NES NES/15/32
Item 4(Enclosure)
April 2015
CHIEF EXECUTIVE’S REPORT
Caroline Lamb, Acting Chief Executive
April2015
INTRODUCTION
The agenda for our April Board meeting includes an important strategic item on improving the educational experience of postgraduate doctors and dentists in training. The Board has been kept informed through the Chief Executive’s report of discussions about lead employer arrangements for this group of staff, which was picked up last summer under the auspices of the HR Shared Services programme. We now believe that this proposition needs to be decoupled from the HR Shared Services Programme, and it is important that the Board has an opportunity to discuss and fully understand the issues and the potential solutions.
The Board agenda also includes an update on health and social care integration, particularly covering the new Integration Joint Boards (IJBs) which are now entering their shadow year.This is an important development in the delivery of health and care and Board members will wish to be kept informed as the IJBs develop their strategic plans. We are also providing an update on the progress towards the implementation of revalidation in Nursing and Midwifery; and an overview of the work of the Organisational Performance Improvement team in NES in supporting improvement activity across our organisation.
ANNOUNCEMENTS
Board members will wish to congratulate Professor RoseMarie Parr on her appointment as the Chief Pharmaceutical Officer in Scotland. As a result of this appointment, RoseMarie will also be stepping down as an Executive Director of the NES Board.
Board members will wish to note thatAlan Walker,will be retiringin September2015, following over13 Years in post as Director of Postgraduate General Dental PracticeEducation in the West Region. Duringhis time as Director of Postgraduate General Dental PracticeEducation, Alan has made an outstanding contribution todental education and training, in both undergraduate and postgraduate domains, within theWest and across Scotland. In particular,he hasled the development of the START programme fordentists wishing to becomeVocational Trainers; instigated the use of Portal for Vocational Training recruitment and latterly led the role out of vocational training as a national workstream. Alan has played a key role in the developmentand implementation of the Dental Vision.
AWARDS
The NES Reducing Antibiotic Prescribing in Dentistry project carried out by the TRiaDS programme won the 2015 virtual poster presentation award at the 3rd Healthcare Improvement Scotland Annual Symposium. Posters were presented as three minute ‘speed’ presentations highlighting the work carried out and its impact on the delivery of health and social care in Scotland. This conference which launched the Evidence Directorate of Healthcare Improvement Scotland and celebrated its strategic alliance with the Health Services Research Unit and Health Economics Research Unit, University of Aberdeen, was attended by around 100 delegates from across the UK.
Dr Ann Wales, Programme Director for Knowledge Management, has been selected by the Global Advisory Council for the World Education Congressfor the Knowledge Management Leadership Award. The award recognises Ann's work in knowledge management and knowledge mobilisation for healthcare, throughThe Knowledge Network and Knowledge into Action initiatives. Theaim of the Awards is to "recognize the Best of Best, organized for a professional cause".The overall objective is to set standards of excellence for educational practice. The award will be presented at the World Education Congress in July 2015.
EVENTS
Board members may wish to note that the first NES All Staff Conference is being held at Heriot Watt University, Riccarton, Edinburgh on Wednesday 27th May.
This national event, which is open to all staff in NES, at all levels and from all locations will enable staff to share their experiences and showcase the work of their individual Directorates as well as providing an opportunity to celebrate success through the recognition of colleagues who are nominated for a NES STARS award. The NES STARS is our Staff Thanks and Recognition Scheme and awards will be made to people nominated by colleagues within NES who have gone the extra mile in demonstrating our values and behaviours at work.
MID YEAR REVIEW WITH SCOTTISH GOVERNMENT
On 26th March 2015 we had our mid year review with Scottish Government. This was attended by Caroline Lamb, Stewart Irvine, David Felix and Colette Ferguson from NES and Shirley Rodgers (Director of Workforce), Janet McVey (CNO Directorate), Ian Finlay (CMO Directorate), Dave McLeod (Workforce) and Paul Bowtle (Workforce) from SGHSCD.
We took the opportunity to present to SG colleagues on our Digital Transformation and in particular how we are using, and planning to use data to help us understand more about our users preferences in relation to education and training; and also in analysing and therefore better understanding the movement between undergraduate programmes and into and through postgraduate training posts and the workforce. Shirley and colleagues were very impressed by the presentation and complimented NES on our on-going work and achievements.
ANNUAL REVIEW WITH SCOTTISH GOVERNMENT
It has been confirmed that we will not be on of the NHS Boards receiving a ministerial review this year and it has been stressed to us that this reflects the fact that we are considered to be performing well. We will consider arrangements for a non-ministerial review once the formal guidance issues.
