cheshire and merseyside collaborative bank journey · 2020-06-18 · integrated home bank,...
TRANSCRIPT
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December 2017
Cheshire and Merseyside collaborative bank journey: Optimising workforce capacity
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Part 1: Overview
Part 2: Defining the aim
Part 3: Getting started
Part 4: Governance
Part 5: The collaborative bank, the lead employer model and streamlining
Part 6: Lessons learnt
Annex: Resources
Contents
NHS Improvement
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Part 1: Overview
Part 1: Overview of Cheshire and Merseyside collaborative bank
1. Scope
The Cheshire and Merseyside Collaborative Bank project spans 18
trusts across a 50 mile radius. There is a mixture of acute, mental
health and specialist trusts and at this stage there are no community
or ambulance trusts. It initially covers 6 trusts and all staff groups,
including nursing, medical, allied health professionals (AHPs),
administrative and scientific professionals. The bank will go live in Q4.
2. The model
Each trust has its own bank and will continue to directly employ its
own pool of bank workers but there is a cloud-based platform
enabling the individual banks and pools to connect as part of a
collaborative bank.
In practice this means that where an individual trust bank cannot fill a
bank shift, the shift will be pushed out electronically to staff on other
banks via an app. Any worker can then choose to accept the shift.
The worker will continue to be paid by the host trust with whom they
hold their contract. The host trust will then invoice the trust at which
their bank worker filled a shift via the collaborative bank.
The bank workers can either be substantive employees of the
constituent trusts or have a ‘bank contract’ solely (ie not work
substantively at any of the constituent trusts). This is an important
part of the strategy to encourage agency staff to return to bank work and provide staff with a compelling flexible working offer.
Cheshire and Merseyside Sustainability and Transformation Partnership
Collaborative bank
Agency
Individual internal banks
Direct engagement
Cheshire and Merseyside: four stages of filling a shift
NB Trusts may still use overtime where this is the
most financially and clinically appropriate option.
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Overview: next steps
Part 1: Overview
Extending across the region
The initial proof of concept pilot is sponsored by the HR directors from Cheshire and Merseyside Sustainability and
Transformation Partnership (STP) and covers a subsection of the trusts. There are now early conversations across
the North West region about potential region-wide collaboration in the future.
Alignment of rates
Three years ago, the STP tried to align bank pay rates (without collaborative provision) but this broke down when
trusts proved reluctant to share pay rates. This project has therefore changed approach and focused on setting up a
collaborative approach to bank provision in phase 1 before considering rates in phase 2. It was felt that leaving rates
to phase 2 would help build trust and collaborative working (including data-sharing protocols) before considering
sensitive issues around pay rates. The pay alignment phase of the project will kick off in early 2018 involving directors
of finance, HR directors, medical directors and directors of nursing at a regional level.
Advancing the interoperability of systems
Not all trusts are on the same IT systems so the project needed to allow for a variety of systems within individual
trusts. The project therefore took a multi system ‘no one size fits all’ approach by using a cloud software system (in
this case Allocate during the proof of concept) to connect different systems and different trusts. Cheshire and
Merseyside is working with a variety of systems to explore opportunities for integration and interoperability across the
patch. The pilot has been governed by agreements to ensure procurement and competition rules are not breached.
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Part 2: Defining the aim
The vision
“Applying streamlining principles to create a collaborative bank of high quality staff who can be utilised across the region to maximum capacity and so ensure safe effective care for patients and reduced agency spend.”
Part 2: Defining the aim
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Optimising workforce capacity
Part 2: Defining the aim
Systems/process •Streamlining
•Rostering systems benefits realisation
•Bank systems benefits realisation
•Workforce planning
•Safe care
•Lead employer model
•Data sharing
•Business intelligence
Cost/productivity •Reduction in overall pay bill
•Reduction in agency spend
•Waiting list initiatives (reduce extra duty payments for medical staff)
•Increased shift fill rate
•Occupational health efficiency
•Disclosure and Barring Service checks
•Mandatory and statutory training
•Employment checks
Quality •Improved retention
•Improved safety – staff working extra duty shifts in their own trusts
•Patient experience
•Improved staff survey
•Team unity
•Agreed competencies
•Improved capability
Employee experience •Workforce satisfaction
•Retention
•Morale
•Reduction in burnout
•Improved team working
•Sickness absence
•Health and wellbeing
Optimising workforce capacity
Cheshire and Merseyside STP has established a collaborative bank as part of a broad strategy to optimise
workforce capacity across the footprint. They identified four key dimensions and objectives to this work.
