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Toolkit in action! 

  • Can you identify the key drivers for change that are influencing your NHS organisation and its decision-making?
  • Do you want to demonstrate how your library service is aligned to the priorities of the NHS?
  • Do you need help critically highlighting how your library adds value and impacts upon organisational change, policy and practice?

Then this toolkit is for you!

Find out more about the Toolkit and how you can use it to demonstrate impact!

Operational productivity and performance in English NHS Acute Hospitals: Unwarranted variations

Title of driver: Operational productivity and performance in English NHS Acute Hospitals: Unwarranted variations

Alternative Titles: Productivity in NHS hospitals Carter Review

Source: Lord Carter of Coles (Independent report commissioned by the Department of Health)

Link to main document https://www.gov.uk/government/publications/productivity-in-nhs-hospitals

Publication format: PDF

Date of publication: February 2016

Summary of driver:

Report sets out the findings of Lord Carter’s review of how non-specialist acute hospital trusts can reduce unwarranted variation in productivity and efficiency to save the NHS £5 billion each year by 2020 to 2021.

15 recommendations are made to reduce this variation, including proposing a set of metrics be developed for a ‘model hospital’ for trusts to be benchmarked against.

Key features of driver:

Various sources of unwarranted variation in productivity, costs and efficiency in acute hospitals were identified.

The review looked at clinical staffing, pharmacy and medicines, diagnostics and imaging, procurement, back-office functions, estates and facilities; and at the quality and efficiency of clinical specialties.

The report makes recommendations in 15 areas to reduce this variation, improve quality and productivity, make cost savings, use resources in a cost effective manner and increase efficiency.

The report calls for action by NHS Improvement, NHS England, the Department of Health and hospital trusts with recommendations for the below areas:

  • Developing and implementing a national people strategy – simplifying system structures, raising people management capacity, building greater engagement and improving leadership capability.
  • Ensuring hospital pharmacies and pathology and imaging departments achieve their benchmarks – resulting in pharmacists spending more time on clinical activities, and a consistent approach to the quality and cost of diagnostic services
  • Procurement – trusts should report procurement information monthly to NHS Improvement; collaborate with other trusts and the NHS Supply Chain; and commit to the NHS Procurement Transformation Programme – resulting in increasing transparency and at least 10% reduction in non-pay costs across the NHS.
  • Estates and facilities management – trusts should meet or operate above NHS Improvement’s benchmarks. Including not exceeding a maximum of 35% of floor space for non-clinical functions and 2.5 % of space unoccupied/underused.
  • Trust corporate and administration functions – should be rationalised so that costs don’t exceed 7% of their income by April 2018 and 6% of income by 2020, or have plans for shared service consolidation or outsourcing to other providers.
  • NHS Improvement and NHS England should establish joint clinical governance to set standards of best practice for all specialties.
  • Key digital information systems – should be in place in all trusts.
  • The Department of Health, NHS England and NHS Improvement should work with local government to provide a strategy for trusts focusing patient care on recovery and how patients can leave acute hospital beds as their clinical needs allow.
  • Quality and efficiency opportunities for better collaboration and coordination of clinical services across local health economies – NHS England and NHS Improvement should work with trust boards to identify these.
  • NHS Improvement should develop the Model Hospital and underlying metrics so there is one source of data, benchmarks and practice.
  • Metrics and reporting – NHS Improvement should develop an integrated performance framework to ensure there is one set of metrics and approach to reporting; reducing the reporting burden for trusts.
  • Various deadlines are suggested- all trusts should work towards these and national bodies should develop timetables for efficiency and productivity improvements.