DIGITAL GROUP UPDATE
Turas version1.2 went live on 2ndApril 2015. Turas is the redeveloped application which enables us to manage post-graduate training programmes in medicine, and which will in due course be extended to dentistry and other professions. This version is significantasthe development team was entirely led and staffed by NES team members. The technical and business leadsteam are now commencing the scoping and design phase forthe e-Portfolio and revalidation application that will commencetechnical development in May 2015. Again, this will be delivered byan entirely NES staffed team. The Family Nurse Partnership team have started their work on the pilot of the NES Digital Virtual component of the Single Unified Environment. They have received their Agile / Product Owner training and are working with theNES Digital development team based in 2CQ on an audit of digital resources to be migrated into the newplatform.TheNES Web team are providing resource and expertiseto both these projects in the area of user experience and best of breed design.
The new activity focussed NES Intranet went live at the start of February. This was entirely designed and built by the NES Web team and has been recognised as a significant improvement on the previous Intranet.
There will be an opportunity at the Board Planning Day on 14th May for Board members to receive a fuller presentation on the Digital Transformation and to see a demonstration of Turas.
MEDICINE
Recruitment 2015
Foundation recruitment has closed, and has been oversubscribed once again. Across the UK, there were 399 more applicants than places (in 2014 the figure was 293). Assuming that the additional places currently funded by DH/HEE and SG/NES remain in place, we anticipate that all applicants will be placed by the start of the programme in August. However, there is as yet no long-term solution to the problem of foundation over-supply, and Universities continue to admit significantly more undergraduates than the available funded number of foundation places.
Round one ST recruitment (core + run-through) is in the closing phases, and so numbers are not yet final – clearing and round 2 are still to follow. As at 1/4/15, the overall fill rate in Scotland was 85%, (compared to 79% in England). Most specialties have 100% fill, including core medicine, core anaesthetics, core EM, obstetrics and paediatrics. The challenges are core psychiatry (78%, England = 61%) where Scotland put in extra posts, and GP (70%, England = 68%), where England has expanded the number of posts by 222. Some English regions have only 30% fill. We are developing a non-training pre-GP year for those that narrowly miss selection, with the aim of giving them the opportunity to reapply next year.
Gaps in Programmes. With the development and deployment of Turas, we are now in a much stronger position to take a view on strategies we might develop to address the problem of gaps in training programmes. Firstly, our overall fill rates are good with some 97% of total establishment filled through recruitment (compared to a consultant vacancy rate of 7%). Secondly, unfilled posts account for only some gaps – the leading causes are maternity leave, out of programme research, and trainees competing CCT mid-year and leaving to a consultant post. We think that we could significantly reduce gaps due to OOPR and CCT leavers, by creating additional temporary NTNs and advanced training fellowships by making use of the ‘vacancy factor’ which we currently leave with Boards.
GMC Progression Data
We drew attention to this dataset in our midyear review with Scottish Government; and it is clearly going to be a valuable tool in understanding how trainees flow through the system. Early messages are (i) Almost half of all doctors who complete foundation do not move directly into specialty training but do ‘something else’ for 1-2 years, before re-entering the system. We think that many are simply not yet ready to make a specialty/career choice, and are choosing to gain experience in non-training posts in the UK or overseas. (ii) Graduates of Scottish schools seem more likely to be lost to the system than graduates of English schools. Three years after completing foundation, about 16% of graduates of Scottish schools are not working in the UK, compared to about 5% of graduates of English schools.
FAMILY NURSE PARTNERSHIP (FNP)
A recent milestone for FNP internationally has been achieved as both NES and NHS Lothian celebrated 5 years of programme delivery in March 2015. Edinburgh city, and NHS Lothian, are now able to offer a sustained concurrent service to all eligible teenage mothers in Edinburgh, this being the first city globally to achieve this coverage. The milestone event was celebrated recently at Edinburgh Castle, where Scotland's First Minister, Nicola Sturgeon, hosted the occasion. Acting Chief Executive, Caroline Lamb, Executive Nurse Director, Dr Colette Ferguson, FNP Clinical Director, Gail Trotter, and Education Projects Manager, Alison Knights, attended the celebration.
NES’s role to support FNP implementation to all NHS Boards where the programme is viable remains on target and it is anticipated that, by 2018, an FNP place will be available to every eligible young first time teenage mother in the country – Scotland will be the first country to achieve full national coverage. Professor David Olds, pioneer of FNP has expressed a keenness to learn from the work undertaken by NES who have supported this large scale expansion, at the same time ensuring high quality across all areas of the programme.
PLAYING OUR PART – IMPLEMENTING THE PREVENT STRATEGY
NES is required by the Scottish Government to develop an action plan to implement the Prevent Strategy which is part of the UK Government’s counter- terrorism strategy.
Guidance has been provided to enable health boards to:
Understand what radicalisation means and raise awareness amongst staff.
