1

Workforce Assurance Tool Linking workforce to quality and safety

2

Contents• The need for effective workforce assurance

• Assurance framework overview

• Current assurance challenges and how the system will meet these challenges

• The intended benefits of the system

• Principles underpinning the system

• Key components of the system

• How the system can by used by different groups

• Expected levels of efforts and return to use the system

• The data that the system will have access to

• The main components of the tool

• System views, navigation and functionality

• Triggers, metrics and data thresholds

• Access to the system

• User exercises

Section 1

Background and Context

Section 2

The system and how it will work

Module 3

Intro to the Tool

3

Section 1Background and Context

4

BackgroundWest Midlands & Mid StaffordshireThe situation within the Trust was unremarkable in many ways. They needed to understand the gap between the reality within the Trust and the evidence of assurance being provided:

•Cumulative impacts were hard to spot: individual years may show nothing of concern, but over a period of multiple years concerns may be evident.

•Connections between the underlying facts need to be understood, and different lines of enquiry triangulated to gain assurance

•Patient experience has a clear link to assurance

•Staff and trainee voice really important

We also learnt from our experience that:

•False assurance is easy to achieve

•There is no substitute for going to look and see

•Corporate memory is important to understand cumulative impacts over time

3 – Tool1 – Background 2 – System

5

• The impact of workforce on patient safety and experience has increased in priority since the issues at Mid-Staffordshire.

• The Francis Report due for release in early summer and will examine why such failures in the system happen – focus on workforce skill and grade mix.

• Huge system change resulting in the move towards an NHS Operating Model for quality

• It is imperative we have a process in place to act as an early warning system.

Impact3 – Tool1 – Background 2 – System

6

The need for effective workforce assurancea. Right people, right place, right time

An appropriately sized, skilled, organised and motivated workforce is critical to delivering efficient, quality & safe services.

b. Managing RiskWorkforce assurance in the NHS is the process of managing risk and assuring that the composition of the workforce can deliver cost effective, safe and high quality care. Regardless of reforms to the NHS that result from ‘Liberating the NHS’, the need for assurance processes that review and challenge workforce plans is likely to remain.

c. Quality & SafetyWho leads this process in the new system architecture is yet to be determined but it is critical providers are given the tools to review the impact of workforce changes on quality and safety for themselves

d. Manage ChangeAssurance is needed due to the pressures and inherent risks associated with large scale workforce change from:

• Tough financial settlements – workforce expenditures represent 70% of the total NHS spend and although in recent years workforce numbers have increased inline with overall spending growth, there is now a very significant productivity challenge related to achieving the overall £20 billion national QIPP target.

• Increasing demands for services, and the challenges and focus resulting from the Robert Francis Inquiry into Mid-Staffordshire NHS Foundation Trust.

3 – Tool1 – Background 2 – System

7

The Assurance Framework3 – Tool1 – Background 2 – System

8

Section 2The system and how it will work

9Automated to reduce manual data manipulation and handling burden

Data: Utilising existing national data sources 3 – Tool1 – Background 2 – System

10

What the tool is intended for...

The Tool IS intended to provide:• The workforce element that will link with

wider system level assurance• Triangulation between workforce,

activity and finance data• A national platform to workforce

assurance that can be adapted as appropriate for each SHA

• Best practice approach that is built on existing published literature

• An approach that recognises that assurance criteria will change and be refined over time

The Tool IS NOT intended to be:• A tool to publish information• A performance management tool• A data collection tool; existing data is

used• A directorate, divisional and professional

assurance tool as other resources are available for this

3 – Tool1 – Background 2 – System

11

WAT - Core Benefits

Provide a tool and legacy for trusts so that they can self assure and pre-emptively

respond to concerns of assurers

Take a more integrated approach to assurance activities (looking across

activity, finance, quality and workforce)

Call on robust evidence and

analysis as support for key decision

makingJustify Decisions

Change the nature of assurance engagement with trust boards

and management teams

3 – Tool1 – Background 2 – System

12

Section 3:Introduction to the Tool

13

My Analysis My ResourcesMy Actions

OrganisationDashboard

MetricDashboard

Help

Workforce Assurance Portal

My Flags

Key Components

My QualitativeIndicators

My Plans

My Threads

My Notes

My Assurance Logs

Supporting Materials

Community

Data Sources

FAQ

Workforce Dictionary

3 – Tool1 – Background 2 – System

14 14

Purpose:• This component contains the primary

dashboards within the system that operate at regional, organisation and specific metric levels.

• Each dashboard highlights areas of potential workforce risk and provides functionality to allow users to drill into risk areas to see more detail.

• The dashboards also allow users to view the underlying data, and perform comparisons against peer organisations.

My analysis Regional User View

Organisational Dashboard

Metric Dashboard

3 – Tool1 – Background 2 – System

15 15

Click in any of + or – signs to expand /

contract the section

Summary scores are colour coded and

displayed against each assurance category

• It will initially present the scores against each assurance group, using the navigation users can drill down into detail on specific metrics

Organisational dashboard

3 – Tool1 – Background 2 – System 4 – FAQ’s

16 16

Contribution of this metric to the Assurance Group score

• Opening up different assurance categories allows you to drill down to metric information.

• Clicking on any of the icons provides further information on the metric.

• The icons next to each metrics indicate:• Uploaded: the values displayed have been

directly uploaded from another source• Calculated: the values displayed have been

calculated from other information uploaded.

Actual value of this metric

WeightingThings to note on adding of scores:•If there is only 1 metric then this will be the same as the trigger score (e.g. CIP example)•If there is more than one metric in the trigger then these wont necessarily equal the trigger score due to the weighting

Metrics

3 – Tool1 – Background 2 – System 4 – FAQ’s

17 17

Purpose:• Whereas the My Analysis section primarily allows you to

view information within the system, the My Actions component allows you to undertake six different types of actions within the system

Key Actions:• Logs: regional assurers can automate their process of

monthly log recording • Threads: records communications and exchange between

Trusts and regional assurers can be recorded and tracked• Quantitative Indicators: can be recorded, viewed and

edited• Notes: user specific notes can be recorded which can only

be viewed by the author• Flags: alerts and flags can be viewed and overridden.• Plan data: trust plans can be uploaded into the system• Reports: reports can be viewed and searched for my

organisation, date and scoring method

Things to note:•Not all action types are available to all users. Which actions you have access to will depend on the user profile you have.•Within the majority of the My Analysis components there are links to the actions that you may wish to take at any given time.

My Actions

3 – Tool1 – Background 2 – System 4 – FAQ’s

18 18

Purpose of My Resources:• The component provides access to a range of help

resources for the system including:• FAQs• Help files• Training Guides

• The section also provide access to the community forums / discussion groups

Purpose of Administration:• This component provides the SHA with the capability to

control security access to information in the portal based on organisational preferences and reporting agreements

• It also enables the SHA to manage the standardised list of workforce dimensions so that these can be updated should the need arise

• As a user, you will not be able to view the Administer component of the portal

My Resources and Administration

3 – Tool1 – Background 2 – System 4 – FAQ’s