Primary audience: Department of Health, NHS Improvement, NHS England, Acute Trust Boards

Impact on library policy/practice:

Libraries are not specifically mentioned but:

  • The focus on efficiency, quality and benchmarking may lead to increased interest in resources for business decision making, and clinical/service auditing.
  • Consortia purchasing of library resources could contribute towards cost reduction.
  • Libraries can supply resources on leadership and people management to support the staffing changes proposed.
  • Library staff could partake in any leadership training and development made available by their trusts – for CPD and to improve the structure and leadership of the library service.
  • Library services can highlight that by having trust computers available in their setting – they are supporting staff to have access to the digital information systems the report calls for.
  • Working in collaboration with other libraries to deliver projects and services e.g. inter-library loans could support the initiative of collaboration and cost reduction.

However with the stipulation for the maximum percentage of hospital floor space for non-clinical functions – if trusts feel they need to reduce non-clinical floor space, libraries may be one of the areas that faces challenges to their use of space. Library managers will need to highlight the value of the library service to counter this pressure.

Date last updated: November 2016

Due for review: November 2017

Group member responsible: FG

Delivering high quality, effective, compassionate care

Title of driver: Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values: A mandate from the Government to Health Education England: April 2016 to March 2017

Source: Department of Health

Link to main document

Publication format: PDF

Date of publication: October 2016

Summary of driver:

This is the Government’s mandate to Health Education England for the year 2016/17, and sets out the priorities for HEE to help deliver the NHS Five Year Forward View.

Pre-registration nursing and midwifery course will no longer be funded through NHS bursaries or HEE funded tuition from August 2017. The aim is to allow the creation of up to 10,000 new training places.

The NHS Apprenticeship scheme will be advanced.

A new nursing associate role will be introduced, bridging the gap between HCAs and nurses and allowing HCAs to progress to a nursing role.

Key features of driver:

As well as the changes to pre-registration nursing and midwifery training, and leadership education, other objectives include an increase in the primary care workforce (5,000 more GPs and 5,000 other community staff).

The new nursing associate role will provide care in primary, secondary and social care settings, and the role will be available to existing health care assistants as well as new staff. HEE will be working with higher education to provide training courses, and 1,000 new nursing associates will be in training by the end of 2016.

There are some changes to community pharmacy planned, to integrate community pharmacists into the NHS, and to introduce clinical pharmacist posts in general practice. There will also be an expansion in the psychologist workforce to support the ‘Improved Access to Psychological Therapies’ programme.

HEE will be working with key partners to support the development of an integrated workforce across the NHS and social care, as the Government is committed to integrating them by 2020. HEE will also work to reduce reliance on overseas staff.

Primary audience: NHS senior managers, including education and training directors, national bodies involved in education and quality (e.g. CQC, NICE etc.). HEE and LETBs, professional bodies.

Impact on library policy/practice:

The increase in the number of pre-registration nursing and midwifery students may have a bigger impact on joint HE/NHS library services, but all health libraries may see an increase in demand from students on clinical placements. Since these students will no longer receive bursaries, there could also be an increase in their expectations of what libraries should provide.

The new Nursing Associate role could see an increase in demand from staff that are not traditionally heavy users of the library. They may well require more support than other groups, and resources that reflect their training requirements.

One other potentially large impact on health libraries is the proposed integration of health and social care. NHS libraries have not traditionally served local authority social care staff, but this may become a need in the future, especially as staff work more flexibly across health and social care boundaries. At a national level, work may need to be done to ensure that the core collection reflects the needs of social care, and to integrate resources such as Social Care Online into existing platforms such as NICE Evidence or HDAS. It would be advantageous to have a national approach to funding health library services to support social care that doesn’t rely on each individual service having to negotiate with local authorities.

Finally, HEE will promote the adoption of digital technologies by healthcare professionals, both in and outside of work, and libraries could support this by providing training and guidance on the use of technologies that library users might use in their personal lives, and position ourselves as friendly technology experts.

Date last updated: November 2016

Due for review: November 2017

Group member responsible: JC

NHS Operational Planning and Contracting Guidance

Link to main document:

Publication format:  PDF

Date of publication: 22/09/2016

Summary of driver: This document outlines how NHS operational planning and contractual processes will change to support Sustainability and Transformation Plans (STPs) and the “financial reset”. STPs are a different way of working and are seen as the way forward with partnership behaviours and reducing silo working.

