rate may limit the potential for service redesign initiatives which utilise staff turnover as a means of exploring the option for developing new models of service delivery.

Figure 3.18 shows the projected leavers for the CHP by service area over the next year using the 5.42% leavers rate as a guide.

The table also includes a projected retirals figure based on the retiral of all staff aged 60 (an average figure based on the mid point between 55 and 65 where trained nursing staff may choose to retire.

For the purposes of this workforce plan retiral projections are based on an assumed retiral age of 62 for all staff. The projections used for the Mental Health component of

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the workforce use 58 as a projected retiral age (this takes into account staff with Mental Health Officer status who are likely to retire earlier).

Note that the assumed retiral figure is conservative and actual retirals may fall below this level. The figures will be monitored against actual retirals and may be revised for future workforce plans in light of trends established across the next few years

Leavers by Service Area

Figure 3.18

Service Area Current Headcount

Current WTE

Projected Leavers* (W.T.E)

Projected Retirals** (W.T.E)

Total Staff Loss (W.T.E)

Administrative & Other Support Staff 91 65.22 3.54 2.03 5.57Children & Families Services 133 103.07 5.59 0.00 5.59Community Learning Disability Services 18 15.23 0.83 0.00 0.83Community Mental Health Services 56 50.18 2.72 0.00 2.72Elderly Inpatient Mental Health Services 174 149.68 8.11 15.45 23.56Health & Community Care Services 224 174.58 9.46 2.23 11.69Planning & Health Improvement 27 21.08 1.14 0.00 1.14

Total 723 579.05 31.38 19.71 51.09

**Retirals based on avaerage Retiral Age of 62 Years, (or 58 for staff with Mental Health Officer status)* Leavers projections based on 2007/08 avaerage of 5.42%

RENFREWSHIRE CHPProjected Leavers and Retirals 2008/09

Figure 3.19 shows the projected leavers for the CHP by service area over the next 3 years (the timeframe of the CHP Development Plan).

Figure 3.19

Service Area Current Headcount

Current WTE

Projected Leavers* (W.T.E)

Projected Retirals** (W.T.E)

Total Staff Loss (W.T.E)

Administrative & Other Support Staff 91 65.22 10.61 9.12 19.73Children & Families Services 133 103.07 16.76 5.01 21.77Community Learning Disability Services 18 15.23 2.48 0.00 2.48Community Mental Health Services 56 50.18 8.16 2.43 10.59Elderly Inpatient Mental Health Services 174 149.68 24.34 26.71 51.05Health & Community Care Services 224 174.58 28.39 6.08 34.47Planning & Health Improvement 27 21.08 3.43 0.00 3.43

Total 723 579.05 94.15 49.35 143.50

RENFREWSHIRE CHPProjected Leavers and Retirals 2008/11

* Leavers projections based on 2007/08 avaerage of 5.42%**Retirals based on avaerage Retiral Age of 62 Years, (or 58 for staff with Mental Health Officer status)

Over the course of the next three years the CHP anticipates losing a maximum of 143.5 wte staff mainly from the larger service areas such as Health & Community Care and Mental Health Services. In future it is expected that trends within each

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service area may be identified in order to assist any “hot spots” where leaver and retiral levels are in excess of the anticipated projections.

Independent Contractor Groups

General Medical Practice Staff

In September 2007 the General Medical Practice workforce across NHSScotland took part in a workforce survey in partnership with the Scottish General Practice Committee (SGPC). The response within Renfrewshire CHP was an encouraging 80% and the information shown in figure 2.20 has been extrapolated from the responses provided.

Figure 3.20

81 48 1290 1 10 5 58 3 11

Practice Management 24 6 3019 48 673 15 18

Admin/Clerical 61 199 2600 3 30 0 00 0 03 4 7

Total 198 331 529

PhlebotomistAllied Health ProfessionalCounsellorOther

Practice Nursing Registered Practice NurseHealth Care/Primary Care AssistantsGeneral Clerical Staff

Occupation Full-time Part-time

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RENREWSHIRE CHP Estimated General Medical Practice Staff (as at September 2007)

Other

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Performer (Partner)Performer salariedPerformer retaineePerformer registrar

Staff Group

It is anticipated that over the next five year period a number of General Medical practice staff will retire and figure 3.21 breaks down the projected retiral into staff groupings.

Figure 3.21

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Staff Group No of staffGP 10Practice Manager 6Practice Nurse 3Admin/Clerical 23Other 2

Total 44

Renfrewshire CHPProjected General Medical Practice Retirals

2008 to 2013

Under existing contractual arrangements there is no formal requirement for independent contractors to provide specific information on their workforce. This being the case there is no detailed information on the characteristics on other independent contractor workforces.

Renfrewshire CHP links to a number of other contractor groups and the CHP contains 30 General Dental Practices, 44 Pharmacies and 20 Optometry Practices.

For effective workforce planning it is important that an appropriate system of collecting workforce information for independent contractors is developed. The Scottish Government’s Workforce Planning Department are, at present, exploring opportunities to progress in this area following discussions with the relevant professional bodies and other interested stakeholders. Renfrewshire CHP awaits the results of this process and will implement any necessary actions at local level.

4 The Future WorkforceNHS Greater Glasgow and Clyde has adopted the career framework developed by Skills for Health which has also been adopted by NHS Scotland as a whole.

The Career Framework is aligned to pay modernisation so frontline Staff are able to take their Knowledge and Skills Framework outlines and build a personal development plan with competences for their current or future level of development. A workforce with the maximum levels of skills will be able to deliver effective and contemporary healthcare for patients.

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New and emerging workforce roles can be described through the identification of competences, and linked to an appropriate level of the Framework. This will assist with the development of new roles and ensure that all existing occupations are accommodated.

The strategic principle of career progression encompasses a wide range of both individual and organisational progression and achievement, and highlights the importance of building skills to enable people to join the NHS and wider health sector. The Career Framework builds on this concept, enabling Staff to develop their skills and competences through learning and development, to progress their careers through the levels of the framework.

As well as progressing through the levels, there is the opportunity for career movement within each level of the framework, to support motivation and retention.

It facilitates the transferability of roles, skills, competences and educational qualifications across the NHS. Thus Staff can achieve wider recognition of their achievements, opening up new opportunities to them to develop their careers.

Current Renfrewshire CHP Workforce using the NHS Careers Framework

Figure 4.1

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RENFREWSHIRE CHPCurrent Workforce using NHS Career Framework

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ADMIN AHP ANCILLARY MEDICAL & DENTALNURSING (TR.) NURSING (UNTR.) PSYCHOLOGY TECHNICIANS

Figure 4.1 shows a “Christmas Tree Model” representing the positions of the current directly employed workforce within Renfrewshire CHP.

The majority of the CHP workforce is distributed across two distinct categories at present. There are a large number of Staff grouped within framework levels 2 & 3, mainly unregistered Nursing and Allied Health Professions Staff.

A larger group of Staff appear in framework levels 5 & 6 and these are mainly registered Nursing and Allied Health Professions Staff with a small number of Administrative Staff.

Under the NHS career framework level 5 is seen as the entry point for qualified Staff. It is expected that those Staff who wish to progress their career from levels 2, 3 & 4 would require to undertake an appropriate registerable qualification.

In the future though this “two tier” workforce is expected to undergo significant changes as shown in Figure 4.2.

