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.

Leadership in today’s NHS: delivering the impossible

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? 

Opportunity to support the increasing demand for knowledge resources related to sustainable leadership.

Source: King’s Fund

Link to main document 

Date of publication: July 2018

Summary of driver:

This report is based on a survey of NHS trusts and foundation trusts carried out by NHS Providers in 2017. Consisting of qualitative interviews and a roundtable event with frontline leaders and national stakeholders, the survey showed that leadership vacancies are widespread and that a culture of blaming individuals for failure is making leadership roles less attractive. The report also highlights the widespread challenges in meeting financial and performance targets as demands on services continue to increase. The challenges facing leaders of NHS trusts have changed and there is now a greater emphasis placed on working collaboratively as part of more integrated health and care systems.

 

Developing People – Improving Care: A national framework for action on improvement and leadership development in NHS-funded services.

Title of driver: Developing People – Improving Care: A national framework for action on improvement and leadership development in NHS-funded services.

Source: National Improvement and Leadership Development Board

Impact on library policy/practice:

• Library staff should take up the opportunity to attend training which their organisations provide, to develop leadership and talent management skills for the benefit of themselves, their library services and for when working with other libraries and services in wider projects.

• There may be increased interest in the resources the library can provide to support the in-house development of leadership, talent management, systems leadership skills and training courses. Some libraries may wish to expand their collections in these areas.

• Libraries may be able to highlight how their provision of literature searching skills training, literature search services and inter-library loan services can ease access to leadership and improvement resources; which the framework indicates can be difficult to access.

Link to main document:

https://improvement.nhs.uk/uploads/documents/Developing_People-Improving_Care-010216.pdf

Summary: https://improvement.nhs.uk/uploads/documents/10591-NHS_-Improving_Care-Summary.pdf

Publication format: PDF

Date of publication: 1 December 2016

Summary of driver: This is the framework developed by 10 organisations that form the National Leadership and Improvement Board, to guide the development of compassionate leadership, systems leadership, quality improvement and talent management skills amongst NHS staff.

This is the first version of the framework – further regular updates are envisioned.

Key features of driver:

• This is a framework for developing the skills of NHS funded staff at all levels, in clinical and non-clinical roles; and will in future include social care staff.
• The focus is on developing leadership and improvement skills and knowledge to close gaps identified in the NHS Five Year Forward View:
  • Systems leadership, for cross boundary working and joining up healthcare systems,
  • Quality improvement methods knowledge
  • Compassionate and inclusive leadership
  • Talent management

• The ultimate aim is that these capabilities will later be represented in senior leadership and management teams.

 

• These skills should result in continuous improvement of the healthcare system, patient care, improve population health and value for money, and will develop future leaders.

• Local organisations are tasked with reviewing their people development strategies, priorities and budgets so that these capabilities can be developed; primarily by: using their existing funding, developing training in-house and sharing knowledge and experience amongst themselves.

• National oversight bodies see their role as providing to support, supporting structures and schemes, and guidance for the development of these skills.

• The framework lays out a series of actions for the next 12 months and for 1 – 3 years’ time for national oversight bodies to provide this support, build networks and develop national leadership and management schemes. These actions are mainly for: NHS England, Health Education England, NHS Leadership Academy, NHS Equality and Diversity Council, NHS Improvement, Care Quality Commission, Department of Health and the National Improvement and Leadership Development Board.

Primary audience: Senior managers in NHS organisations and partners, and the organisations making up the National Leadership and Improvement Board.

Date last updated: February 2017

Due for review: February 2018

Group member responsible: FG

Implementing the NHS five year forward view: aligning policies with the plan

Source:  Link to main document: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/implementing-the-nhs-five-year-forward-view-kingsfund-feb15.pdf

Publication format:  PDF (36 pages)

Date of publication: February 2015

Summary of driver: This is the implementation plan for the NHS Five Year Forward View, which was published October 2014 and proposes major change within the NHS over a five year timeframe. The implementation plan describes why the changes need to be made, makes practical proposals to remove barriers to healthcare and how the new implementation models can be supported. The report highlights the levels of funding required to meet this vision and the need for the NHS to have high-quality and consistent leadership.

