Introducing KSF in a

Medical Physics Department

Hugh Wilkins

Medical Physics DepartmentRoyal Devon & Exeter Hospital

AfC Project Structure

Project Steering Group

Terms & Conditions

Communication

Payroll /IT

Monitoring &Evaluation

Training/Knowledge Skills

Framework

ServiceModernisation

Finance

JobEvaluation

Nominated Lead

KSF - Main Purpose

• Provides NHS-wide framework that can be used consistently across the service to support:

– Personal development in post

– Career development

– Service development – Equality and diversity

What is the NHS KSF ?What is the NHS KSF ?• Common descriptions of the knowledge and

skills that need to be applied in the NHS

• Applicable and transferable across the NHS

• Simple, easy to explain and understand

• Feasible to implement

What the NHS KSF is not

• Does not seek to describe what people are like or their attitudes

• Does not describe the exact knowledge and skills that people need to develop

• Does not determine job weight or pay band (JES does this)

The NHS KSF in context• Links with current and emerging UK or

national quality assured standards or competencies

• Supportive of the NHS Plan and related developments (eg Skills Escalator, Lifelong Learning Framework and the wider HR strategy)

• Included in development of the Electronic Staff Record (Computerised tool for EI sites)

e-KSF

• Web-based KSF: www.e-ksf.org• Library (KSF Outline examples)• Links with ESR (electronic staff record)

for annual review (PDR – personal development review)

• Find out more at: www.e-ksfnow.org

Structure of the NHS KSF• 30 dimensions:

– 6 core dimensions for all posts– 24 specific dimensions

• Each dimension has 4 levels• Level titles further supported by indicators• Clear examples of application for different posts• References to other standards, competences etc

Core Dimensions

NHSKSF

Equality & Diversity

Personal &

People

Development

QualityService

Improvement

Communication

Health, Safety & Security

24 Specific Dimensions- Promotion of HWB

- Assessment & care planning

- Protection of HWB

- Enablement to address HWB needs

- Provision of care to meet HWB needs

- Assessment & treatment planning

- Interventions & treatments

- Biomedical investigation & intervention

- Equipment & devices to meet HWB needs

- Products to meet HWB needs

- Systems, vehicles & equipment

- Environments & buildings

- Transport & logistics

CORE

- Info processing

- Info collection & analysis

- Knowledge & info resources

- Learning & development

- Development & innovation

- Procurement & commissioning

- Financial management

- Services & project management

- People management

- Capacity & capability

- Public relations &marketing

Health & Well Being (HWB) 1-10

Estates & Facilities (EF) 1-3

Information & Knowledge (IK) 1-3

General (G) 1-8

Example of Level DescriptorsC2 Personal and People Development

Level 1 Contribute to own personal development

Level 2 Develop own skills and knowledge and provide information to others to help their development

Level 3 Develop oneself and contribute to the development of others

Level 4 Develop oneself and others in area of practice

C2 Personal & People Development, Level 2:

Outline for Post1 2 3 4

1 Communication X2 Personal and people development X3 Health, safety and security X4 Service improvement X5 Quality X6 Equality and diversity X

HWB6 Assessment and treatment planning XHWB7 Interventions and treatments X

KSF Outline

SPECIFIC DIMENSIONS

CORE DIMENSIONS

Outlines for Post and Individual

1 2 3 4

1 Communication X2 Personal and people development X3 Health, safety and security X4 Service improvement X5 Quality X6 Equality and diversity X

HWB6 Assessment and treatment planning XHWB7 Interventions and treatments X

KSF Outline

SPECIFIC DIMENSIONS

CORE DIMENSIONS

KSF – What is it?