Figure 4.2 shows a model of the expected changes to the CHP workforce which will take place over next 5 years. The “Christmas Tree” shows a picture of the overall workforce rather than breaking down into specific disciplines as in Figure 4.1.

It is noticeable that there is significant growth in the size of the workforce in Career Framework Level 4 where it is expected that role redesign will create a new group of “para” professionals who will be able to progress through framework levels 5 and 6.

It is expected that this new group of staff at level 4 will be the result of discussion currently on-going with Further and Higher Education Institutes to create a support role for existing qualified staff. Given this it’s likely that such staff will be directly

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recruited into the workforce from education and as such there is limited growth in levels 2 and 3 in the future workforce.

Increases in levels 7 and 8 are projected to recognise the development of new consultant roles across Nursing and Allied Health Professions and this will provide additional career development opportunities for staff working within these disciplines.

RENFREWSHIRE CHPFuture Workforce using the NHS Careers Framework

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Future Workforce

The CHP, in discussion with staff side partners and partners in joint services has begun to identify and scope out potential service and role redesign opportunities (see details below) and this will allow us to provide more detailed information in future Workforce Plans on the impact of service re-design on specific service areas and disciplines.

Affordability

The CHP Implementation Plan is considered to be affordable over a three year period and the workforce plan is based on the CHP Implementation Plan.

This assumes that pay rates increase by no more than inflation. It is assumed that, over a five year period, the introduction of new contractual arrangements (Consultant Contract, GMS Contract and Agenda for Change) will lead to productivity gains with headcount relating more closely to activity.

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NHS Greater Glasgow & Clyde will require to generate significant cost savings in future years to pay for existing commitments to service development. Any further development of new services within the CHP will require to be balanced with “efficient government” gains in other areas within existing budgets. This may require a shift from indirect to direct care within the overall resource envelope. Planning for this will involve setting indicative targets for direct care v. support staff ratios.

Availability

Research by Scottish Enterprise Glasgow gives an indication of where labour demand will increase over the next few years and this contains a mixture of net employment growth as well as demand created by retirement. Job opportunities are forecast to continue in call centres, hospitality, retail, construction, transport, media and audio-visual, public sector and the financial sector. Some additional 20,000 vacancies, over and above normal attrition levels, are expected over the next few years.

At the same time the demographics of the population are changing with a significant decrease, of almost a fifth, in the proportion entering the labour market and an increase in the proportion leaving the labour market through retirement of almost a quarter.

Renfrewshire CHP has developed an Employability Framework through the Learning and Work sub group. There is mention in the framework about the "Condition Management" Programme - the joint venture between the NHS and jobcentre plus for those on incapacity benefit.

Being in work brings physical, mental, spiritual and financial benefits while being out of work can be detrimental to health and wellbeing. The workplace setting is a major opportunity for health improvement.

Although this is a time of relatively high employment there are still individuals who are not in work. In Renfrewshire 21,500 (21%) of the working age population are economically inactive, similar to Scotland and slightly below the UK average. The

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majority of the workless population (64%) are in receipt of Incapacity Benefit. Specific programmes have be developed to reduce the number of unemployed receiving Job Seekers Allowance however, this has had very little impact on the individuals claiming incapacity benefit.

The Scottish Index of Multiple Deprivation 2006 data identifies 14,750 people as employment deprived in Renfrewshire (13.8% of the working age population) – ranking Renfrewshire as 7th in Scotland.

The Scottish Executive launched Workforce Plus: An Employability Framework in 2006 setting out a national approach to enable Public Sector agencies, employers and the voluntary sector to work together to support individuals entering or returning to work. Renfrewshire is one of the 7 local government areas targeted in this framework to move individuals from benefit to work.

Through Renfrewshire’s Community Planning Partnership Learning and Work group an Employability Action Plan has been developed linked closely with the Regeneration Outcome Agreement to drive change for the economically inactive population. In terms of the NHS support, Renfrewshire was one of the first areas to implement ‘Condition Management’ a joint venture with Jobcentreplus and NHS for those on Incapacity Benefit.

Key priorities for the CHP to improve the health of the working age population in Renfrewshire are:

Through Renfrewshire Community Planning Learning and Work group support the Employability Framework.

Explore with ‘Condition Management’ programme pathways back to work which may be supported by the wider NHS services.

As an employer the CHP is promoting and taking forward ‘Healthy Working Lives Award’ for its’ staff.

Support organisations in Renfrewshire promote health led by the Healthy Working Lives Team.

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Adaptability

There is a close relationship between workforce planning and the planning of learning and education. The parallel processes are undertaken in collaboration.

Delivering For Health

National Workforce Plan

Local Delivery Plan

NHS Board Workforce Plan

NHS GG&C

Learning and

Education Plan

Service Development

Plans / Clinical Strategies

Service Area

Workforce Plans

Staff Group

Workforce Plans

Local Learning

And Education

Plans

The CHP Learning & Education plan is prepared on an annual basis and based to a significant extent on national and local priorities arising local service modernisation/ redesign and the workforce implications as well as data collected from Personal Development Plans.

This plan also identifies system-wide and corporate training requirements so that the organisation has a coherent view of the overall Learning & Education needs. These needs will then be considered in the context of available resources and prioritised in the light of the Workforce Plan. To facilitate this important flow of information, the Learning & Education Advisor is a member of the CHP’s Development Group as well as the Joint Workforce Planning and Development Group with Renfrewshire Council.

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Factors influencing the Future Workforce

In March 2008 members of the Renfrewshire CHP Extended Management Team attended a Workforce Planning Event where they were asked to envisage the profile of the CHP workforce of the future.

Those present at the event indicated that the future workforce was likely to be:

1. A skilled workforce involving more generic healthcare responsibilities and linked to the provision of joint training initiatives yet still retaining a level of professional identity.

2. A workforce built on the concept of mobility and flexibility with the emergence of clear career pathways allowing for wider opportunities for development across traditional professional boundaries.

Those present were also asked to consider the factors affecting the development of Renfrewshire CHP under a series of 4 different headings:

Political Economic Social Technological.

Political Factors

Within the timescale of the workforce plan it is anticipated that a number of political factors will influence the development of services within Renfrewshire CHP

The impact of the recent elections to the Scottish Parliament and the resulting change to a minority government creates a degree of uncertainty with regard to the direction of overall health policy. This may continue for some time as the political environment within Scotland becomes increasingly contested by parties of similar levels of popularity. Examples of potential changes include fewer Health Boards and Local Authorities through boundary change or directly elected health boards.

It is expected that there will be increasing pressure on resources as a result of new financial pressures brought about by different and constantly changing policy initiatives

The NHS will find itself under increasing scrutiny in relation to the efficient use of public resources which will lead to further debate on the provision of services using different models (i.e. private versus public health care).

Financial constraints will necessitate a scrutiny of public expenditure levels and Public sector pay awards in the future will become increasingly tight. This will occur in an environment where public sector organisations are increasingly competing with the private sector for a share of a reduced labour pool. This difficulty may be further exacerbated as graduates require to secure higher paid jobs to offset loans acquired during their time in education

In the longer term it is expected that specific pressure groups will begin to influence the shape of service delivery through more effective issue led campaigns and there

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will be a tension between user expectations and clinical delivery brought on by the expectation of bespoke services and the availability of resources to meet these new expectations

There will be an increase drive towards harmonisation of terms and conditions of service as the level of joint working and training increases and it is also likely that changes in relation to employing authorities may become more apparent as the lines between health and social care become increasing blurred.