Take appropriate action at various levels within the organisation and with partner agencies to prevent staff or patients being radicalised or exploited.
Be confident in responding effectively when such incidents are identified.
A generic prevent awareness training package is being made available to health boards so that they can target specific health board needs. Judy Thomson has been identified as the NES Prevent Lead and will take this forward on our behalf.
IMATTER AND STAFF EXPERIENCE
iMatter is the national model for enabling continuous improvement in staff experience in NHS Scotland. Co-produced with over 250 staff, and tested with over 3,000, at 4 pilot Boards across Scotland in 2013/14: Dumfries & Galloway, Forth Valley, Tayside and the National Waiting Times Centre; it consists of a validated online questionnaire of 29 rating statements that elicits the views of teams of staff on their experience at work, in their team, of their direct line manager and in their organisation.
Following some minor delays, the online tool was launched in December 2014, with the questionnaire going live at the beginning of February 2015. Boards are required to have ensured that all members of staff have had the opportunity to complete the questionnaire for the first time by the end of 2016. This is then to be completed annually and used as the basis for teams developing and owning action plans for improving their experience at work.
In NES, the Executive Team agreed in May 2014 to implement iMatter across all Directorates and for the Chief Executive and Direct Reports by the end of 2015. This will minimise the potential for overlap between cohorts that would arise if the questionnaire was live in some Directorates for the first time whilst also live in others for the second. Our phasing of Directorates is as follows:
Phase 1: Dec 2014 – June 2015 – 144 staff
Pharmacy, Procurement & Corporate Resources*, Psychology
Phase 2: May 2015 – Sept 2015 – 251 staff
Medical, Workforce
Phase 3: Sept 2015 – Jan 2016 – 328 staff
Dental, Executive Team, NMAHP
* In light of Finance Transformation timings in 2015, Finance Teams will now join Procurement & Corporate Resources in Year 2, Phase 1 taking the total number of staff for this Phase to 177.
This will be repeated each year to establish this activity as business as usual.
In early April, Phase 1 Team Managers were provided with access to their team reports. They now have until mid June to: meet with their teams, share the results and use these as the basis for a discussion around what works well and what could be improved in terms of their team’s experience at work, and to develop and document an Action Plan.
Our Phase 1 response rate of 93% was the best in NHS Scotland. The EEI score for the organisation at this early stage is an encouraging 81%. This is within the range of 80-100% for employee engagement scores that characterise high performing organisations.
CALENDAR
2nd March: NES & The Alliance
Sonya Lam, Director of AHP, Bob Parry, Associate Director and I met with Ian Welsh, CEO, Health and Social Care Alliance and Shelley Gray, Director of Policy and Communication for one of our regular meetings.
The discussions followed on from a previous joint meeting between NES and The Alliance in which agreement had been reached in principle to explore more formal partnership working and to take forward exploratory work. The aim of the partnership was for both organisations to work effectively together and enhance the achievement of each organisations aims in relation to Long Term Conditions.
At this meeting we identified key roles and responsibilities, gained further understanding and appreciation of both organisations contributions and support to health and social care integration, provide an update from the Health and Social Care Alliance and NES and to further discuss opportunities to discuss partnership working.
3rd March: JIT / SSSC / NES Meeting
Bob Parry and I met with Colleagues Margaret Whoriskey, Director (JIT) and Anna Fowlie, Chief Executive (SSSC). We discussed developments in relation to the Integration Joint Boards (IJBs) and also potential developments to consolidate improvement capacity across Healthcare Improvement Scotland, JIT and the Scottish Government Quality and Efficiency Support Team (QuEST).
4th March : Board for Academic Medicine
I attended the Board for Academic Medicine meeting which is Chaired by Sir David Carter and items for discussion included the Research Excellence Framework results, Career Pathways for Clinical Academies in Scotland and Recruitment and Retention issues.
10th & 11th March: NHS Chief Executives Meeting
I attended the NHS Board Chief Executives Meeting, which took place over the afternoon of 10thMarch and the morning of 11thMarch. Items for discussion included Healthcare Scientist Delivery Plan, Sharing Intelligence for Health and Social Care, Sustainability and Seven Day Services. There was also a session on Shared Services which was led by Ian Crichton and Carolyn Low.
16th March: Catriona Renfrew
I met with Catriona Renfrew, Director of Corporate Planning and Policy at NHS Greater Glasgow and Clyde to discuss live issues in NHSGG&C, and particularly the impact of health and social care integration.
16thMarch: Academy of Medical Royal Colleges and Faculties in Scotland
I attended the Academy meeting where a presentation was given by Professor Monty Mythen, Clinical Lead, RCoA on Perioperative Medicine. Other items for discussion included Recruitment and Retention of the Medical Workforce, Health and Wellbeing, Professionalism and Excellence in Scottish Medicine and Shape of Training