Josephine Grant

DIRECTORATE MANAGER

Donna Pond

TRADE UNION REP

William Tennant

STAKEHOLDER

David McGann

PLANNING MANAGER

Elizabeth Shaw

WARD/DEPARTMENT TEAM

Polly Wright

LEARNING AND
DEVELOPMENT MANAGER

Jamie Waterfield

AUDIT MANAGER
 

Martha Tyler

CLINICAL LEAD

Patrick Baker

WORKFORCE PLANNER/
WOD BUSINESS PARTNER

Sarah Jane Smith

FINANCE
MANAGER

Colin Troughton

SERVICE IMPROVEMENT MANAGER

The Repository
of Useful Things

Workforce Transformation and Skill Mix Toolkit Resource

 
 
 

Stage 2

 

Stage 1

Stage 3

Stage 4

Stage 4 – Undertake a task/activity analysis.

You will need to define the tasks that will be involved in providing the new service. Working with the team, brain storm what tasks are necessary for your service. You might also need to think about whether what you do is essential to your service. Has there been some ‘drift’, with things being done that do not form part of your core service. This is another opportunity to check whether the tasks undertaken are being performed by the appropriate staff and gain an understanding of how prudently you are utilising your staff (e.g. what can be delegated, can time be freed up to focus on higher level skills and functions).

TOOLS AND RESOURCES

OUTCOME OF STAGE 4

You will have a clear understanding of what tasks and functions currently make up your service, what tasks will make up your new service and who should perform them

Stage 5

WHO CAN HELP AT THIS STAGE

Stage 5 – What competencies will your staff need.

Once you have a list of tasks necessary for service provision you will need to identify the National Occupational Standards (NOS) and competencies necessary to undertake these tasks. Look at the Skills for Health database and identify competencies based on what happens in the redefined service 80% of the time. Once you have identified the competencies you can decide whether they would have to be undertaken by a regulated or unregulated practitioner.

National Occupational Standards (NOS) are statements of the standards of performance individuals must achieve when carrying out functions in the workplace, together with specifications of the underpinning knowledge and understanding. Developing NOS standards can appear overwhelming at first glance but colleagues are available to help with this specialist area.

You will have a competence profile for the redesigned service

OUTCOME OF STAGE 5

You will have matched the competencies against the regulated/unregulated workforce

Stage 6

Stage 6 – Training.

You must ensure that your staff are properly trained and competent to undertake the tasks and fulfil the roles of the redesigned service. Undertaking a Training Needs Analysis will help you identify the gap between the required competence and the current competence of staff.

Consider external providers e.g third sector/specialist organisations.

WHO CAN HELP AT THIS STAGE

Workforce Planner/
WOD Business Partner

...should be able to advise on where the required training can be accessed.

Finance Manager

...will help you establish the costs of the training required.

OUTCOME OF STAGE 6

You will have produced a comprehensive training needs analysis that will identify the training required by your staff

Stage 7

Stage 7 – Implementation.

Decide with your team how this change will be implemented and draw up an action plan. Remember to keep other departments updated of any changes that may impact on them.

Workforce Planner/
WOD Business Partner

...should be able to support you in designing an evaluation tool.

Stakeholders

Your stakeholders will include your staff, patients, carers and other services who will be able to provide feedback on the success of the change.

OUTCOME OF STAGE 7

Service is maintained with minimal disruption

WHO CAN HELP AT THIS STAGE

Trade Union Rep

Your trade union rep will work alongside your team and other stakeholder to ensure their opinions are heard.

Learning and Development Manager

Your L&D manager will help you work through the options available in relation to NOS standards and competencies for specific tasks along with how to access training.

You will have identified the appropriate NOS standards

You will have identified funding for training

Learning and Development Manager

...will be able to support you in identifying what training is available and how to access it.

Stage 8

References

  • Standards and Guidance for Role Redesign in the NHS in Wales, Workforce Education and Development Services

  • Competence Based Approach to workforce Redesign, Betsi Cadwaladr University Health Board

  • Workforce change Abertawe Bro Morgannwg University Health Board

  • Imison C, Castle-Clark S and Watson R (2016) Reshaping the workforce to deliver the care patients need. Research report. Nuffield Trust.

You will have an understanding of whether the changes you have made are sustainable or if more support is necessary

OUTCOME OF STAGE 8

To ensure the redesigned service/transformed workforce is fulfilling the vision for the service and that the change is sustainable an evaluation should be undertaken. Prior to staring the process a baseline assessment would be helpful this should be repeated at intervals post change to measure the impact. You will need to measure workforce outcomes as well as clinical outcomes.

Stage 8 – Evaluation.

WHO CAN HELP AT THIS STAGE

Finance Manager

...will be able to help you evaluate the costs of the change.

Audit Manager

....will be able to help you identify how and what outcomes to measure.

WHO CAN HELP AT THIS STAGE

Directorate Manager

...will act as link with other departments informing them of changes to the service.

Clinical Lead

...will support staff through any change and act as link with other senior clinicians who need to be informed of changes to the service.

All stakeholders are fully informed

Team

Your team will identify what tasks are undertaken by whom and whether this could be undertaken by someone else.

Team

Your team will be able to help define which competencies support the tasks identified as essential for the new service.

Team

Your team will be central to the implementation of the new role/service change making sure high quality patient care is not disrupted. 

Stage 1 – Identify area/service for change and the reason for change.

  • Who is the service for?

  • What does the service provide now/should it provide when transformed? Stage 4 of the Workforce Planning Guidance and Resource document may be helpful at this stage

  • Can the existing workforce deliver the transformed service?