Changes to the structure of the workforce will influence the dynamics between Trade Unions and Professional bodies and the future may be quite different from the current landscape in relation to power bases.

The CHP must budget for an expected shortfall in the additional funding suggested within Shifting the Balance of Care as it should be anticipated that the resource transfer from secondary to primary care implied will be significantly slower or ultimately smaller than predicted

Environmental

Changes in social attitudes will also help shape services in future. It is anticipated that the more politically aware population will influence opportunities for education and housing. This may impact on the health improvement agenda where we currently see inequalities in the overall health benefits of services to people living in deprived areas. “Green” issues may begin to impact across health with an increasing tendency towards consideration of the impacts of service delivery (e.g. travel to work and accessibility of services).

People are generally living longer and healthier lives, and life expectancy has risen. In future more people will live with live with long term health conditions, such as Alzheimer’s disease and diabetes.

The health problems of an affluent society are related to poor diets, substance abuse including alcohol and tobacco, stress, and sedentary lifestyles.

It is clear that the development of new technologies and medicines will increasingly influence the delivery of care. While these new technologies will be effective they will also be expensive, and in a climate of greater patient awareness, this will drive the overall costs of medication to much higher levels than previously experienced.

Existing hospitals and other NHS estate will not be fit for purpose in future and will require to be upgraded or replaced

Sociological Factors

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It is recognised that a number of sociological changes could impact both on the nature of the services we deliver and on our ability to deliver these in the next five years through our workforce. These include:

Changing population including the increase in the number of older people within the current and future population; the reducing birth rate and the impact on this of immigrant workers

Changing family structure, including a greater number of people living on their own, and in single occupancy accommodation; multi-generational families and dispersed families.

Equality and diversity issues, including different cultural backgrounds; different expectations of health care provision locally; health issues amongst different ethnic minorities; and associated costs, e.g. use of language interpreters.

Wealth in the local community including taxation with those earning paying for more; and the number of people not in work along with alcohol and drugs abuse reaching second and third generation levels.

Education and, in particular, the focus on changes in career expectations with jobs no longer being for life, and levels of illiteracy amongst school leaves.

Public service funding with health competing with other public services which have a high sociological priority such as prison services.

The growing upward trend in the numbers of older people within the population linked to the desire to care for people in their own homes indicates that there will be a requirement to expand the level of service currently provided. There is a planned review of community nursing services within NHS Greater Glasgow and Clyde which may also impact on the way services are delivered, not to mention a national review which is currently being piloted. Given that additional funding is likely to be minimal the challenge will be to examine the way in which services are delivered and determine how the workforce can be designed to deliver these effectively, at the same time providing interesting and rewarding roles for our staff.

Also impacting on the delivery of services is the role of carer, recognising that this role may be more challenging as carers themselves become older. One of the issues we may need to address within the CHP is identifying and developing members of the community into this role.

Increasing female employment will decrease family care at home, creating a demand for professional care from the health and social care sector. This may necessitate an increase in the number of care professionals. Current demographic trends, however, indicate an emerging shortage of workers to fill health and social care positions.

All of the factors highlighted above could potentially impact on our ability to recruit and retain suitably qualified and motivated staff to deliver services to our clients. Issues on which we will need to focus include the scope to positively market the CHP as an employer of choice, identify effective sources of recruitment, promote opportunities to train and develop staff in-house including identifying entry level posts suitable for people in the community not in work. Plans for how we will approach these challenges are dealt with later in this report.

Technological factors

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Over recent years the increase in the use of a variety of electronic devices has meant that information is rapidly transferred between staff and across organisations. This has brought both benefits and increasing pressures in coping with the amounts of information. It has also increased the expectation that information will be actioned more quickly.

The technology which includes email, mobile phones, personal computers, blackberry devices has already impacted significantly on the ways in which staff work.

It is already possible to have a range of help for staff in relation to databases, research and electronic libraries, web sites such as the Health Scotland site. It is possible to use electronic records and to schedule appointments electronically and to text the information to patients.

Over the next five years, the implications are that technological possibilities will continue to increase. Some of the uses might include patients making more use of systems and communicating directly by email and text messages, or by use of the internet to research medical conditions and treatments. The expectations of patients may increase as the range of medical possibilities increases.

Conversely some of the misinformation on public health immunisation campaigns can be communicated in a much more organised and pervasive manner by those with a vested interest in agitating and organising support through pressure groups. This has already been demonstrated through the Measles Mumps Rubella immunisation publicity and misinformation.

Technology can therefore be viewed as both a benefit and as a potential mechanism for instilling doubts about procedures. Where we have built such a dependence upon systems working, when there are leaks of data or systems are unavailable there are serious issues for patient confidentiality and care.

These are important concerns for the future, and for development of central data stores which will generate national records, chronologies and ability to share information electronically between health services and local authorities.

If there is an increased use of telemedicine, the non verbal contact information will be lost to diagnosis. The use of electronic identification badges could mean that a variety of information is stored within the badge and its use developed far beyond its original conception. The remote use of technology may mean that many more staff could potentially work from home and miss the communication from colleagues.

It is therefore important that we use technology for the benefit of service development and patient care and that technologically possibilities should not drive decisions.

Technology will also be used as a learning and education tool for staff where training can be delivered quickly and at convenient times. Links to higher and further education course work will increasingly be delivered through new technological developments again leading to greater efficiencies. Existing (and future staff) will require to embrace these changing models of learning and this may have initial training implications for those staff initially unfamiliar with the use of information technology systems.

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Joint Workforce Planning & Development Group (JWPDG)

The JWPDG was established in 2007 as one of the cross-cutting groups in support of joint planning in Renfrewshire. As well as identifying service drivers and workforce planning issues emerging from the work of the Joint Planning, Performance & Implementation Groups (JPPIG’s) this group is taking forward the following actions as part of its current work plan:

The development of protocols and guideline in support of joint working including employee performance, recruitment and retention, application of terms and conditions, redeployment, induction and preparation of a joint recruitment pack.

Identifying ways to support and contribute to the employability strategy to improve access to work for vulnerable groups from the employers’ perspective

Exploring the potential for expanding joint traing and development activity and sharing of training resources

Developing and building relationships with education and training providers to support both the training and development plan and the employability agenda.

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5 National, Regional and Local Actions:Challenges and Actions

Recruitment / Retention

There are a number of recruitment challenges facing the organisation in the future not the least of which is the increase in the retirement age leading to an older workforce in the next five to ten years. In order to address this change, measures require to be implemented to encourage older staff to remain within the organisation and to ensure that employees are adequately trained to enable them to meet the changing roles of the new partnerships.

In future it will be necessary to analyse the success levels of local recruitment campaigns and establish trend data to monitor on an on-going basis to ensure that the CHP maintains the ability to recruit appropriately trained staff.

This task must be closely linked to a competent workforce planning process which identifies short/medium and long term recruitment needs/succession planning as part of the CHP planning process. It will also be necessary to identify the availability of appropriate skills within local labour market and we will ensure more local advertisement/promotion, engagement e.g. recruitment fairs by working closely with local JobCentre Plus, and the Volunteer Centre.

