A Workforce Strategy for A Workforce Strategy for the Integrated Substance the Integrated Substance

Misuse ServiceMisuse Service

Supporting Models of CareSupporting Models of Care

The StrategyThe Strategy

• Three year strategyThree year strategy

• Embraces local vision of “whole Embraces local vision of “whole system” commissioningsystem” commissioning

• Maps the workforce across the four Maps the workforce across the four tiers of treatment and service tiers of treatment and service provisionprovision

AssumptionsAssumptions

• Maximising partnership workingMaximising partnership working• Integrated care pathways and ways Integrated care pathways and ways

of workingof working• Embraces “improving working lives” Embraces “improving working lives”

agendaagenda• Clinical governanceClinical governance• Learning organisationLearning organisation

Components of the Components of the strategy strategy

1.1. Matching the workforce you want with the Matching the workforce you want with the workforce you need workforce you need

2.2. Recruitment and retentionRecruitment and retention

3.3. Training and development and lifelong Training and development and lifelong learninglearning

4.4. Appraisal and SupervisionAppraisal and Supervision

5.5. User and carer involvementUser and carer involvement

6.6. Rewarding excellence and commitment in Rewarding excellence and commitment in staffstaff

7.7. LeadershipLeadership

1. From the workforce you 1. From the workforce you have to the workforce you have to the workforce you

needneed• Undertake a staff profile – suggested Undertake a staff profile – suggested

approaches: -approaches: -– By treatment tier ( models of care)By treatment tier ( models of care)– By team ( alcohol, young persons, DTTOs)By team ( alcohol, young persons, DTTOs)– By professional groupBy professional group

• Define the skills and competencies Define the skills and competencies required for each subgroup of staffrequired for each subgroup of staff

• Undertake a training needs analysis Undertake a training needs analysis – use DANOS and existing job – use DANOS and existing job descriptionsdescriptions

Building up the staff Building up the staff profileprofile

Coordinate access and provision of training

Professional development plan

Training Needs Analysis

Review job description

Define Skills and competencies

Team member

Training needs analysisTraining needs analysis

• Map expected skills and competencies Map expected skills and competencies against existing skills and competenciesagainst existing skills and competencies

• Work with individuals using staff appraisal Work with individuals using staff appraisal process to produce a personal development process to produce a personal development planplan

• Review and update every job description Review and update every job description and cross reference with DANOSand cross reference with DANOS

• Training plan should address any Training plan should address any knowledge gaps as defined by the training knowledge gaps as defined by the training needs analysisneeds analysis

Profiling the workforceProfiling the workforce

• Development of workforce profile toolDevelopment of workforce profile toolComplies with DANOS and NOSComplies with DANOS and NOSReflects Whole systemReflects Whole system working working

• Develop a series of service Develop a series of service specificationsspecifications

Adult voluntary treatment servicesAdult voluntary treatment servicesYoung persons servicesYoung persons servicesCriminal justice drug treatment teamsCriminal justice drug treatment teamsRecovery and aftercare teams ( e.g. Accord Recovery and aftercare teams ( e.g. Accord

ABLE Progress 2 work etc)ABLE Progress 2 work etc)

2. Recruitment and 2. Recruitment and RetentionRetention

• Production of Job Production of Job descriptions that reflect descriptions that reflect integrated service integrated service provisionprovision

• New practitioners New practitioners identified in accordance identified in accordance with provision of Models with provision of Models of Careof Care

• Develop management Develop management systems that support systems that support integration of workforceintegration of workforce

• Understand the labour Understand the labour market locally and market locally and nationallynationally

• Ensure appraisal Ensure appraisal systems are adequately systems are adequately resourcedresourced

• Implement Implement “Improving “Improving working lives”working lives”

• Improve workforce Improve workforce experience e.g. experience e.g.

