Interim NHS People Plan

What does this mean for libraries? 

Increasing use of technology and scientific innovation can transform care (p.5) and LKS can support this through current awareness services to alert staff to new developments, and through knowledge management to enable sharing of knowledge and best practice.

Libraries can provide access to evidence, for example through evidence searches, to evaluate and support the introduction of new technologies and ways of working, to help create a culture where digitally supported care is the norm (p.52).

There will be a need to help NHS staff gain new digital skills to help transform care pathways and clinical practice, and enable more efficient ways of working (p.5). While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

Increases in student numbers as urgent workforce shortages such as in nursing are addressed (p.5) may require the introduction of new services to support them whilst on placement with NHS organisations, and may require LKS to work more in collaboration with university library services. Libraries support lifelong learning and continuing professional development of the whole workforce, and this will be key as technology changes and careers become more flexible (p.30) and will support the retention of staff.

The move toward Integrated Care Systems (ICSs) may have implications for the way library services are organised locally, and there may be a need to greater collaboration and partnership across a whole ICS. There will also be more partnership working between ICSs and local authorities that may lead to greater collaboration with public library services. It is expected that ICSs will become the main main organising unit for local health services by 2021 (p.55).

Source: NHS England

Link to main document

Date of publication: June 2019

Summary of driver:

The Interim NHS People Plan sets out the vision for 1.3 million people who work for the NHS to enable them to deliver the NHS Long Term Plan, with a focus on the immediate actions that need to be taken.

It argues that work will be much more multidisciplinary, people will have more flexible and less linear careers, and technology will enable people to work to their full potential. People want a better work/life balance.

The plan is organised around several themes:

1. Making the NHS the best place to work

There is compelling evidence that the more engaged staff are, the more effective and productive they are. Staff report not having enough time, and sickness absence is higher than in the rest of the economy. The NHS needs to become an employer of excellence.

The report sets out actions to attract and retain staff.

2. Improving our leadership culture

Leaders need to develop a positive, compassionate, inclusive and people-centred culture.

3. Addressing urgent workforce shortages in nursing

Although there are shortages in lots of NHS professions, nursing is seen as the most urgent challenge.

4. Delivering 21^st century care

The NHS Long Term Plan sets our priorities such as increasing care in the community, redesigning and reducing pressure on emergency hospital services, more personalised care, digitally enabled primary and outpatient care and a focus on population health and reducing health inequalities.

This requires continued growth in the workforce and its transformation to one that is more flexible and adaptive, has a different skill mix and – through changes in ways of working – has more time to provide care.

The workforce needs to be ready to exploit the opportunities offered by technology and scientific innovation to transform care and release more time for care.

5. A new operating model for workforce

Workforce activities need to happen at the optimal level – whether national, regional, system or organisational – with the expectation of an increasing role for integrated care systems (ICSs) as they develop.

The Plan starts to set out how the principle of subsidiarity will apply to people-related functions by setting out what functions can potentially be carried out at which levels.

6. Immediate next steps

The Plan focuses on the urgent actions that need to be taken over the next year, and a full People Plan that cover five years is still being developed.

At the end of the Plan is a table detailing all of the proposed actions, who will do them, and the timescale.

National survey of local innovation and research needs of the NHS

What does this mean for libraries?

• Libraries can actively look to disseminate information about national or local research and innovation projects to their users / organisation through current awareness services, literature searches or in specific focused events or activities to raise awareness.
• This could be an opportunity to establish links with local research & development departments to establish which subject areas are of interest so current awareness services or bulletins addressing those topics can be provided; and raise awareness within the research and development team of the library’s ability to assist with literature searches, access to information databases, and searches for grey literature.
• Libraries could host research coffee mornings or similar as meeting opportunities for researchers and those interested in innovation in their organisation to meet up and discuss potential projects, and lessons learned from failed projects.
• Libraries could find out about their local regional Academic Health Science Network and disseminate to their organisation / service users information about what projects the research network is currently running.

Source: AHSN (Academic Health Science Network)

Link to main document

Date of publication: April 2019

Summary of driver:

This report summarises the national findings from a survey to identify local NHS innovation and research needs in England.

The views of local health stakeholders, including clinical leaders, managers and directors, within each AHSN (Academic Health Science Network) were sought.

There were some differences in regional priorities, but common themes emerged that reflected wider challenges facing the NHS and align with the NHS Long Term Plan.

These include a need for innovation and research addressing:

• workforce challenges
• delivering mental health services and providing care for patients with mental health needs
• integrating services to provide effective care for patients with complex needs – including multi-morbidity and frailty.
• research into the needs for specific patient groups – people with mental health conditions, older people and socially-isolated people.
• using digital and artificial intelligence technology.