As well as seeking to recruit new Staff the CHP will also conduct activities to monitor the satisfaction of existing employees as a means of retaining experienced staff. In doing so the CHP will review the results of staff satisfaction surveys and ensure the full implementation of the NHS Scotland Staff Governance Standard2. We will monitor staff leaver and turnover rates within the overall CHP Performance Monitoring Framework

In order to achieve this, links require to be forged and maintained with educational establishments i.e. schools and colleges to ensure that opportunities are available to achieve qualifications which will match the practical skills and educational criteria in the combined NHS, Social Work and Education Arena of the future.

In view of the joint working practices currently in place, consideration must be given to harmonised terms and conditions throughout the organisation, robust policies which are more in line with private companies and remuneration commensurate to the responsibilities of the role. This work is being taken forward within the Joint Workforce Planning Group.

In order to fully meet the challenges for the future, the organisation must ensure that it is leading the competition for the future workforce. This can be achieved by ensuring the attractiveness of the organisation, by building a reputation for highly skilled staff who are motivated, fairly and equitably treated and encouraged to remain within the organisation.

The organisation as a whole is currently going through a redesign in terms of recruitment processes in line with the Pay Modernisation process and this will allow service managers to investigate the opportunities for local service redesign.

2NHS Staff Governance Standard

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It will be essential that the AFC process is successfully implemented and acts as a catalyst to support recruitment and retention initiatives within Renfrewshire CHP. We will use AFC Job Descriptions for recruitment purposes, implement KSF and PDP for all staff within the CHP and ensure that all future posts have KSF outlines completed prior to advertisement.

It is also important that the CHP is seen as a leader in establishing a Healthcare Service that recognises the social diversity of the area and that our CHP workforce fairly reflects the diversity of the local population. We will implement the Renfrewshire CHP Equalities Action Plan3 and contribute to improving the health of the CHP population by signposting patients to our local employability service through the CHP Employability Pilot Project4. The Joint Workforce Planning Group will address the opportunities to support employability initiatives, including those developed through Renfrewshire Workforce Plus, from the employer perspective as well as supporting the NHS GG&C Working for Health programme.

Education & Development

As the CHP develops there is little doubt that Staff and partners will be faced with an initial period of change and it will be necessary to engage with Staff and partners to create an understanding of developing roles with the aim of supporting future staff development and retaining the skills and knowledge currently available within the CHP.

The CHP has an established Development Group which brings together managers from across the CHP with HR, OD and L&E colleagues. This group has responsibility for the CHP Learning & Education Plan and has implemented a number of initiatives to support staff development and to recognise and value input to service improvement by individuals and teams. In addition the group has a role to link work which is built into the CHP Development Plan, outputs from redesign projects and other changes in service structures to ensure a fit with the CHP OD and L&E Plans, and indeed to address the L&E issues in the Workforce Plan.In order to support role development within the CHP it will be important to have identified career progression pathways and forward plan for the appropriate future education and development needs within the pathways. Creating linkages to the KSF, NHS Careers Framework and other existing competency frameworks e.g. skills for health, national occupational standards and social care competencies, will ensure that pathways will be both robust and fit for purpose.Developing new and changed roles may require different approaches to delivering learning, education and development support and our Learning and Education team will work with Heads of Service and their teams to identify the development needs of individual Staff groups through the personal development and planning process. The CHP Learning Plan will be used to provide structure and identified priorities in this area.

Practical issues such as backfill arrangements and administration implications will be reviewed to ensure that barriers to development are reduced to a minimum.

3 RenfrewshireCHP Equalities Action Plan4 RenfrewshireCHP Employability Pilot Project

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Staff will also be supported through the personal development planning process to manage the balance between organisational and professional demands on individual development.

The GG&C Learning & Education Team will work with Higher Education Institutions (HEI’s) and Further Education Institutions (FEI’s) through the Strategic Alliance to ensure the development and availability of appropriate educational programmes.

Educational links to HEIs and FEIs are important to the CHP and this is evidenced by the support of CHP staff acting as supervisors for placement students - our potential workforce of the future. To enable effective supervision, adequate resources i.e. supervisor time commitments and the related impact on clinical caseload, should be taken into account when placements are allocated. An induction pathway for Staff will be developed utilising existing programmes and support mechanisms e.g. GGC Single System Induction, Flying Start, Get Going Together and mentoring.

Working with the GG&C E Learning Team we will exploit e-learning opportunities and consider the existing and future IT skills requirements of Staff.

As part of this process we will utilise existing knowledge and skills within services to support education and development needs of others. The e KSF tool has the potential to provide this information. We will expand the opportunities for learning and development through shadowing, work placements and secondments etc and identify relevant learning and development opportunities provided by NES.

We will progress the integration of Health and Social Work and support this through Multi-agency Learning and Education providing the opportunity for sharing good practice and ensuring consistent approach to practices.

All this activity must, of course, be carried out in an environment where the public rightly demands that public monies are utilised efficiently and effectively. To this end the CHP will ensure value for money in education and development by maintaining systems whereby all learning and development opportunities are recorded on individuals Personal Development Plans and their effectiveness evaluated through the review process.

To further our approach to the efficient development of staff our Learning and Education Team will seek opportunities for consistent approaches to learning, education and development across GGC and our local authority area in order to utilise common programmes where appropriate and learn from best practice and previous experience.

Service & Role Design

The CHP recognises that the workforce implications of changes to services is a priority and as such has taken action to ensure that service and role redesign activity is included as part of the CHP Development Plan.

Service Managers will be supported in developing an understanding of workforce planning processes and aspects of service and role redesign. We will do this by making sure that Service Managers undertake training using NHS National

44


Workforce Projects “6 Steps e-learning” programme5. We will also deliver Service & Role Redesign training and develop skills in redesign work as part of the CHP OD Plan.

It is expected that new skills developed by managers will assist in progressing service changes in areas where staff may be concerned about the nature of change, it’s effect on individual roles and contractual conditions and the development of new models of service.

Securing transitional funding, is expected to be also be an significant issue. This is particularly important given the need to maintain existing services, whilst moving towards redesigned models of care.

Given this the CHP will monitor the progress of factors influencing the availability of transitional funding such as the Acute Services Review (ASR). The impact of Shifting the Balance of Care and the implications of the ASR on Renfrewshire CHP will be closely monitored. Where possible we will establish the resource transfer requirements for the CHP associated with the ASR and scope the potential new service and roles required and the associated workforce implications of these changes.

As part of our workforce planning agenda where service redesign/vacancies occur we will review the appropriate skills mix for service areas. We recognise that the CHPs retention rate limits the potential for service and role redesign through “natural wastage”.

It is also important to note that the redesign of services may affect other services and how they operate.

Given this it will be necessary to review alternative approaches to encouraging service and role redesign such as the use of opportunities arising from Pay Modernisation process to introduce new ways of working, new roles i.e. Extended/Specialist roles.

The CHP has a number of change and redesign projects established which are actively addressing staffing structure and skill-mix issues to ensure delivery of services designed to meet patient and client needs. The intention is to ensure that the final proposals are appropriately future-proofed to take account of issues highlighted in the Workforce Plan including recruitment and retention, and learning and education. This currently includes:

Physiotherapy Review - to review all aspects of the service and to make clear recommendations for change within the service. This will include an an in depth analysis of current service provision to inform recommendations for the redesign of service to increase efficiency and effectiveness in terms of providing best practice and enhance patient care.

Podiatry Review Speech & Language Review Children & Families Team Development – to design and direct the local

implementation of the NHS GG&C Health Visitor Review, move towards a service models based on geographical team including all children’s services and improve joint working with Renfrewshire Council and other agencies.