• secondments, secondments, sabbaticals, portfolio sabbaticals, portfolio workingworking

• Ensure estate keeps Ensure estate keeps pace with workforce pace with workforce expansionexpansion

Successful recruitment and Successful recruitment and retention – points for retention – points for

considerationconsideration• Standardised employer policies and Standardised employer policies and

procedures can act as barrier when developing procedures can act as barrier when developing posts that cross interfacesposts that cross interfaces

• Avoid staff burn out Avoid staff burn out • Significant time and resources are required to Significant time and resources are required to • Implement clinical supervision and staff Implement clinical supervision and staff

appraisalappraisal• Ensure estate and management costs are Ensure estate and management costs are

considered when services are expanded or considered when services are expanded or redesignedredesigned

3. Joint training and 3. Joint training and DevelopmentDevelopment

• Key to an effective workforceKey to an effective workforce

• Perceived area of strength in the Perceived area of strength in the districtdistrict

• Decision made to develop a separate Decision made to develop a separate strategy to support workforce strategy to support workforce developmentdevelopment

The training strategyThe training strategy

Three elementsThree elements– Three year strategy linked to Models of Care Three year strategy linked to Models of Care

– Defines training associated with each tier of Defines training associated with each tier of serviceservice

– To develop a system of quality assurance to To develop a system of quality assurance to support trainers and ensure training is support trainers and ensure training is consistent, accurate and in line with national consistent, accurate and in line with national and local policyand local policy

AssumptionsAssumptions

• Maximising Partnerships working –public health Maximising Partnerships working –public health training team , SWYT, Turning Pointtraining team , SWYT, Turning Point

• Access – comprehensive, equitable and Access – comprehensive, equitable and systematic systematic

• Funding – pooling resourcesFunding – pooling resources• Uni vs. multidisciplinary trainingUni vs. multidisciplinary training• Leadership training investment in management Leadership training investment in management

skillsskills• AccreditationAccreditation• Implement a variety of learning styles to attract Implement a variety of learning styles to attract

and retain staffand retain staff

ContributorsContributors

• Public Health Training teamPublic Health Training team• Tripartite management teamTripartite management team• Members of the MOC steering group Members of the MOC steering group

and JCG and JCG

Who is the strategy for?Who is the strategy for?

• Team leaders, managers, commissionersTeam leaders, managers, commissioners• To inform and support personal learning plansTo inform and support personal learning plans• Support appraisalSupport appraisal• Enhance service developmentEnhance service development• To raise awareness amongst stakeholders of To raise awareness amongst stakeholders of

what is available what is available • To highlight responsibilities of stakeholders To highlight responsibilities of stakeholders

with respect to ensuring and maintain with respect to ensuring and maintain appropriate levels of staff training in appropriate levels of staff training in substance misusesubstance misuse

The training strategy – The training strategy – how is it laid out?how is it laid out?

For each service tierFor each service tier– Defines specific role and function. E.g. Defines specific role and function. E.g.

screening and recognition skillsscreening and recognition skills– Defines the training requiredDefines the training required– Describes the courses available ( local, Describes the courses available ( local,

regional, national)regional, national)– What qualifications/quality assurance is What qualifications/quality assurance is

required through the trainingrequired through the training– DANOS and NOS categoryDANOS and NOS category– Examples of training provider and how to Examples of training provider and how to

access themaccess them

Opportunities and Opportunities and challenges aheadchallenges ahead

• Maintain existing levels of trainingMaintain existing levels of training• Enrich partnership workingEnrich partnership working

– Training practitioners forumTraining practitioners forum– Joint training events – shared care for Joint training events – shared care for

GPs and support staff, dual diagnosis, GPs and support staff, dual diagnosis, acute trust staff trainingacute trust staff training

• Encourage innovationEncourage innovation– Overdose trainingOverdose training– NHS Learning account, and fixersNHS Learning account, and fixers

Opportunities and Opportunities and challenges ahead (2)challenges ahead (2)

• Quality assurance Quality assurance • Trainer support – ( peer review and Trainer support – ( peer review and

appraisal)appraisal)• Sharing learning across the regionSharing learning across the region• Keeping up with pace of change ( new Keeping up with pace of change ( new

services e.g. CJIP, nGMS, Alcohol, out services e.g. CJIP, nGMS, Alcohol, out of hours )of hours )

• Meeting the needs of the CDRPMeeting the needs of the CDRP• Meeting needs of exMeeting needs of ex