Key features of driver:

The document lists four key drivers, each with recommendations for action and finishes with a summary of recommendations

How services are commissioned and paid for

• Innovations in commissioning and contracting – NHS commissioners to be supported by national bodies in order to achieve this
• Importance of investing in the development of system leaders
• Development of federation/networks/super partnerships (multispecialty community provider) to enable general practices to deliver a wider range of services
• Provision of proactive care in the community
• Integrated commissioning- combining CCG and NHS England funding
• NHS commissioners to work with interested general practices as pilot MCPs.
• Formation of primary and acute care systems- single organisations to provide NHS services (GP/hospital/mental health/community care) running as virtual or physical organisations
• Innovation in payment systems- capitated budgets/pooled budgets/integrated personal commissioning

How the NHS is regulated

• Improvements in quality of health and social care- CQC to survey patients and service users
• Whole-system intervention regime to support challenged health economies
• NHS England and Monitor should review current rules on procurement and tendering to enable creation of new care models
• Opportunity for local areas to have access to central legal advice

How improvements in care are delivered by local leaders

• Development of leaders at all levels in the NHS
• Providing all NHS staff with the skills and support requires to improve patient care
• Every NHS organisation to take responsibility for the development of leaders and providing staff with skills in quality improvement
• National bodies to develop explicit strategy for quality improvement
• Currently most NHS leaders are organisational leaders and the Five Year Forward View is aligned with system leaders
• Provider leadership- outlined in the Dalton review

How might a transformation fund contribute?

• King’s Fund has argued for a transformation fun d to help provide financial support through change
• Prime role is for transformation fun to pump-prime new care models whilst existing models are decommissioned
• Important to recognise that some health economies may gain, some may lose and new organisations may be created
• Looking to how mental health moved from hospital care to community services and lessons learned

Where next?

• Care models set out in the Five Year Forward View are a starting point and not the end of the story
• Commitment to real-time evaluation and learning
• Creation of vanguard sites to fast-track new care models
• Imbalance between the opportunities offered by the Five Year Forward View and the current situation of financial deficits/A&E pressures/waiting time performance
• National bodies have the responsibility to reinforce the idea that the delivery of the Five Year Forward View is as important an operational performance

Primary audience: NHS England, NHS Commissioners, NHS Providers

Impact on library policy/practice:

None of drivers are specifically aimed at libraries but there opportunities for libraries.

• The recommendation for ‘Leadership and improvement expertise’ when referring to the NHS becoming a learning organisation states ‘national support for improvement being provided through small teams of credible experts’. We are the credible experts in our field (p20).
• Vision of NHS becoming a learning organisation (as outlined in Berwick report 2013) is a great opportunity to expand and promote our skill sets and services (p20).
• Providing all NHS staff with the resources required to update their skills – literature search training/critical appraisal training/how to access information online, I order to improve patient care.
• Undertake literature searches on the relevant subjects and promote current awareness on leadership and community topics.
• Possibility of keeping GPs engaged with library and knowledge services.

 

Date last updated: February 2015

Due for review:  December 2016

Group member responsible: LK

State of Care 2013/14

Source: Care Quality Commission (CQC)

Link to main document 

Publication format: PDF (90 pages)

Date of publication: October 2014

Summary of driver: This is the fifth annual CQC report on the state of health and care services in England. It shows that shows there are many excellent health care services but the variation in quality in England is unacceptably wide.