5 National Workforce Projects 6 Steps resource – www.healthcareworkforce.nhs.uk/resources

http://www.healthcareworkforce.nhs.uk/resources


District Nursing – a Steering Group will develop a comprehensive project plan by 31 October 2008 which address the full scope of the services under review and within available resources and agree a workplan for this review.

6. Action Plan, Implementation and Monitoring

An action plan outlining specific tasks, lead responsibilities and timescales is included within this chapter.

It is expected that the process of implementation and monitoring will be included in future as part of the CHP Implementation planning process with responsibility falling to the ?Head of Human Resources.

The Workforce Plan will be reviewed annually.

ACTION PLANReference Challenge Areas for Action Specific Actions Lead

ResponsibilityTimescale

Improve resources utilisation

Not in Development Plan

Review current level of Weight Management service provision and compare to service need

HoH&CC


Develop and deliver training packages on identified nutrition topics for staff and carers working with adults with Learning Disabilities

HoH&CC


Identify training needs of community dietitians in relation to paediatrics/children and agree an appropriate cost effective way to address the needs

HoH&CC

Review existing Palliative Care resources

GMoR&A (Clyde) 2008-09

Review Anti-Stigma training across sectorsand partner agencies in line with the National ‘See Me’ Programme and the Mental Health Act

GMMHPC March 2009

Shift in the Balance of Care


Develop a comprehensive Mental Health Strategy that will include priorities such as: a Crisis Resolution Team, an Assertive Outreach Team, a Primary Care Mental Health Team, a reduction in the number of adult continuing care beds

GMMHPC

Within Palliative Care, develop a programme of early supported discharge for COPD patients


Learning Disabilities - review and HoH&CC March 2009

Renfrewshire CHP Workforce Plan 2008-2011Draft Version April 2008

report on day support services and implement an action planReview 2004 Balance of Care for Frail Elderly in line with National Norms and Local Needs

HoH&CC March 2009

Review EMI Continuing Care Services in line with National Norms and Local Needs

HoH&CC March 2009

Develop a Rehabilitation Framework for Older People

HoH&CC March 2009

Implement the Intensive Home Treatment Team, Renfrewshire-wide

GMMHPC March 2009

Review Day Services/Day Hospital Services

HoH&CC Sept 2008

Implement NHS GG&C CommunityRehabilitation Framework in Renfrewshire

HoH&CC March 2009

Focus resources on areas of greatest need


Develop a suicide prevention action plan to submit to the Scottish Executive (through both Community Planning and the CHP

GMMHPC


Offer basic mental health training to all those working with looked after and accommodated children

HoCS

Target the smoking cessation service to areas of highest smoking prevalence and target specific groups e.g. homeless and housebound adults and those already engaged in addictions services

HoP&HI March 2009

Improve meeting the needs of people with Autistic Spectrum Disorder

HoH&CC Sept 2008

48


Build a network of health support to homeless people and those at risk of homelessness

HoP&HI March 2009

Provide local accessible sexual healthinformation, targeting vulnerable and hard to reach groups

HoP&HI Dec 2008

Contribute to multi-agency working inRenfrewshire to develop on the Employability framework and reduce the number of workless people by 4500 by 2010

HoP&HI Dec 2008

Reduce the number of drug related deaths

GMMHPC Report March 2009

Reduce the harm to children affected by substance misusing parents/carers through improved multi-agency support to parents and children

GMMHPC March 2009

Reduce the number of alcohol related deaths - early identification, gender sensitive, addressing non-compliance, strengthening effective treatment and joint working

GMMHPC Report March 2009

Develop and implement a work plan for LAAC health services

HoCS March 2009

Implementation of the Integrated Assessment Framework across Children’s Services in Renfrewshire CHP

HoCS March 2009

Reference Challenge Areas for Action Specific Actions Lead Responsibility

Timescale

Improve access Not in Development Plan

In partnership with Acute services, develop and implement a Hepatitis

GMMHPC

49


Nurse Specialist post based within the drug service as part of the harm reduction team (Funding available for 2 years from the national HCV allocation)


Further develop the Acute Alcohol Liaison Service by extending the remit into the Accident and Emergency Dept. at the RAHContinue to implement and support the West of Scotland ‘Childsmile’ initiative - increase the number of new-born children, identified to be at increased risk of developing caries, in accessing services within identified GeneralDental Practices with the support of dental health support workers

HoP&HI March 2009

Improve access to a range of psychological therapies

HoP&HI March 2009

To reduce waiting times to access specialist drug/alcohol services

GMMHPC March 2009

Implementation of opportunistic screening and brief interventions, for alcohol. (SIGN 74)

GMMHPC March 2009/2010

Roll out the plan for improving services for children with Visual Impairment across GG&C

HoCS 2008-2010

Modernise services Not in Development Plan

Identify training and development needs for NHS staff involved in delivering weight management services across the CHP

HoH&CC

Not in Development Review specialist service caseload GMMHPC

50


Plan (Addictions/Drugs) and negotiate appropriate return of cases to GP Shared Care


Establish a joint learning disability service, joint protocols and an integrated care pathway

HoH&CC


Secure the role of Allied Health Professionals within the Community Learning Disability Team across Renfrewshire CHP and agree level of input

HoH&CC


Participate in NHS Greater Glasgow and Clyde’s review of Health Visiting Services and the redesign of Children’s Hospital Services

HoCS

Create Sandyford Renfrewshire hub and sexual health satellite clinics

HoP&HI Dec 2008


Support workforce changes e.g. Health Visiting Review and Community Nursing

HoHR


Provide local support to key service improvement and service redesign initiatives across the CHP

HoOD

Explore with the ‘Condition Management’ Programme pathways back to work which may be supported by the wider NHS services

HoP&HI March 2009

Devise and support the development of a Carer’s Strategy that ensures the needs of carers are considered across Renfrewshire

HoH&CC March 2009

Develop a proforma for joint working HoH&CC August

51


with the other JPPIGs to ensure carers needs and priorities are integral to service developments/redesign plans, including access to information and respite

2008

Ensure mainstreaming and embedding of Agenda for Change to further modernise services and realise the potential benefits

HOHR Ongoing

Launch the Oral Health Action Team (OHAT) in Renfrewshire

HoP&HI May 2008

Implement Renfrewshire-wide Primary Care Mental Health

GMMHPC March 2009

Manage roll-out of Greater Glasgow Weight Management service to Renfrewshire and Clyde areas

HoH&CC March 2009

Roll out the Glasgow diabetes LES to Clyde and enhance the care of diabetic patients

HoH&CC March 2009

Continue with GG&C Speech and Language Therapy Services redesign

HoCS March 2009

Continue to redesign the School Health Service in line with the Scottish Framework for Nursing in Schools

HoCS March 2009

Implementation of Children and FamiliesTeams within Renfrewshire

HoCS 2008-1010

Review of health services to special needs schools

HoCS March 2009

Improve individual health status

Lead the implementation of the CAMHS Framework for mental health promotion, prevention and care

HoCS March 2009

52


Support the Employability Framework HoP&HI March 2009Improve support for carers of those receiving palliative care


Embed health improvement in Joint Planning Groups

HoP&HI March 2009

Implement Live Active in Renfrewshire HoP&HI Dec 2008Implement Eat Up in Renfrewshire HoP&HI Dec 2008Implement Shape Up in Renfrewshire HoP&HI Dec 2008Implementation of the HPV Programme in Schools

HoCS March 2009

Encourage staff fitness and physical activity within the CHP

HoP&HI March 2009

Effective organisation Audit staff training needs in palliative care across the sector


Complete the implementation of the Gold Standard framework, implementation of the Liverpool Care Pathway and audit staff training needs across the palliative care sector


Develop a carers training programme for staff

HoH&CC 2008-2010

Promote and support staff health within the CHP, maximising attendance at work and aiming to meet the national target of 4% sickness absence levels

HoHR March 2009

Invest in leadership development based onleadership requirements (as defined by NHSGG&C’s leadership competency framework).