The survey also asked about respondents’ ability to access innovation and research in their region and confidence in implementing it.

The survey identified where research existed in the respondents’ priority areas, using it and implementing the research were identified as potential problems.

Improvements in communication and dissemination of information were identified as improvements needed to raise awareness of research and innovation; whilst sharing knowledge was identified as important for improving the application of innovation and research.

NHS Long Term Plan

What does this mean for libraries?

Increases in demand from students, such as nursing students on placement in NHS organisations, and increases in medical student numbers will have an impact on the workload of LKS, and may require the introduction of new services to support them, such as having access to good WiFi or lockers, and more collaboration with university library services.

A move towards more Integrated Care Systems, and potentially more collaborative working under the auspices of Sustainability and Transformation Partnerships (STPs) could have implications for LKS that have SLAs with only some local organisations, and more work may need to be done to encourage organisations that currently don’t contribute to LKS to do so, so that all staff in an area have equitable funded access.

LKS are ideally placed to help get better value for the NHS and get the most out of the investment in it by making the evidence base accessible and encouraging its use and application. It could be a good opportunity to promote time saving services such as current awareness and mediated evidence searches. LKS can also support innovation and change through encouraging and supporting knowledge management.

There may be a need to help NHS staff become more familiar with digital systems, particularly to help retain staff that are less confident with IT. While some areas are more difficult for LKS to provide training in (such as patient records) there may be areas that we can help with, such as helping staff become familiar with mobile devices and the use of apps.

With the focus on preventing illness, LKS will have a role to play in supporting the provision of good-quality health information for patient and carers.

Katie Nicholas of Health Education England has prepared a useful summary of references to evidence, knowledge, innovation and Topol in the NHS Long Term Plan.

Source: NHS England

Link to main document

Date of publication: January 2019

Summary of driver:

This is the first stage in planning for the next ten years of the NHS in England. Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) will have until the autumn to say how they are going to implement the plan locally.

It is said to be ambitious but realistic.

There are three main areas of health and care this plan aims to tackle:

1. Making sure everyone gets the best start in life

This includes taking further action on childhood obesity, increasing funding for children and young people’s mental health, reducing stillbirths and mother and child deaths during birth by 50% and delivering the best treatments available for children with cancer, including CAR-T and proton beam therapy.

2. Delivering world-class care for major health problems (both physical and mental)

This includes preventing 150,000 heart attacks, strokes and dementia cases, spending at least £2.3bn more a year on mental health care, delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24, and saving 55,000 more lives a year by diagnosing more cancers early.

3. Supporting people to age well

This includes increasing funding for primary and community care by at least £4.5bn, bringing together different professionals to coordinate care better, developing more rapid community response teams to prevent unnecessary hospital spells, and speed up discharges home and upgrading NHS staff support to people living in care homes.

The planned means to do this include:

1. Doing things differently

This includes encouraging more collaboration between GPs, their teams and community services, as ‘primary care networks’, to increase the services they can provide jointly, and increase the focus on NHS organisations working with their local partners, as ‘Integrated Care Systems’, to plan and deliver services which meet the needs of their communities.

2. Preventing illness and tackling health inequalities

This will include action on helping people stop smoking, overcome drinking problems and avoid Type 2 diabetes.

3. Backing our workforce

There are planned thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships. There will also be work to improve staff retention.

4. Making better use of data and digital technology

Among other plans, there will be a new NHS App, better access to digital tools and patient records for staff.

5. Getting the most out of taxpayers’ investment in the NHS

Identifying ways to reduce duplication in how clinical services are delivered, and make better use of the NHS’ combined buying power to get commonly-used products for cheaper, and reduce spend on administration.

Making the most of the money: efficiency and the long-term plan.

What does this mean for libraries? 

This piece of research is intended to feed into the NHS long-term plan, and was an opportunity for local NHS leaders to say where they think efficiency savings can be made in practice.

As such, it reflects some of the initiatives already happening and some possible future ones, but it is not policy as yet and we will need to see which of these ideas makes it into any future NHS plans.

Source: NHS Providers

Link to main document

Date of publication: October 2018

Summary of driver:

Using feedback from Trust leaders, this reports looks at areas where efficiency savings could be made, to contribute to long-term planning for the NHS.

The three main areas looked at are cost reductions, productivity improvements, and system efficiencies.

Areas of possible cost reductions identified included reducing transactional costs, agency spends, procurement, and collaborative IT purchasing. Rising staff costs due to pay awards was identified as a cost pressure.

Productivity improvements included the Getting It Right First Time (GIRFT) programme and use of lean methodologies.

System efficiencies were seen as a potentially big contributor to savings, and this might include collaborative or integrated working, admissions reduction, use of technology to redesign pathways, Trust mergers, and new workforce roles.