Key features of driver:

• CQC’s tougher, people-centred, expert-led and more rigorous inspections are seeing some outstanding care and we have already rated many good services.
• The report also finds care that is inadequate or requires improvement. The variation in the quality of health and adult social care is unacceptably wide.
• The principle of keeping people safe from harm is fundamental. Too many providers have not got to grips with the basics of safety. Of the first NHS acute hospitals rated, eight out of 82 were rated inadequate for safety, and 57 were rated as requires improvement for safety. (It is important to bear in mind, though, that the early inspections of acute hospitals under the new CQC approach mostly focused on those that were deemed higher risk. This picture is not representative of acute hospitals across England.)
• Strong, effective leadership at all levels within an organisation is vital. Strong, effective leadership drives up quality and safety overall.
• There is a mounting financial challenge in health and adult social care. But this should not excuse inadequate care. Providers must learn from the outstanding examples of others who have the same resources.
• The CQC challenges providers and the care system to accept where there are problems and to use our inspections to drive up care quality.

A summary and infographic of the report findings are also available.

Primary audience: All health and social care providers in England, members of the public and other stakeholders.

Impact on library policy/practice: Leadership is identified as a key theme in this report.  Libraries are in a position to support the educational requirements of those healthcare professionals undertaking development to improve their leadership skills.  Libraries are a knowledge hub; we can ensure that the best clinical and management knowledge is easily available to decision-makers in the organisation, in order to tackle the challenges identified in this report, particularly around quality of care and safety.  Libraries are ideally placed to identify and disseminate best practice that can assist health care organisations in providing quality care with limited resources.

Date last updated: February 2015

Due for review: February 2016

Group member responsible: VT

White Paper: the new era of thinking and practice in change and transformation

Title of driver: White Paper: the new era of thinking and practice in change and transformation: a call to action for leaders of health and care

Source: NHS Improving Quality

Link to main document

Publication format: Available as PDF and e-publication

Date of publication: July 2014

Summary of driver:

This paper examines trends in change and transformation from multiple industries, and argues that change needs to happen at a faster rate and become more disruptive.

The paper tries to identify the implications and opportunities for leaders of health and care, including embracing disruption and ‘disruptors’ to create an environment where innovation is encouraged. It provide leaders of change with 15 actions to support change, and makes available ideas, opinions, research and resources about the future direction of change.

Key features of driver: 

The paper asks several questions about organisational and system change, including:

• Who does it (many change agents, not just a few)
• Where it happens (increasingly ‘at the edge’ of organisations and systems)
• The skills and mindsets that change agents need

The paper also includes four case studies:

• Living Well in Cornwall and the Isles of Scilly – Striving for a collective humility in finding a way to work together for the person’s benefit
• A grass-roots movement sparked by students coming together to prevent avoidable pressure ulcers
• The NHS Change Day ‘hubbies’: a voluntary self-organising network of local leaders
• The School for Health and Care Radicals – teaching change agents to rock the boat and stay in it

Primary audience: Leaders in health and care

Impact on library policy/practice:

One of the five enablers of the ‘emerging direction’ in change outlined in the paper is ‘Curate rather than create knowledge’. It suggests that improvement leaders will need to become curators of knowledge (collecting, filtering, evaluating, contextualising and sharing knowledge from multiple sources) and this will include more tacit knowledge or ‘know-how’ in future.

This might mean library staff supporting the knowledge management agenda in their organisations, or supporting leaders to use the necessary tools to curate knowledge (which could include applications such as Twitter, Storify and LinkedIn).

In one sense curation of knowledge is something we already do in literature searches, and we already teach users how to collect and filter knowledge using traditional tools such as bibliographic databases. It may be that we simply need to rebrand some of what we do, or extend it to cover new tools.

Digital skills will become increasingly important for leaders, and again this may involve library staff in providing training and support for non-traditional information resources and applications.