HoHD March 2009

53


Offer advice and support to all staff on life long learning to motivate individuals and help them achieve their full potential and career aspirations

L&EM (Non-CityPartnerships)

March 2009

Ensure the learning and education needs of staff working in the CHP are identified and addressed. Work closely with the Senior Management Team to conduct a more in depth analysis of training needs

L&EM (Non-CityPartnerships)

March 2009

Gain SMT support for the CHP to progress Healthy Working Lives and agree structure to manage and lead the process. Register for the Healthy Working Lives scheme and carry outbaseline survey

HoP&HI March 2009

Ensure AHP review phases are progressing within timescales

HoH&CC Reviewphase reportsdue May2008 forPhysio, and June2008 forPodiatry andPaediatricDietetics

Consider how best to take forward therequirements of the Long Terms Conditions Strategy once published

CD 2008-2010

54


Ensure the actions from the RenfrewshireChild Protection Committee Action Plan are

taken forward within the CHP

HoCS March 2009

Ensure all A & C staff have both individual and team based objectives and a Personal Development Plan to support the achievement of the CHP Objectives

HoA June 2008

Implement Staff training in: Team Development Customer Care Administration Team Event

HoAApril 2008May 2008May 2008

Appendix 1

55


References

The main documents which have been referred to in this plan are listed below, together with useful websites.

RenfrewshireCHP Development Plan

RenfrewshireCHP Equalities Action Plan

RenfrewshireCHP Employability Pilot Project

Healthy Working Lives http://www.scotland.gov.uk/Publications/2004/08/hwls/pdf

Agenda for Change http://www.paymodernisation.scot.nhs.uk/AfC/

Building a Health Service Fit for the Future, A National Framework for Service Change in the NHS in Scotland (the Kerr Report): Scottish Executive Health Department, May 2005 http://www.scotland.gov.uk/publications/2005/05/23141500/15035

Delivering for Health: Scottish Executive Health Department, November 2005 http://www.scotland.gov.uk/Publications/2005/11/02102635/26356

Fair to All, Personal to Each – The Next Steps for NHS Scotland: Scottish Executive Health Department, December 2004 http://www.scotland.gov.uk/Publications/2004/12/20400/48699

Forensic Nursing Workforce Project Group Report, November 2005http://www.forensicnetwork.scot.nhs.uk (to obtain a copy contact: Sharon Bruce 01555 841340)

Getting the Right Workforce, Getting the Workforce Right: Scottish Executive Health Department, 2005

56

http://www.forensicnetwork.scot.nhs.uk/

http://www.scotland.gov.uk/Publications/2004/12/20400/48699


http://www.scotland.gov.uk/publications/2005/05/23141500/15035

http://www.paymodernisation.scot.nhs.uk/AfC/

http://www.scotland.gov.uk/Publications/2004/08/hwls/pdf


http://www.show.scot.nhs.uk/sehd/workforcedevelopment/Publications/camh_workforce_strategic_rev.pdf

Hall 4: Health for All Children – Guidance on Implementation in Scotland: Scottish Executive Health Department, 2004http://www.scotland.gov.uk/consultations/health/hfac.pdf

HDL(2001)71: Cancer in Scotland: Action for Change: Regional Cancer Advisory Groups (RCAG), September 2001 http://www.show.scot.nhs.uk/sehd/mels/HDL2001_71.htm

HDL(2004)46: Regional Planning, December 2004 http://www.show.scot.nhs.uk/sehd/mels/HDL2004_46.pdf

HDL(2005)52: National Workforce Planning Framework 2005 Guidance, November 2005 http://www.show.scot.nhs.uk/sehd/mels/HDL2005_52.pdf

ISD Scotland http://www.isdscotland.org

Mental Health Care & Treatment (Scotland) Act 2003http://www.opsi.gov.uk/legislation/scotland/acts2003/20030013.htm

National Workforce Planning Framework: Scottish Executive Health Department, 2005 http://www.scotland.gov.uk/Publications/2005/08/30112522/25230

New Deal Contract http://www.show.scot.nhs.uk/newdealsupport/

NHS Education for Scotland Strategic Work Plan 2005-2008 – Educational Solutions for Workforce Developmenthttp://www.nes.scot.nhs.uk/FOI/class_b/documents/NES_strategic_workplan0508.pdf

Nursing and Midwifery Workload & Workforce Planning Project: Scottish Executive Health Department, 2004

57

http://www.nes.scot.nhs.uk/FOI/class_b/documents/NES_strategic_workplan0508.pdf

http://www.show.scot.nhs.uk/newdealsupport/


http://www.opsi.gov.uk/legislation/scotland/acts2003/20030013.htm

http://www.isdscotland.org/

http://www.show.scot.nhs.uk/sehd/mels/HDL2005_52.pdf

http://www.show.scot.nhs.uk/sehd/mels/HDL2004_46.pdf

http://www.show.scot.nhs.uk/sehd/mels/HDL2001_71.htm

http://www.scotland.gov.uk/consultations/health/hfac.pdf

http://www.show.scot.nhs.uk/sehd/workforcedevelopment/Publications/camh_workforce_strategic_rev.pdf



Pay Modernisation http://www.paymodernisation.scot.nhs.uk

Planning Together, Final Report of the Scottish Integrated Workforce Planning Group: Scottish Executive Health Department, January 2002 http://www.scotland.gov.uk/library3/health/ptfr-00.asp

Registrar General for Scotland http://www.gro-scotland.gov.uk/statistics/index.html

Scottish Health Workforce Plan 2004 Baseline: Scottish Executive Health Department, 2004 http://www.scotland.gov.uk/publications/2004/04/19306

Scottish Workforce Information Standard System http://www.show.scot.nhs.uk/swiss/

West Region Workforce Planning Websitewww.westworkforceplanning.scot.nhs.uk

Better Health, Better Care: Planning Tomorrow's Workforce Todayhttp://www.scottishexecutive.gov.uk/Publications/2007/12/13102832/9Rights, Relationships and Recovery: The National Review of Mental Health Nursing in Scotlandhttp://www.scottishexecutive.gov.uk/Publications/2007/07/06133401/5

Visible, Accessible and Integrated Care: Report of the Review of Nursing in the Community in Scotlandhttp://www.scottishexecutive.gov.uk/Publications/2007/07/16091605/13

Nursing and Midwifery Workload and Workforce Planning Project: A Good Practice Guide in the Use of Supplementary Staffinghttp://www.scottishexecutive.gov.uk/Publications/2007/12/20141732/8