Key features of driver:

  • Streamlining of the annual round of NHS planning and contracting.
  • Move away from annual contracts towards two year contracts as default
  • Priorities and performance assessment – lists nine “must do” priorities, originally listed in 2016/17 and will remain in place for 2017/18 and 2018/19.  These must be delivered within the financial resources available each year
  • Developing operational plans and agreeing contracts for 2017-19
  • Finance and business rules – submission of local finance plans illustrating achievement  financial balance within available resources
  • Specialised services and other direct commissioning- new framework enabling STPs to contribute specialised care to population based health services and outcomes
  • Commissioning in the evolving system – continued evolvement of CCG ‘s role
  • System-wide set of changes in order to ensure NHS can deliver the right care in the right place with optimal value
  • Working with local government/patients/communities and creating wider partnerships with the third sector

List of annexes to support guidance.

  • Annex 1 – The Government’s Mandate to NHS England 2020 goals
  • Annex 2 – The CCG Improvement and Assessment Framework
  • Annex 3 – NHS Improvement Single Oversight Framework
  • Annex 4 – October Guidance on STPs
  • Annex 5 – NHS England and NHS Improvement approach to establishing shared financial control totals
  • Annex 6 – General Practice Forward View Planning requirements
  • Annex 7 – Cancer services transformation planning requirements
  • Annex 8 – Mental health transformation planning requirements

Primary audience: NHS/healthcare senior management, local government, third agency staff, public health staff, commissioners.

Impact on library policy/practice:

  • LKS already work collaboratively across boundaries- opportunities to expand and push to national as well as show in-house how collaborative and partnership working can benefit organisations. Initiative in working closer with LKS colleagues in relevant STP footprint
  • Opportunities to create and strengthen links with CCGs’ as their role evolves and increase
  • Support the Government’s Mandate to NHS England 2020 goals for the NHS to be the world’s largest learning organisation via the provision of resources to enable staff to deliver the required recommendations
  • Support/ provide evidence requests for information on service reconfiguration/collaboration, operational topics / efficiency savings

Date last updated: November 2016

Due for review:  November 2017

Group member responsible: LK

My name is Leanne and I used the MAP project plan template

Even though I have been involved with the MAP Toolkit since 2013 (I presented at HLG 2014 dontcha know) and I love it, I have always been a bit apprehensive of synthesising drivers/writing up case studies/using project plans. It’s all to do with the language (and a fair helping of imposter syndrome) and the fact that I feel intimidated by the terminology/language and what I believe are the requirements for synthesising drivers/writing up case studies/using project plans. Am I clever enough to write case study? What would be a useful topic for a case study? And then there is the age old problem of thinking you need something spectacular to write about because everything else is ‘part of the job’ and we are just getting on with it. Could I write a project plan? Am I the type of person to use a project plan? If I was to do a project plan for a work based project do I need to worry when I start to project plan my non work life?

The other day I really needed to get some thoughts down on paper about something that was spinning out of control in my mind. I’ve been part of a fairly meaty discussion lately which has taken on a juggernaut type life of its own and the initial thing I wanted to do has grown massively to incorporate things that didn’t even feature on my radar (but did on other peoples).

So, I took a journey out of my comfort zone, stopped off at the MAP Toolkit, clicked on the ‘Ideas Capture’ tab and downloaded the project plan template. And I filled it in. And I actually enjoyed it. And it focussed my thoughts. And it made me think of the ‘bigger picture’. And it helped me get perspective. And when I shared it with other people it helped generate a great discussion. This discussion has resulted in the project plan being re-written to include a wider catchment of ideas.

And I would definitely use it again. And it turns out that yes, my name is Leanne and I AM the type of person who would use a project plan…..