Date last updated: October 2014

Due for review: October 2015

Group member responsible: JC

New Evidence on Management & Leadership

Source: Health Services and Delivery Research Programme

Link to main document

Publication format: pdf (online)

Date of publication: December 2013

Summary of driver: Publication provides key findings from 14 new studies on management and leadership practice within the healthcare

Key features of driver:

• Gaps identified in current evidence on management and leadership of healthcare called for the commissioning of research into these areas.
• Studies published in 2013 addresses key questions on the subject
• Subjects ranged from research into managerial capacity, engaging clinical staff as managers, understanding the work of frontline and middle managers, exploring the nature of leadership and the way in which managers use evidence
• The research summaries findings from the studies and why they are important. They should help organisations and individuals to understand better the ways in which effective managers improve services for patients

Primary audience: All healthcare staff with managerial or leadership responsiibilities

Impact on library policy/practice:

The library service has a key role to play in the creation and development of specialist resources to help support staff develop effective management and leadership skills

Opportunity to promote resources and services on in-house management and leadership courses and events aimed at such staff groups

Evidence-based training on specialist management healthcare databases

Opportunity to engage with staff groups and set up current awareness services for particular management topic areas

Enables library staff to foster links with learning and development staff to promote courses and seek possible funding for specialist collections

Date last updated: August 2014

Due for review: August 2015

Group member responsible: JW

Leadership Zone (Shrewsbury and Telford Hospital NHS Trust)

Project Team

Library Services Manager, Shrewsbury and Telford Hospital NHS Trust,  and both Site Librarians in collaboration with the Trust’s Leadership Academy manager.

Resources Required

Funding and space for additional bookstock, technical expertise in developing a website for leadership, staff time in developing collections and promoting them.

Timeframe

April 2012 onwards

“The Story”

In April 2012 we reconfigured some of the shelving in the Shrewsbury Health Library to create an area devoted to leadership and management books that included comfortable seating and chairs to encourage discussion and group working.

Over 170 new print books have been purchased for the collection, many based on reading lists provided by the Trust’s Leadership Academy manager, to support courses being undertaken by staff in the Trust.

More recently, over 200 e-books have been made available on a ‘patron-driven acquisition’ basis so we only buy the titles that are used, and we have begun a corporate subscription to the Health Service Journal.

In addition, we have also developed a Leadership Knowledge Centre to bring together our leadership resources.

Alignment to local, regional and national drivers

The Trust produced a leadership academy strategy (1), and employed a Leadership Development Manager in 2011, making this a high-priority.

The Leadership Development Manager in turn has promoted leadership education, and organised conferences that has increased leadership education uptake, and the need for library services to support the leadership agenda.

Several reports have stressed the link between leadership skills and better patient care, such as the Francis report about the clinical leadership failings at Mid-Staffordshire Hospital.

Partly as a consequence of this, the NHS Leadership Academy is actively promoting leadership learning for NHS staff.

1. Shrewsbury and Telford Hospital NHS Trust (2011). The Leadership Academy.

Impact of this project/service

During the period April – Septemeber 2012, issues from management books increased by 50% over the previous six months (from 747 to 1,118) and remained high with 1,064 issues in the six months to Apr 2013.

We’ve taken part in two of the Trust’s Leadership Conferences where we had a stall with management books and articles, resulting in much higher visibility for the leadership and management collections.

The Leadership Academy Manager has provided us with reading lists, and has also asked us to provide her with lists of books on leadership and coaching, along with QR codes so she can promote the lists to course attendees in the Trust.

Lessons Learned

One of our concerns was the breaking up of the standard classification sequence, and whether this would cause confusion. So far it doesn’t appear to have been a problem, but we made sure we had signposting in place, and the leadership collection books are identified with a coloured label protector.

The soft seating area has proved popular, but not with our target audience! Nursing students tend to be the biggest users of the seating area.

We would probably attract a lot more users likely to use the management collections if we could offer NHS WiFi and they could access their emails or hot-desk in the library, but this is something we have not been able to do so far.

Sustainability / next steps?

We have continued to build the physical and virtual collections of stock from our usual book budget, so it has proved sustainable.

We are gradually moving into e-books, but are offering these via patron-driven acquisition, so we only pay for what is used, but these will all be available via the catalogue so increasing the range of books available without taking up more shelf space (something we are beginning to run out of).

Contact details

Jason Curtis, Site Librarian, Royal Shrewsbury Hospital
jason.curtis@sath.nhs.uk, 01743 492507

Date case study completed:  March 2014