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Collaborative bank: end-to-end process
Part 2: Defining the aim
E-rostering
Vacancy
release
E-booking and
e-timesheets
Payroll and
invoicing
Enhanced
reporting Bank growth
Seamless
technology Cost control
Informed decisions
and insights
Fully integrated rostering solution with ESR and other
critical systems interfaces
Integrated home bank, collaborative bank and direct
engagement staffing solutions
Benefits realisation mapped via real-time reporting
Standardised rates of pay with integrated payment processes
Integrated multi-platform ‘app’-enabled booking and
deployment systems to allow sharing of staff across trusts
App-enabled
technology to
support
attraction to
grow NHS local
banks
To realise the opportunities of the streamlining and collaborative bank programmes, Cheshire and Merseyside has
prioritised making sure the IT systems architecture which underpin them is interoperable (ie the systems can connect to
one another electronically) across the ‘end-to-end’ process, from rostering and the electronic staff record (ESR) to shift
booking and payroll. The diagram below illustrates the different components and opportunities.
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Part 3: Getting started Scoping the project
Part 3: Getting started
When setting out to optimise workforce capacity across Cheshire and Merseyside, the
project began by exploring the challenges and opportunities ahead and how in
practice a collaborative bank could be best implemented. This approach is
summarised in the questions below.
1. What is working well and we can do more of?
2. What is inefficient or against the principles of
streamlining?
3. What could we stop doing?
4. What opportunities have we not yet explored?
5. Where/who can we learn from?
6. What is preventing us from progressing?
7. Who are the key stakeholders?
8. How can we remove any blocks?
9. Who can help?
10. How do we get started?
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Checklist for getting started
Part 3: Getting started
1 STP HR directors and directors of finance sign up to the project
2 Resource allocation
3 Agree terms of reference (ToR)/memorandum of understanding (MoU)/project governance
4 Diagnostic: current state assessment and analysis
5 Options appraisal: identify opportunities
6 Review and refine ToR/MoU/project governance / escalation points
7 Kickstart pilots/proof of concept
8 Benefits realisation – What is the end game? What does success look like?
9 Do, learn, review
Ongoing
stakeholder
engagement
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Part 4: Governance Aligning the collaborative bank project with the North West Streamlining programme
Part 4: Governance
Cheshire and Merseyside’s collaborative bank project emerged from the North West regional streamlining programme
and its governance structure, so close alignment between the two projects was seen as key. The HR Deputy Director
and Director networks provided a forum through which both projects could be discussed and joined up. See Section 5 for
more details.
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Collaborative bank project governance structures
Part 4: Governance
| Local workforce advisory board (LWAB) | Regional streamlining programme
| HR directors network| Directors of finance | HR deputy directors network |
Collaborative bank steering group
IT systems, processes and information governance
Procurement Terms and conditions
‘Grow your own bank’
Finance and benefits realisation
Direct engagement
Optimising systems capabilities
Communications, marketing and stakeholder engagement
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Core membership
Steering group chair
Project manager
Strategic project lead
Deputy HR director lead
Temporary staffing lead
Medical staffing lead
Recruitment lead
Terms and conditions lead
Information governance lead
Finance lead
Procurement lead
HR systems
ESR lead, regional team
Extra members
Occupational health lead
Medical workforce lead
Nursing and midwifery workforce lead
Allied health professional workforce lead
Communications and marketing lead
Director of medical education lead
LWAB/Health Education England representative
Staff side representative
Potential system suppliers for proof of concept
trials/pilots
NHS Employers representative
Lead employer representative
Programme manager Streamlining
Representative of HTE framework
Education and training lead
Information technology lead
Project steering group
Part 4: Governance
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Part 5: The collaborative bank, the lead employer model and streamlining
Collaborative banks depend on effective alignment of systems and processes between trusts. A key challenge for many collaborative banks, for example, is managing the different training and skills requirements between trusts.
Cheshire and Merseyside addressed these barriers through the North West streamlining programme which involves collective planning and processes to make it easier for staff to move between roles in different NHS organisations. This allows organisations in a particular region, and across the country, to realise benefits including cost savings, recruitment efficiencies and improved staff experience.
The streamlining pilot in the North West is exploring ways of harmonising and passporting training requirements between trusts. This includes exploring the role of the revalidation officer for doctors on the bank and the governance which will need to surround it.
Also as part of the collaborative bank proof of concept, Cheshire and Merseyside are identifying the most common roles filled by the bank and agreeing common naming conventions that can be expanded to include any staff group as the system develops. The bank staff system also allows for competencies, knowledge, skills and experience to be defined when the shift request is sent out.