 

10 big questions for STPs. One big question for LKS

Source:  Knowledge for Healthcare blog post by Imrana Ghumra and Sue Lacey Bryant

Link to main document:  

Publication format:  Blog post (Knowledge for Healthcare)

Date of publication: 12th May 2016

Summary of driver:

This blog post discusses the Sustainability Transformation Plan (STP) as outlined in the NHS Five Year Forward View Shared Planning Guidance.

STPs will be the driver for change and transformation in healthcare between 2016-2021. Priorities and requirements have been rounded up into ’10 big questions’.

Links to relevant information such as the 44 STP footprints, a more detailed briefing of the ’10 big questions’ and an introductory presentation and action planning grid are embedded in the blog post.

The post rounds up with one BIG question for LKS- how can we help?

Key features of driver:

Local Workforce Action Boards (LWABs) have been set up and  are responsible for delivering 4 key pieces of work, starting with an action plan that covers the ’10 big questions for STPs’ which as listed below.

  • How are you going to prevent ill health and moderate demand for healthcare?
  • How are you engaging patients, communities and NHS staff?
  • How will you support, invest in and improve general practice?
  • How will you implement new care models that address local challenges?
  • How will you achieve and maintain performance against core standards?
  • How will you achieve our 2020 ambitions on key clinical priorities?
  • How will you improve quality and safety?
  • How will you deploy technology to accelerate change?
  • How will you develop the workforce you need to deliver?
  • How will you achieve and maintain financial balance?.

Primary audience:  All healthcare and NHS senior management, all NHS staff, local government, Health Education England, DoH.

Impact on library policy/practice:

  • The opportunity to link in with senior management and highlight their information needs and find out what information people need to move forward with their STP.
  • Ideal opportunity to promote time saving resources such as current awareness and LKS evidence searches.
  • Possibility of collaborative purchasing opportunities with other LKS both within and outside relevant STP footprint for resources purchasing to deliver financial savings and fitting in with Knowledge for Healthcare.
  • Once STP is finalised continue to maintain and feed new relationships with senior management and LKS colleagues.
  • Opportunities to showcase how LKS can support  innovation and change, such as  knowledge management skills and running simple KM events to encourage knowledge sharing, e.g randomised coffee trials and knowledge cafes
  • LKS can be an information hub on STPs for patients/carers on site, as well as connecting with public library colleagues.
  • Possible provision of LKS for the Local Workforce Action Boards.

Date last updated: May 2016

Due for review: May 2017

Group member responsible: LK

 

Mind the Gap: Exploring the Needs of Early Career Nurses and Midwives in the Workplace

Source: Summary report from Birmingham and Solihull LETC Every Student Counts Project. Published by Health Education England.

Link to main document

Publication format: PDF

Date of publication: May 2015

Summary of driver: This is the report of a project looking at recruitment and retention of early career nurses and midwives (currently consisting of Generation Y). Research was conducted among final year students and newly qualified staff showing that early career nurses and midwives wanted, among other things, clear progression pathways, care and support from team leaders, spiritedness, meaningful work, developmental support and flexibility to achieve work-life balance.

It also looks at the differing needs of four different ‘generations’ of nurses and midwives (Baby Boomers, Generation X, Generation Y and Generation Z) in terms of support required for their career, and also the differing values, expectation and motivations of each generation. Generation Z are those just entering higher education now, born after 1995, so will be entering the workforce shortly.

Key features of driver:

  • Overviews of the characteristics of each generation as infographics
  • More detailed information about the workplace needs of Generation Y (born 1980 – 1994) who make up 35% of the NHS workforce

Primary audience: Health Education England, employers and education providers

Impact on library policy/practice:

It’s difficult to pinpoint specific implications for library services, as the report is focused on the work environment, and the generational cohort descriptions are very stereotyped. It may be that characteristics shaped by differing learning styles may have a bigger impact for us.

Date last updated: August 2016

Due for review: August 2017

Group member responsible: JC

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