Delivering for Healthhttp://www.sehd.scot.nhs.uk/argyllandclyde/newsletter.pdf

58

http://www.sehd.scot.nhs.uk/argyllandclyde/newsletter.pdf

http://www.scottishexecutive.gov.uk/Publications/2007/12/20141732/8




http://www.westworkforceplanning.scot.nhs.uk/

http://www.show.scot.nhs.uk/swiss/

http://www.scotland.gov.uk/publications/2004/04/19306

http://www.gro-scotland.gov.uk/statistics/index.html

http://www.scotland.gov.uk/library3/health/ptfr-00.asp

http://www.paymodernisation.scot.nhs.uk/



National Workforce Projects 6 Steps resource – www.healthcareworkforce.nhs.uk/resources

Staff Governance Standardhttp://www.scotland.gov.uk/Resource/Doc/46905/0033885.pdf

Smoking

National Policies Department of Health (1998) Smoking Kills: A White Paper on Tobacco, set targets for

reducing smoking rates with 3 priority areas; Children and Young People, the most disadvantaged adults and pregnant women. http://www.archive.official-documents.co.uk/document/cm41/4177/4177.htm

Towards a Healthier Scotland: A White Paper on Health (1999) Tobacco Targets for Scotland and a focus on inequalities.http://www.scotland.gov.uk/library/documents-w7/tahs-00.htm

Our National Health: Plan for Action, Plan for Change (2000). Commitment to working to reduce harmful impact of tobacco.http://www.scotland.gov.uk/Resource/Doc/158732/0043081.pdf

Cancer in Scotland (2001)http://www.scotland.gov.uk/Resource/Doc/158657/0043044.pdf

Smoking Cessation Guidelines for Scotland (2001) (2004 Update)http://www.hebsweb.com/services/pubs/pdf/SmokingCes2004.pdf

A Breath of Fresh Air for Scotland (2004)

59

http://www.hebsweb.com/services/pubs/pdf/SmokingCes2004.pdf

http://www.scotland.gov.uk/Resource/Doc/158657/0043044.pdf


http://www.scotland.gov.uk/library/documents-w7/tahs-00.htm

http://www.archive.official-documents.co.uk/document/cm41/4177/4177.htm


http://www.healthcareworkforce.nhs.uk/resources



Smoking in Public Places – Consultation and Legislation (2004)http://www.scotland.gov.uk/Resource/Doc/30859/0012649.pdf

Towards a Future without Tobacco (2006) The report of the Smoking Prevention Working Grouphttp://www.scotland.gov.uk/Resource/Doc/155323/0041722.pdf

Local Policies Glasgow Tobacco Strategy (2005)

http://www.smokingconcerns.com/pdf.pl?file=smoking/news/TobaccoStrategyfinal.pdf

Joint Health Improvement Plan for Renfrewshire 2005-2008

Renfrewshire CHP Health Improvement Action Plan 2005/6

Weight Management

National Policies SIGN 8: Obesity in Scotland, 1996

http://www.sign.ac.uk/pdf/sign8.pdf

SIGN 69: Management of Obesity in Children and Young People, 2003http://www.sign.ac.uk/pdf/sign69.pdf

NICE clinical guideline 43: Obesityhttp://guidance.nice.org.uk/CG43/niceguidance/pdf/english/dowload.dspx

Hungry for Success - A Whole School Approach to School Meals in Scotland. Final Report of

60

http://guidance.nice.org.uk/CG43/niceguidance/pdf/english/dowload.dspx



http://www.smokingconcerns.com/pdf.pl?file=smoking/news/TobaccoStrategyfinal.pdf





the Expert Panel on School Meals. November 2002 http://www.scotland.gov.uk/consultations/education/hfsc.pdf

Health Promotion and Nutrition in Schools (Scotland) Bill 2006http://www.scottish.parliament.uk/business/bills/68-SchoolsHN/b68s2-introd.pdf

Pre 5 Nutritional Guidelineshttp://www.scotland.gov.uk/Resource/Doc/37428/0009566.pdf

National Breastfeeding Policyhttp://www.scotland.gov.uk/library2/doc15/bfrw-01.asp#b9

Local Policies Have a Heart Paisley, Phase 2

http://www.haveaheart.org.uk/PAGES/MOVING.HTM

Renfrewshire Physical Activity, Sport & Health Strategy - draft out for consultationhttp://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/AttachmentsByTitle/els-Draft-Physical-Activity-Sport-and-Health-Strategy-November-2006.pdf/$FILE/els-Draft-Physical-Activity-Sport-and-Health-Strategy-November-2006.pdf

Weight Management Strategy for Glasgow Weight Management Service – not available yet

Renfrewshire Hungry for Success Action Planhttp://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/AttachmentsByTitle/sw-Actionplan.pdf/$FILE/sw-Actionplan.pdf

Alcohol

National Policies National alcohol plan (update awaited)

61

http://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/AttachmentsByTitle/sw-Actionplan.pdf/$FILE/sw-Actionplan.pdf

http://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/AttachmentsByTitle/sw-Actionplan.pdf/$FILE/sw-Actionplan.pdf

http://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/AttachmentsByTitle/els-Draft-Physical-Activity-Sport-and-Health-Strategy-November-2006.pdf/$FILE/els-Draft-Physical-Activity-Sport-and-Health-Strategy-November-2006.pdf



http://www.haveaheart.org.uk/PAGES/MOVING.HTM

http://www.scotland.gov.uk/library2/doc15/bfrw-01.asp#b9


http://www.scottish.parliament.uk/business/bills/68-SchoolsHN/b68s2-introd.pdf

http://www.scotland.gov.uk/consultations/education/hfsc.pdf



AAT/DAT Corporate Action Planshttp://www.lanadat.org.uk/ladat/files/CAP%202004.pdf

Older People

National PoliciesWe are committed to the vision in the Future Care of Older People in Scotland http://www.scotland.gov.uk/Resource/Doc/112906/0027388.pdf and the principles espoused in the Framework for Joint Services for Older People (Better Outcomes for Older People) http://www.scotland.gov.uk/consultations/social/boopl.pdf and the Kerr Report http://www.scotland.gov.uk/Resource/Doc/924/0012113.pdfThe Joint Performance Information and Assessment Framework (JPIAF) http://www.sehd.scot.nhs.uk/publications/CC2007_02.pdf now captures information about: single shared assessments delayed discharges over 65s admitted as emergency to hospital older people in care homes older people supported at home receiving 10+ hours home care per week.

Physical Disabilities and Long Term Illness

National Policies SIGN dysphagia management

http://www.sign.ac.uk/pdf/qrg78.pdf

NSF framework – Long Term Conditions (England and Wales)http://www.wales.nhs.uk/documents/cons_doc-e.pdf

Building on Successhttp://www.scotland.gov.uk/Resource/Doc/47034/0013836.pdf

62


http://www.wales.nhs.uk/documents/cons_doc-e.pdf


http://www.sehd.scot.nhs.uk/publications/CC2007_02.pdf


http://www.scotland.gov.uk/consultations/social/boopl.pdf


http://www.lanadat.org.uk/ladat/files/CAP%202004.pdf



Palliative Care

National PoliciesMany national guidelines and policies relate to palliative care and the professions which support this care. Those specific to palliative care include: Cancer in Scotland – Action for Change


NHS QIS students for specialist palliative carehttp://www.nhshealthquality.org/nhsqis/files/SPC.pdf

Nursing people with cancer in Scotland – A Frameworkhttp://www.scotland.gov.uk/Resource/Doc/47237/0013496.pdf

A Framework for Adult Cancer Nursing Services http://www.rcn.org.uk/members/downloads/RCNCancerFrameworkAug2003.pdf

NICE Guidelines (England) 2006.