WHO CAN HELP AT THIS STAGE

​The main issues facing the service

An understanding of the work to be undertaken

OUTCOME OF STAGE 1

A clear understanding who your stakeholders are

Engaged, informed staff

Finance Manager

Financial implications
+/- business case.

Service Improvement Manager

Patient flow data.

Directorate Manager

...will be responsible for the budget and will input on the strategic direction of the service.

TOOLS AND RESOURCES

The tools below may help you with the evidence to support your case for change

Be realistic about the time and capacity needed to support change it can often take a number of years to implement transformation successfully. Transformation can require significant cultural change in order to engage staff good communication is a must. You should undertake a risk analysis early on in the process to ensure that the benefits of the change outweigh any disadvantages. Consider:

  • Do you understand the patient flow?

  • Are there going to be financial implications?

  • Benchmark against other similar services – look at what other organisations are doing, are there any good example out there?

  • Who else/what other services will be affected by changes to the service?

Clinical Lead

...will support the team in identifying why and how the service could change and the impact on roles.

Tips when undertaking workforce transformation

  • Take time to plan the service required

  • Engage with the other team members who can help you

  • Be realistic about the time and capacity needed to support change

  • Create a culture receptive to change by engaging and investing in your staff

  • Have a strong communication and change management approach

  • Consider any relevant legislation e.g Nurse Staffing Wales Levels Wales Act (2016)

  • Remember that if you are investing in one area you may need to disinvest in another area

  • Build roles on a detailed understanding of patient need, staff skills and the work to be undertaken and the time it will take to develop the skills you require

  • Develop and invest in training capability

  • Ensure the sustainability of new or extended roles

  • Evaluate the impact and efficacy of the change

  • Consider whether any new /changed roles should be integrated either across organisations or professions.

Prior to stating the process you need to understand your organisation’s drivers for change e.g the development of a new service, difficulty in recruiting staff. You may have considered these drivers as part of your workforce planning process. Service transformation and workforce transformation are linked. You cannot change the way a service is delivered without there being some impact on the workforce; likewise if you change your workforce structure the way the service is delivered will change.

Visit the WEDS website to find tools that will help you - www.weds.wales.nhs.uk

  • Develop a workforce response to changes in care, now and in the future

  • Ensure a sufficient supply of staff with the skills required

  • Enable up skilling of the current workforce

WEDS have developed an interactive version of the Role Redesign toolkit. This resource has been developed to support managers through the process of workforce transformation and skill mix which can help you to:

  • Develop and promote new ways of working

  • Support you to deliver some of the changes that have been identified within your workforce plan or help you to identify and plan for your future workforce roles, skills and competencies

Workforce planning and workforce transformation are closely linked, the changes you are introducing should have been identified in your medium term organisational plan which usually covers 1-3 years. You must engage with your team and stakeholders to get their ideas; bottom up ideas/changes are often more successful. This is not something that can be undertaken by one person alone, it needs the whole team to contribute their specific expertise to the project.

The Operational Team

Stage 2 – Understand what your service currently does.

Identify the aims of the service, what functions and tasks are carried out by the service and who carries out these tasks and functions. Ideally this should be performed with a working group of the front line qualified staff who work in the service, since they have direct experience on how the service functions. A detailed analysis of tasks will be taken in Stage 4. This should involve:

  • Understanding what the service does

  • When and where the service is delivered
  • Identifying all the functions carried out in order to deliver the service, these can be in broad groups or themes

  • Identify who undertakes the tasks

  • What contribution, if any, do volunteers make

Once you have all the information and data you can produce a business case.

WHO CAN HELP AT THIS STAGE

Planning Manager

...establish whether new service fits into organisational plan.

Clinical Lead

...will act as part of the team in identifying who currently does what.

Team/Stakeholders

...help identify all tasks and who does them.

​A clear understanding of what each member of staff does along the pathway and the blockages/issues

A clear view of what other options are available

Stage 3 – Understand your current skill mix.

You need to know the make-up of your current workforce to be able to plan for the future. You will need to know:

  • how many staff you have from each profession

  • at what band

  • the age profile of your staff

  • is there any legislation that impacts on skills mix e.g Nurse Staffing Wales Levels Wales Act

Access to the tools is restricted due to the nature of the data they contain. The Skill Mix Analyser and Age Profile and Retirement Tool have been designed by WEDS, who will be able to help you. A number of staff in each of the organisations have also been trained to use the Skill Mix Analyser; find out who in your organisation can help you use it. If you have not been trained or do not have access contact your workforce planning lead or support. The Skill Mix Analyser and Age Profile and Retirement Tool will help you obtain information at a higher level such as comparing one organisation with another. Your workforce information team will be able to obtain local information from ESR. You may want to look at turnover rates, skills gaps or current recruitment some of this may have been identified in your workforce plan.

OUTCOME OF STAGE 3

Workforce Planner/
WOD Business Partner

They will have access to the Skill Mix Analyser and the Age Profile and Retirement Tool and be able to support you with getting data from ESR.

Finance Manager

Once you know the skill mix of your current staff/proposed skill mix, your finance manager will support you in planning your budget.

WHO CAN HELP AT THIS STAGE

People trained in the use of the Skill Mix Analyser

Directorate Manager

...will help understand how the current skill mix has evolved and how it can be changed within financial constraints.

You will have a clear understanding of your current/proposed skill mix and the associated costs

TOOLS AND RESOURCES

This business case is one example of a business case, your organisation may have its own process for writing and approving a business case.

OUTCOME OF STAGE 2

Pathway mapping

To undertake a pathway or process map you need a group of staff from your team who understand the pathway or processes undertaken. The pathway or process should be broken down into steps, at each step any issue, bottleneck, who is responsible and the measurement (time) should be identified and recorded.

© 2018 NHS–WEDS  |  www.weds.wales.nhs.uk

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