Key questions for the future of STPs and ICSs

What does this mean for libraries? 

This report is only concerned with the current situation regarding sustainability and transformation partnerships (STPs) and integrated care systems (ICSs), and doesn’t make recommendations. However, it shows that 14 of the 44 STPs have already progressed to become ICSs, and 49% of Trusts agree that ICSs should replace STPs, so it shows that the directions of travel is clearly towards ICSs.

MAP has already looked at the implications of ICSs for LKS in a policy briefing on Integrated Care Organisations.

Source: NHS Providers

Link to main document

Date of publication: August 2018

Summary of driver:

Summarises recent developments in system working, including the state of play of STPs and ICSs.

It also sets out the background to the focus on collaborative working, and looks at some of the models that are emerging. There is also a look at what factors make collaboration more successful.

 A useful infographic summarises the state of play of STPs and ICSs.

Learning from deaths Guidance for NHS trusts on working with bereaved families and carers

What does this mean for libraries?

Library and knowledge services can support staff and members of the public by signposting  to the various reports that informed this document. LKS staff could work with other LKS sectors to signpost to local and national support for bereaved families and carers.

Source: NHS England on behalf of the National Quality Board (NQB).

Link to main document

Date of publication: July 2018 

Summary of driver:

The NHS is committed to creating a learning culture and using patient and public experience to drive improvements. The CQC’s report ‘Learning, Candour and Accountability’ concluded that the way trusts engage with families required significant improvement.

Personal insights and experiences have shaped the guidance and will benefit all those involved following a death. In particular, supporting staff and families after an unexpected, avoidable or traumatic death in NHS care. It has the potential to break down the ‘them and us’ culture that families and carers have experienced.

It is about improving communication and engagement with families and how the NHS learns from its mistakes. It consolidates existing guidance and provides a perspective from family members, who have experienced bereavement within the NHS.

It will help trusts and commissioners to identify where they can make improvements in how they engage with families and carers. It is also a source of information for families and carers so they know what to expect following the loss of their loved one while in a trust’s care.

This information should supplement organisations own information and resources for bereavement support for families and carers.

Guidance breakdown:

• Guiding principles
• Family involvement before a death
• Immediate actions following a death
• Case note reviews
• Information and participation in an investigation
• Access to independent advice, information and advocacy
• Family and carer participation in trust training
• Involving families in action planning an assurance processes
• Action if a family is dissatisfied with an investigation or their involvement

How is the NHS performing? June 2018

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? With services under great pressure, there is a greater need for library and knowledge services to support effective and efficient healthcare. As well as making health care provision safer, K4H impact case studies demonstrate that LKS can help make cost savings, and can support health service transformation.

Source: King’s Fund

Link to main document

Date of publication: July 2018

Summary of driver:

This is the 26^th quarterly report by the King’s Fund, and as well as looking back at what has happened over the past three months, considers the recently announced funding offer for the NHS.

• Services remain under substantial pressure – there are 4.2m waiting for consultant-led care
• There is little optimism that current A&E performance targets can be met
• Some NHS organisations are spiralling further into deficit while others are seeing their surpluses bolstered by centrally-released funding
• There are some positive signs of increased joint working between local providers and commissioners of care
• The recent announcement of a five-year funding offer for the NHS provides an opportunity to make good on previous attempts to deliver out-of-hospital services, including social care
• By March 2018 2,755 people had been waiting more than a year for treatment – the highest number since 2012/13
• The time by which 92% of patients are seen after a referral is now 22 weeks; the highest since March 2009
• GP referrals are growing at a slower rate than before but are still increasing
• Hospital-bed occupancy is at its highest level for eight years
• Emergency admissions in May 2018 were 5.6% higher than the year before
• 44% of CCG finance leads are considering extending waiting lists or reducing activity for certain elective specialties
• In March 2018 only 9 of 137 Trusts with major A&E departments me the 95% standard
• The overall 95% standard has not been achieved since July 2015
• By the end of the 2017/18 financial year the provider sector had a deficit of £960m
• The commissioning sector had an underspend of £955m due to underspending in central NHS England budgets
• Nearly two-fifths of CCGs are expecting to overspend their budgets next year
• 80% of CCGs are considering extending the number of low-value treatments and prescriptions that will no longer be funded
• 42% of Trust finance directors are expecting to end 2018/19 in deficit
• 51% of finance directors and 21% of CCG finance leads feel patient care has worsened in their area over the past year
• However, closer working through STPs and ICSs is starting to pay some dividends
• Acute Trusts account for 87% of Trusts in deficit
• The long-term NHS funding settlement, a Green Paper on social-care reform and a 10-year health and care workforce strategy – taken together – might provide the best opportunity in a decade for health and social-care services to both find some stability and use that stability as a base for more fundamental transformation and improvement.