Part 5: The collaborative bank, the lead employer model and streamlining
Streamlining and the collaborative bank
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Enabler: lead employer model example
St Helens and Knowsley Teaching Hospitals NHS Trust’s lead employer model was implemented in November 2010. Before this there were six lead employer trusts; each responsible for different specialties. And before this each ‘rotational placement’ host was the employer.
Now there is one lead employer streamlined model for Cheshire and Merseyside. This has optimised the benefits realisation opportunities from ESR, Intrepid, BI oracle, Allocate and other technical solutions by automating transactional processes and avoiding duplication with a ‘one stop shop’ approach.
St Helens and Knowsley is also the GP lead employer for the West Midlands, East of England, East Midlands and provides HR advice telephone support for practice managers in Yorkshire and Humberside.
Part 5: The collaborative bank, the lead employer model and streamlining
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Efficiency
• No duplication of employment checks/costs
• No duplication of induction and mandatory training
and associated costs
• No duplication of occupational health checks
• Standardised bank worker contracts and rates of
pay
• Opt-in to collaborative bank from Foundation Year
1/2 recruitment stage onwards (one bank contract)
• No requirement for trusts to have their own locum
banks and the associated costs
Quality
• More robust information for Health Education
England on doctors in training European Working
Time Directive compliance
• Management information to support Annual
Review of Competence Progression process on
doctors working through aligned payroll
transactions
• Assurance through Guardian of safe working
• Robust governance arrangements
• Streamlined data sharing agreements aligned to
General Data Protection Regulations
• Supports retention and workforce satisfaction
How the lead employer model and streamlining support the development of collaborative banks
Part 5: The collaborative bank, the lead employer model and streamlining
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The lead employer model requires an integrated approach to IT systems
Part 5: The collaborative bank, the lead employer model and streamlining
E-expenses
Intrepid/
TIS
Trust
Website
Portal
OLM
ESR/Cohort
interface
BI Oracle
Reporting
E-SVLs
My ESS
ESRS Self
Service
(smart phone
access)
Payroll
e-payslips
TRAC
E-study
leave
E-DBS
Employee
relations
Case
management
Electronic
personal
Files
Exception
reporting
and work
schedules
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Streamlining in action: the lead employer model already acts a ‘workforce passport’
Under the lead employer model, trusts are already able to:
1. Download applicants from Intrepid/ESR pre-employment - √
2. Full use of automatic IAT pre-employment - √
3. Download of training profiles onto ESR - √
4. ID, GMC, Right to Work, etc, information into ESR - √
5. Occupational health information into ESR - (no) cohort √
6. Reference details into ESR - √
7. DBS details into ESR - √
8. E-DBS electronic system TRAC - √
9. In addition – ESR MSS for sickness and leave data - √
10. Mandatory training aligned and in OLM - √
Part 5: The collaborative bank, the lead employer model and streamlining
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Part 6: Lessons learnt
Part 6: Lessons learnt
Alignment to streamlining programme
Agreed STP approach to workforce
supply
Build on existing work
and being flexible to
extend scope as project
evolves and matures
One size may not fit all
Engagement and
commitment
Dedicated resource to
drive delivery
Technological investment
with integrated solutions
Early MOU and data sharing agreement
Benefits realisation
linked to Carter
Cross ‘corporate
function’ input required
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Annex: Resources
The following resources were created as part of the Cheshire and Merseyside Optimising Workforce Capacity project in collaboration with the North West Streamlining group.
They are designed to sit alongside this case study and help those just starting or who have already started similar work to establish a collaborative bank. While ‘one size may not fit all’, we hope sharing these lessons and approaches with others will be valuable.
Acknowledgements
With thanks to Claire Scrafton, Deputy Director of HR at St Helens and Knowsley Teaching Hospitals NHS Trust and Strategic Lead for the Cheshire and Merseyside collaborative bank, for producing this case study to be shared by NHS Improvement.
Annex: Resources
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Resources (1)
Annex: Resources
• Sets out overview including context, vision and aim, potential benefits realisation, total system overview, project structure and deliverables
1. Collaborative bank Introductory summary
• Includes aims and objectives for the workstream, project structure and meeting frequency
2. Terms of reference
• Agreement to formalise objectives of the project, principles for collaboration and roles and responsibilities
3. Memorandum of understanding
• Considers various aspects of the project to include operational management, reporting process, risk management, communication and stakeholder engagement and information governance
4. Project initiation document
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Resources (2)
Annex: Resources
• Supports the monitoring of project management risks and key deliverables
5. Project plan
• Provides oversight of interdependencies within project workstream
6. Interdependencies map
• Internal bank self-assessment form
7. ‘Grow your own bank’ status
• High level report to assess project risks and issues, as well as reporting key milestones
8. Summary and highlight report
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