Mental Health

National PoliciesA number of national policies shape and drive the development of Mental Health Services, including: Framework for Mental Health Services in Scotland (1997)

http://www.show.scot.nhs.uk/publications/mental_health_services/mhs/circann.htm

Adults with Incapacity Act (2000)http://www.opsi.gov.uk/legislation/scotland/acts2000/20000004.htm

Choose Life - Scottish Executive's National Strategy & Action Plan to Improve Mental Health

63


http://www.show.scot.nhs.uk/publications/mental_health_services/mhs/circann.htm

http://www.rcn.org.uk/members/downloads/RCNCancerFrameworkAug2003.pdf


http://www.nhshealthquality.org/nhsqis/files/SPC.pdf



& Well -being (2002)http://www.scotland.gov.uk/Resource/Doc/46932/0013932.pdf

Mental Health (Care & Treatment) (Scotland) Act 2003http://www.opsi.gov.uk/legislation/scotland/acts2003/20030013.htm

Delivering for Mental Health (2006)http://www.scotland.gov.uk/Resource/Doc/157157/0042281.pdf

Addictions

National PoliciesThe following are policies and national documents relevant to the Addiction Services Getting Our Priorities Right


Hidden Harm – next stepshttp://www.scotland.gov.uk/Resource/Doc/114027/0027764.pdf

Mind the Gapshttp://www.scotland.gov.uk/Resource/Doc/47063/0013752.pdf

Joint futures – single shared assessmenthttp://www.sehd.scot.nhs.uk/publications/DC20011129CCD8single.pdf

National alcohol plan (update awaited)http://www.scotland.gov.uk/Resource/Doc/166474/0045367.pdf

National Quality Standards for Substance Misuse serviceshttp://www.scotland.gov.uk/Resource/Doc/149486/0039796.pdf

SIGN Guideline – Management of alcohol dependence in primary care

64



http://www.sehd.scot.nhs.uk/publications/DC20011129CCD8single.pdf









Hepatitis C Action Planhttp://www.scotland.gov.uk/Resource/Doc/148746/0039553.pdf

SIGN Guidance – Management of Hepatitis Chttp://www.sign.ac.uk/pdf/sign92.pdf

AAT/DAT Corporate Action Planshttp://www.lanadat.org.uk/ladat/files/CAP%202004.pdf

Learning Disabilities

National PoliciesPolicy context for learning disabilities has been driven by the “Same as You?” Document (http://www.scotland.gov.uk/Resource/Doc/159140/0043285.pdf), and subsequent Partnership in Practice (PiP) Agreements (http://www.scotland.gov.uk/Resource/Doc/1248/0015431.doc). More recently, the drive to integrate services has been prompted by Joint Futures, Social Inclusion Policy and the national report for health “Promoting Health, Supporting Inclusion” (http://www.scotland.gov.uk/Resource/Doc/46746/0013983.pdf). Finally, direction is given in:

Protecting Vulnerable Adults – Interagency Policy and Procedures

Adults with Incapacity Act, 2000 (Scotland) http://www.opsi.gov.uk/legislation/scotland/acts2000/20000004.htm

Mental Health Care & Treatment (Scotland) Act, 2003 http://www.opsi.gov.uk/legislation/scotland/acts2003/20030013.htm

Additional Support for Learning Act, 2005

65




http://www.scotland.gov.uk/Resource/Doc/1248/0015431.doc


http://www.lanadat.org.uk/ladat/files/CAP%202004.pdf





http://www.opsi.gov.uk/legislation/scotland/ssi2005/20050325.htm

Children

National Policies For Scotland’s Children – Better Integrated Children’s Services Scottish Executive 2001

Part 1 - http://www.scotland.gov.uk/library3/education/fcsr%20pt1.pdfPart 2 - http://www.scotland.gov.uk/library3/education/fcsr%20pt2.pdf

Getting Our Priorities Right 2002: Policy and Practice Guidelines for Working with Children and Families Affected by Problem Drug Use, Scottish Executive, -2002http://www.scotland.gov.uk/Resource/Doc/159094/0043262.pdf

It’s Everyone’s Job to Make Sure I’m Alright – Report of the Child Protection Audit and Review, Scottish Executive – 2002http://www.scotland.gov.uk/consultations/health/hfac.pdf

The Framework for Nursing in Schools, Scottish Executive 2005.http://www.scotland.gov.uk/Resource/Doc/47034/0023958.pdf

The Protection of Children Scotland Act Scottish Executive, 2003http://www.opsi.gov.uk/legislation/scotland/acts2003/20030005.htm

Hidden Harm: Responding to the Need of Children of Problem Drugs Users – Home Office 2003http://www.drugs.gov.uk/publication-search/young-people/hidden-harm-summary?view=Binary

Protecting Children and Young People: The Charter, Framework for Standards, Scottish Executive 2004http://www.scotland.gov.uk/Resource/Doc/1181/0008818.pdf

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http://www.drugs.gov.uk/publication-search/young-people/hidden-harm-summary?view=Binary

http://www.drugs.gov.uk/publication-search/young-people/hidden-harm-summary?view=Binary



http://www.scotland.gov.uk/consultations/health/hfac.pdf


http://www.scotland.gov.uk/library3/education/fcsr%20pt2.pdf

http://www.scotland.gov.uk/library3/education/fcsr%20pt1.pdf

http://www.opsi.gov.uk/legislation/scotland/ssi2005/20050325.htm


Guidance on the Production of Integrated Children’s Services Plan, Scottish Executive, 2004http://www.scotland.gov.uk/Resource/Doc/163531/0044420.pdf

Getting It Right for Every Child – Proposals for Action, Scottish Executive, 2005http://www.scotland.gov.uk/Resource/Doc/54357/0013270.pdf

A Common Approach to Inspecting Services for Children and Young People – HMIE Services for Children Unit 2005http://www.hmie.gov.uk/documents/publication/caiscyp.pdf

How Well Are Children Protected And Their Needs Met – Self Evaluation Using Quality Indicators, HMIE 2005http://www.hmie.gov.uk/documents/publication/hwcpnm-03.html

Draft Quality Improvement Framework for Children, Young People and their Families, Scottish Executive 2006http://www.scotland.gov.uk/Resource/Doc/1141/0038322.pdf

Children and Young People’s Mental Health : A Framework for Promotion, Prevention and Care, Scottish Executive 2005http://www.scotland.gov.uk/consultations/health/cypmh.pdf

Health for All Children, Scottish Executive, 2005http://www.scotland.gov.uk/Resource/Doc/37432/0011167.pdf

Improving Health in Scotland – the Challenge, Scottish Executive, 2003http://www.scotland.gov.uk/Resource/Doc/47034/0013854.pdf

Education (Additional Support for Learning) (Scotland) Act 2004http://www.opsi.gov.uk/legislation/scotland/acts2004/20040004.htm

Hungry for Success – A Whole School Approach to School Meals in Scotland 2002

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http://www.scotland.gov.uk/consultations/health/cypmh.pdf


http://www.hmie.gov.uk/documents/publication/hwcpnm-03.html

http://www.hmie.gov.uk/documents/publication/caiscyp.pdf





Being Well – Doing Well, a Framework for Health Promoting Schools in Scotland 2004http://www.healthpromotingschools.co.uk/images/beingwelldoingwell_tcm4-121991.pdf

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http://www.healthpromotingschools.co.uk/images/beingwelldoingwell_tcm4-121991.pdf


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