The Topol Review: Preparing the healthcare workforce to deliver the digital future: Interim Report June 2018 – A Call For Evidence

What does this mean for libraries? 

The interim report specifically talks about the need for evidence to support the introduction of new healthcare technologies, and library staff can support the accessing and use of the evidence-base, as well as providing support to healthcare staff that wish to publish evidence.

There will be an increasing demand for knowledge resources on the topics covered by the review, to support the education of new as well as existing healthcare staff.

Some of the technologies are some years away, but there are some such as wearable technologies (for example Fitbits) that are becoming commonplace and there may be an argument for library staff to become familiar with them, or to provide loanable devices so healthcare staff can try them out. Although in most NHS organisations the IT infrastructure is not always conducive to new technologies, where it is, library staff could argue the need to support initiatives such as Skype or other video communications (such as is being done at the Mid-Cheshire Hospitals NHS Trust), or other digital technologies.

At the moment, the interim review is seeking evidence to inform the final review, and once this is published the implications for libraries may become clearer but the overall thrust of the review is that new technologies will become more dominant in the NHS, and there is a case for library staff to be given the support to become more tech-savvy so they can support the wider workforce.

Source: Health Education England (HEE)

Link to main document

Date of publication: June 2018

Summary of driver: This is an interim report of a review commissioned by the Secretary of State for Health and Social Care to look at technological developments and how they impact on the future workforce.

In particular, the review will be looking three themes: genomics, digital medicine, and artificial intelligence (AI) and robotics. These are likely to change the roles of healthcare staff, and the report is concerned with the skills required to use these technologies, and which professions will be most impacted by the changes. It is also concerned with the education and training needs of current and future NHS staff.

The review proposes three key principles to govern the future workforce strategy. Firstly, patients should be empowered to use new technologies to be more actively involved and engaged in their care. Secondly, the introduction of any new technology needs to be supported by robust evidence. Thirdly, new technologies should free up more time for care and enhance the patient-clinician relationship.

Evidence and comments are being sought from those interested in workforce education and development, with a view to informing the Final Report which is planned to be presented in December 2018.

The Government’s Serious Violence Strategy: Policy Briefing

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? 

Whilst this driver will be implemented at a national level, there are some things libraries can do to support it

• The opportunity to deliver evidence and knowledge to teams experiencing issues with the impact of serious violence
• Opportunity to link in with other sectors to raise awareness of the strategy

Source: HM Government

Link to main document 

Date of publication: April 2018

Summary of driver:  This document illustrates the Government’s approach to address the rise in serious violent crime in the UK. It outlines proposals with education, health, social services, housing, youth services and victim support in order to achieve this. The overarching message in this strategy is that tackling serious violence is not a law enforcement issue alone and it requires cross sector working involving a range of partners. In particular, it needs the support of communities thinking about what they can themselves do to help prevent violent crime happening in the first place and how they can support measures to get young people and young adults involved in positive activities.

Making sense of integrated care systems

Title: Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England

A policy briefing is available for LKS staff to share in their organisations.  Produced by the JET Library at Mid Cheshire Hospitals NHS Foundation Trust.  Feel free to reproduce it (with acknowledgement).

What does this mean for libraries? 

• Share this resource with colleagues who are involved in the creation of integrated care systems, integrated care partnerships, accountable care systems and accountable care organisations.
• There may be an opportunity to deliver evidence and knowledge to managers, commissioners and transformation teams as health care services undergo this change.
• As organisational boundaries blur and take a ‘whole population’ approach, LKS may be required to adapt their service delivery models accordingly.
• If healthcare moves away from a competitive structure and towards a collaborative one, there will be many opportunities relating to knowledge management that could support the sharing and dissemination of good practice, innovation and organisational knowledge.
• LKS will have to consider how the negotiation and procurement of resources needs to adapt to reflect the changes in organisational structures.
• There is a clear role for technology in supporting the emergence of integrated care systems and Accountable Care Organisations that presents an opportunity for digitally enabled LKS.

Source: King’s Fund

Link to main document 

Date of publication: February 2018

Summary of driver:  Crucially, this document indicates that the first wave of 10 “shadow accountable care systems” being supported by NHS England have been renamed Integrated Care Systems. This name describes more accurately the work being carried out. The long read outlines that integrated care is being tackled differently in different places and a variety of terms are being used. For the purpose of this document, the following are defined as being the main 3 approaches to integrated care:

• Integrated care systems (ICSs)
• Integrated care partnerships (ICPs)
• Accountable care organisations (ACOs)

The document also outlines the new care models, provides an update on the 10 integrated care systems, discusses the controversy around ACOs and privatisation, future developments and concludes by providing support for the approach.