• The Knowledge & Skills Framework• one of 3 key strands within Agenda for

Change:– terms and conditions.– job evaluation– the NHS KSF and its associated development

review process (together these form the basis of the career and pay progression strand)

Career and Pay Progression

• Designed to ensure consistency & fairness

• Normal expectation of progression through pay bands based on applying necessary knowledge & skills to the job

• Foundation gateway review against subset of KSF outline

• 2nd gateway review against full KSF outline

Pay StructurePAY BANDS Incremental Pay Points

within each Band

GATEWAY

KSF OUTLINE defines the SKILLS &

KNOWLEDGE required to perform that job

KSF FOUNDATION defines basic SKILLS &

KNOWLEDGE expected of person

recently in post (6 - 12 months)

GATEWAY

987654321

Pay StructurePAY BANDS

98765432 Progression up through Band determined by

annual Development Review

Incremental Pay Points within each Band

GATEWAY

KSF OUTLINE defines the SKILLS &

KNOWLEDGE required to perform that job

GATEWAY

1

Dimension Level for Post

Job Title: Nuclear Medicine Technologist

For illustrative purposes only

Foundation

Band: TBA

KSF Outline – Example 1

C1 CommunicationsC2 Personal & people developmentC3 Health, safety & securityC4 Service improvementC5 QualityC6 Equality & diversity

332232

HWB3 Protection of health & wellbeingHWB6 Assessment & treatment planning

22

2111abcd2111

HWB8 Biomedical investigation & interventionHWB10 Products to meet health & wellbeing needs

22

1-

EF1 Systems, vehicles and equipmentIK1 Information processing

33

11

Dimension Level for Post

Job Title: Head of Nuclear Medicine

For illustrative purposes only

Foundation

Band: TBA

KSF Outline – Example 2

C1 CommunicationsC2 Personal & people developmentC3 Health, safety & securityC4 Service improvementC5 QualityC6 Equality & diversity

444443

HWB3 Protection of health & wellbeingHWB6 Assessment & treatment planning

42

43232232

HWB8 Biomedical investigation & intervention 2EF1 Systems, vehicles and equipmentIK2 Information collection and analysis

33

G4 Financial managementG6 People management

44

22323

Producing KSF Outlines

1. Confirm job purpose2. Select specific dimensions3. Identify levels for core and specific

dimensions4. Compile areas of application5. Create subset for Foundation Gateway

(repeat steps 3 & 4 for FG)

Which KSF Outline?

Stage 1 Outline Matrix

Stage 2 Outline Stage 1 + Examples of Application

Stage 3 Outline Stages 1&2 + FG subset Matrix

Stage 4 Outline Stages 1,2&3 + FG subset Examples of Application

KSF Drivers

• NHS Plan• Modernisation Agency• KSFDG (now KSFG)

(KSF Development Group)

• Under development since ~2000• Handbook published Oct 2004

(version 7)

Exeter HCS/CS KSF Involvement

• KSFDG -> RD&E Trust, wanting HCS / CS example outline for national library / web-site

• Concern, JE & banding context• Contacted IPEM, HPA representatives• Contacted CS colleagues:

– Biochemists– Clinical Measurements– Molecular Genetics

Exeter HCS/CS KSF Developments

• Departmental Workshop (-> stage 1 outlines)

• Follow-up Workshop Feb 2005TH (KSFDG) working closely with small group of CSs at registration stage & line managers

(-> stage 2 example outline)

• Stage 2 KSF Outline– Draft 1 – Draft 2– Draft 3

• -> KSF national library

NHS KNOWLEDGE AND SKILLS FRAMEWORK

GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE

• FHCS / KSFDG document • Exeter example outline included as appendix • ? Incorporation into CSO HCS documentation

(Healthcare Scientists Career FrameworkSupporting Agenda for Change Documentation)

NHS KNOWLEDGE AND SKILLS FRAMEWORK

GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE

• Life Sciences• Physical Sciences & Engineering• Physiological Sciences

Common dimensions:– IK1 Information processing– IK2 Information collection & analysis– IK3 Knowledge & information resources– EF1 Systems, vehicles & equipment– G2 Design & development

NHS KNOWLEDGE AND SKILLS FRAMEWORK

GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE

• Physical Sciences & Engineering:– HWB3 Protection of health & wellbeing– HWB7 Interventions & treatment– HWB9 Equipment & devices to meet health & wellbeing needs– EF1 Systems, vehicles & equipment

How will the NHS KSF be used in Development Review?