4. Professional 4. Professional DevelopmentDevelopment

• Every staff member should have a training Every staff member should have a training plan updated annually and reflecting their plan updated annually and reflecting their training needs be it updating their skills or training needs be it updating their skills or acquiring new onesacquiring new ones

• There should be a series of minimum There should be a series of minimum standards in the delivery of training for staff standards in the delivery of training for staff e.g. induction, study leave, protected learning e.g. induction, study leave, protected learning time, attendance at conferences and coursestime, attendance at conferences and courses

• Emphasis of commitment to lifelong learning Emphasis of commitment to lifelong learning from the organisationfrom the organisation

5. Appraisal and 5. Appraisal and SupervisionSupervision

• Mandatory for employees of PCTs and Mandatory for employees of PCTs and other health and social care agenciesother health and social care agencies

• Access to structured supervision for Access to structured supervision for every clinical staff member is a priority every clinical staff member is a priority for the Integrated servicefor the Integrated service

• Not new arrangements for GPs Not new arrangements for GPs ( including GPwSIs)( including GPwSIs)

• Protected time for appraisal and review Protected time for appraisal and review

6. Users and carers6. Users and carers

• ““Need to turn rhetoric into reality”Need to turn rhetoric into reality”– Remuneration to service users for their timeRemuneration to service users for their time– Training, support and advocacy required if Training, support and advocacy required if

service users are to take places on strategic service users are to take places on strategic groupsgroups

– Investment required to project Investment required to project manage/oversee the user involvementmanage/oversee the user involvement

– Avoid tokenismAvoid tokenism• Invest in sustainable service user Invest in sustainable service user

networksnetworks• Consider service users as trainersConsider service users as trainers

Commitments made in the Commitments made in the strategy for users and strategy for users and

carerscarers• Inclusion of experts by experience in training and Inclusion of experts by experience in training and

away day eventsaway day events• Ensure advocacy and needs of users and carers are Ensure advocacy and needs of users and carers are

metmet• User involvement and workforce development : -User involvement and workforce development : -

• NHS learning account projectNHS learning account project• Successfully bid for and implement the “Fixers” service user Successfully bid for and implement the “Fixers” service user

education and training programmeeducation and training programme• Implement the university of Lancashire service user harm Implement the university of Lancashire service user harm

reduction needs assessment skills project reduction needs assessment skills project

• Engage and support user and carer networks and Engage and support user and carer networks and forumsforums

• User focussed monitoring groupsUser focussed monitoring groups• Secure representation on strategy groupsSecure representation on strategy groups

7. Leadership7. Leadership

• Successful integration requires Successful integration requires excellence in Leadership excellence in Leadership

• Integrated services need leadership Integrated services need leadership skills throughout the workforce skills throughout the workforce

• Coordinated investment required to Coordinated investment required to ensure managers and supervisors are ensure managers and supervisors are confident leadersconfident leaders

• Staff empowerment and culture change Staff empowerment and culture change required so that EVERY staff member required so that EVERY staff member considers themselves a leader considers themselves a leader

Leadership – points for Leadership – points for considerationconsideration

• Expensive courses vs. innovative action Expensive courses vs. innovative action learninglearning

• Capitalising on partnerships and in house Capitalising on partnerships and in house schemesschemes

• Cascading learning Cascading learning • Delegating responsibilities throughout the Delegating responsibilities throughout the

workforceworkforce• Culture change/empowerment/raising Culture change/empowerment/raising

expectations – role for TPT cross over with expectations – role for TPT cross over with clinical governance, staff appraisal, clinical governance, staff appraisal, implementing supervisionimplementing supervision

Recommendations Recommendations

• Strategy signed off by MOC and DAT Strategy signed off by MOC and DAT project boardsproject boards

• Work taken forward by the newly Work taken forward by the newly established established workforce education and workforce education and training sub grouptraining sub group

• Implementation requires commitmentImplementation requires commitment• GovernmentGovernment• Department of Health/NTADepartment of Health/NTA• Local Strategic partnershipsLocal Strategic partnerships• NSF LITs implementation teamsNSF LITs implementation teams• CommissionersCommissioners• EmployersEmployers• ProfessionalsProfessionals• Workforce confederationsWorkforce confederations• STAFFSTAFF