Developing new national tool for assessing and planning structure of health workforce area teams, including link with service deliverables.
Benson Wintere responded to feedback from the all levels of the health visiting service to provide a dynamic, adaptable, easy to use tool providing a new strategic framework to align with service development and improvement initiatives.
Lack of effective planning tools to assist current assessment of workforce structure and decision making within the service. This was defined as a service wide workforce and caseload management tool sensitive to deprivation and other key geographic and current service issues faced by health visiting teams and PCT service development managers.
How do we quantify adequacy of practitioners within a team whilst reflecting complexity of associated variables affecting service delivery, and ensuring the tool could be aligned across other PCT’s?
Concerns around variations in service delivery within primary care trusts and lack of transparency and visibility in comparing workloads.
Difficulty in conveying issues to commissioners and other stakeholders in a professional, transparent, independent manner.
Initially the model was scoped with PCTs following on from some of the key points picked up and reported on in an earlier report to the service. This enabled us to ensure we understood (1) the problems being faced, (2) the functionality required and (3) who would be using the tool and relying on the outputs
During the initial pilot, Benson Wintere worked with 2 PCT’s to develop the new methodology to address the concerns expressed by PCT’s across the country around lack of effective planning tools to assist workforce decision making within the service.
The tool was subsequently rolled out across other PCT’s using a workshop approach to populating the tool for each PCT, and ensuring the working group understood the tool and could develop a process to ensure it would be kept updated and enhanced going forward.
One of the key issues was around “comparability” – everyone was doing the same things in a different way. Rather than over engineering the model to reinforce localised approaches, we opted to create a new way of standardising the service. This reflected an ideal that in the future, each service could be delivered to people with similar needs in a similar average time and with similar workforce, regardless of the geographic location or team the family is dealing with. This resulted in the “Future Service Planner” – a standardised tool that each service could update and reinforce over time, reflecting achievable targets for service delivery and enabling comparison with other services for shared learning.
The other key issue was around creating a more dynamic tool that could dig deeper than other current approaches and identify issues that were placing increased pressure on the service. This primarily concerned profiling of deprivation – enabling each local population to be aligned to deprivation bands and for services to be profiled in terms of targeting and time intensity by each deprivation band. Other factors included reflecting travel and administrative commitments occurring more accurately.
We also understood that as well as building in sufficient complexity in the modelling, that the service required a strong frontend to quickly convey messages and key relationships, for example showing estimated workload effectiveness across each locality, and showing “what-if” scenarios of adding or removing practitioners. This provided a key “wow” factor to the tool – something that people “got” as soon as they looked at, and provided a key focal visual for articulating key messages.
The model now been rolled out in a number of PCT’s across the country. Feedback received indicates those working groups who have taken ownership of the tool are using it as a central strategic tool for workforce development and assessment.
The model has provided a stimulus for collecting better information about the service including time taken to perform each service, and classification of area populations into deprivation bandings.
The model was presented by one of the PCT’s at the Unite/CPHVA annual professional conference in October 2010 and has continued to receive positive feedback and generate interest within the service.