• KSF outline for each post

• Match individual against post outline

• Personal development plans agreed and supported

• Linked to Lifelong Learning

Appraisal• Appraisal is the process of joint review

of an individual’s performance & development at work, and agreement of a plan for future knowledge & skills development

The Appraisal Cycle

Informal Progress Reviews

Formal Appraisal

Review

DevelopmentDevelopment

Development

Organisational Objectives

Department Objectives

Individual Objectives

Appraisal Process

• All staff should have an annual appraisal review which includes:– Performance Review – Development Review assessment against

the KSF Outline– Production of Personal Development Plan

(PDP) using the KSF as a development tool– PDP should include any specific objectives

that the individual needs to meet in their post

Performance & Development Review

• Performance Review – Focuses on the individual’s performance in the job,

including any specific personal objectives

– Performance issues must be addressed on an ongoing basis, with no surprises at appraisal

• Development Review – Focuses on individual’s development of skills &

knowledge

– KSF Outline forms template for ongoing development

Initial Preparation

• Arrange a suitable time & venue

• Liaise with your Appraisee– Provide Self Assessment Form & copy of

KSF Outline for their job

– Remind appraisee to review the evidence in their personal Development Portfolio

– Emphasise the positives of appraisal

Document Preparation

• Refer to relevant documents

– Previous year’s appraisal records & PDP

– Job description

– KSF Outline for the job

• Draft a proposed set of objectives

– for discussion during the review

Appraisal Meeting Format

• Introductory remarks, including emphasis on confidentiality

• Review performance against work objectives• Review development against the KSF Outline

– Evidence of achievement in appraisee’s portfolio– Identify skills & knowledge to be developed in next

period• Plan future objectives• Identify training & development needs• Agree future action

Follow Up Actions• Complete appraisal review record & PDP

– Initially paper documents– Eventually an online process

• Appraisee reviews appraisal record, can add comments & signs approval

• Copies of documents for appraiser & appraisee• Carry out agreed actions

– Ongoing monitoring, review & recognition

Managing the Process (1)

• ? Top-down / Bottom-up?• One approach:

– KSF Awareness sessions– Departmental Workshops– Individuals have first stab at producing

draft outlines for their own posts– NB Line Management Structure

Medical Physics Organisational Chart

Director of Medical Physics

Head of Diagnostic Radiology Physics

Prin. Physicist (Brachy.)

0.8wte

Prin. Physicist (QC, R/n Th.)

0.8wte

Prin. Physicist (Eqpt. Mgr.)

Clinical Scientist (Treat. Plan.)

Clinical Scientist

0.4wte

Part ICS Trainee

Part ICS Trainee

Chief RT Clin. Tech. (Equip. Man)

Specialist. Med. Phys.

Technician.

Chief Clin. Technologist (RT Mld

Rm)

Spec. Med. Phys. Tech.

0.59wte

Clin. Tech. (Mld Rm/Hot

lab)

Trainee Clin. Technologist

Trainee Clin. Technologist

Medical Physics Secretary

Secretarial Assistant 0.61wte

Clin. Tech. (Mld Rm)

0.81wte

Supt.Radiographer

Senior X-Ray

Engineer

Osteoporosis Services Mgr.

0.61wte

Senior Technologis

t

Radiographer Nuc. Med.

0.8wte

RadiographerNuc. Med.

Radiographer Nuc. Med.

Radiographer Nuc. Med.

0.8wte

Clinical Technologist

Radiographer, BMD 0.42wte

Osteo. Services Secretary/ Receptionist

0.59wte

Nuclear Medicine Secretary

Secretarial Assistant 0.54wte

Bank Secretary

to DRP

Nuc. Med. Nurse 0.52wte

Nuc. Med. Nurse 0.35wte

Clinical Scientist (Nuc. Med.)

0.5wte

23.09.0523.09.05

Clinical Scientist(QA)

Part IICS Trainee

X-Ray Engineer

Head of Radiotherapy Physics

Managing the Process (2)

One approach (cont.):– Line managers meeting 19.9.05– LMs take greater sense of ownership– Fill in gaps, and aim for consistency– Share amongst line managers:

• Matrix of post levels/dimensions • Draft Stage 2 outlines

Managing the Process (3)

One approach (cont.):– ? Common outlines for multiple staff– 31.10.05 Stage 1 & Stage 2 outlines– ? x.12.05 Stage 3 & Stage 4 outlines– Trust QA/Consistency Panel sign-off

Concerns about KSF

• Influence on banding(particularly if structural change of post)

• Paperwork involved• Time taken to implement• Availability of staff to implement• Training – funding to implement PDPs

Job Evaluation: What It Is• A system for comparing different jobs• Used for establishing relativities between

jobs• The basis for grading jobs in the new pay

structure• Measures jobs not people• Based on the demands of jobs• Involves analysing jobs under factor

headings (e.g. Knowledge and Skills; Responsibilities; Effort)

Early Implementers Wider NHSJan-03 Draft agreementFeb-03 EIs started workJun-03 Effective dateJul-03 StHAs national meeting

Sep-03 Learning networks establishedFirst materials on webInitial geographical seminars

Dec-03 Pay bands & conditions implementedJan-04 Supported seminar programmes commenceMar-04 JE skills training commencesAug-04 KSF stage 1 implementedOct-04 Effective dateApr-05 KSF fully implemented Pay bands & conditions implemented

KSF stage 1 implementationOct-06 KSF fully implemented

Implementation Timetable

KSF Implementation

• Full implementation for all 1.3 million staff by October 2006, with all gateways fully operational.

• Outlines and KSF Development Review therefore need to be in place by October 2005

• KSF-style PDR mandatory from 1.10.05

KSF Implementation Targets

• 60% of outlines by end August 2005• 80% by end of October 2005• 100% by end of December 2005

5/28 SHAs made August targetRD&E 43% by end of August (Stage 1 outlines)

WEBSITESModernisation Agency:

www.modern.nhs.uk/agendaforchangeDepartment of Health:

www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/

ModernisingPay/AgendaForChangeWeb-based KSF at: www.e-ksf.orgFind out more at: www.e-ksfnow.org

Current Best Web-sites for Modernisation Agency / DH KSF

• www.wise.nhs.uk(legacy repository for selected work of the M.A.)

• www.dh.gov.uk(A..Z -> AfC / KSF)

Summary

• KSF Outline identifies the knowledge & skills that a person needs to apply in their post

• Basis of fair & objective appraisal reviews• Guide to development of knowledge & skills• Emphasis of appraisal is on review of ongoing

knowledge & skills development

Current Issues• Steep learning curve – new way of working and

understanding the philosophy of Agenda for Change.

• Getting to grips with the sheer scale of the project.

• Huge implications for time and resources.• Forging new working relationships with

new/existing stakeholders groups or interested parties.

• Developing staff confidence and trust

30

Summary• Plenty of work for everyone• Huge & unprecedented requirement f or staff

involvement• Need to look beyond the f ormal Staff Side• Staff Side need to manage staff involvement• Need shared view of what partnership means in the

EI• Staff will only get most out of this if staff side pull

together• Shared ownership of problems• Shared ownership of solutions

Pay Modernisation - Why?

Governmentcommitssustainedinvestmentin NHS

• Better services for patients

• Better staff development

• Fairer rewards for staff

Finally?