Waltham Forest

Training Hub

Annual Report

2018-19

In the Network Everything is connected

The Contents Executive Summary

Introduction: Challenges 2018-19

Population 1

Population Projections 1

Local Workforce - Health & Social Care 1

Waltham Forest Focus 2018-19

Local & Regional Strategic Aims 2

Building A Sustainable Workforce 2

Impacts: WF Hub Collaborative Investments

Reflections: Lessons Learned As a CEPN

Impacts: Network Legacy & Sustainability

Appendices

Investment 2018-19 3

Investment Impacts : Ongoing 3

Notable Impacts: Retention - Professional Forums 4

Notable Impacts: Primary Care Networks 4

Notable Impacts: Nursing Strategy - GPNs 4

Notable Impacts: Rotational Nurse 5

Notable Impacts: Training = Retention 5

Leading By Example 6

Working at Scale: Physicians Associates 6

Working at Scale: One Workforce 6

Innovation 1: Innovation 1: Digital Training Hub 7

Innovation 2: Primary Care Networks Workforce Planning Toolkit 7

Innovation 3: Roles Catalogue Update 7

Integrated Learning Management System for North East London

8

Using Data & Analysis to deliver OD Change 8

Scalable, Sustainable Workforce: Joined up Working & Workforce Pipelines Strategy 8

Future Investment into WF Hub 9

Future Direction 9

Waltham Forest CEPN Annual Report 2018-19

Executive Summary

Waltham Forest Training Hub has continued to work

collaboratively across the local population footprint on workforce

transformation with local stakeholders from Local Authority,

Patients Association, Healthwatch, Primary Care Commissioning,

Local Education Institutions, Integrated Care Commissioning and

many more. Despite local and regional challenges as a result of

new health and social care system arrangements, 2018-19 has

continued to see a strengthening focus on sustainable delivery

reaching into new areas using digital transformation.

The Training Hub has embedded systematic multi-disciplinary

learning for front line staff across and is now leading

transformation using a digital solution – Digital Training Hub, as

its anchor. The platform includes a learning passporting that can

be shared across Primary Care, Social & Secondary Care

readying staff for integrated working. Waltham Forest Training

Hub is formally placed in the planning for the local Managed

Network of Care & Support framework for Waltham Forest’s

integrated care system led by system commissioning leads. Our

digital pivot includes working directly in partnership with Barts to

achieve primary and social care goals working at scale with local

partners where possible. As a result of this work we are to scope

a collaboration with Newham Training Hub to establish a possible

expansion of our skills matrix.

WF Training Hub maintains its strong year round curriculum for

front line staff based on its Skills Matrix system created in 2016-

17. This system already covers most of primary care staff

ensuring 1000+ multi-disciplinary professionals are being

supported locally. We are now working very closely with

integrated care leads to scope and flesh out a system wide offer

that includes blind spots across social care i.e. domiciliary care,

single handed workers and carers. The aim this past year was to

develop a viable digital product version of our skills matrix and

continue to build a PMO system whilst maintaining core

education training quality support for all our linked staff across

the Training Hub network.

Waltham Forest Training Hub is leading the retention support of

Physicians Associate in North East London with the

establishment of their preceptorship. The programme aims to

socialize the new role into Primary Care but also the wider

system.

The Hub continues working with commissioner’s i.e. palliative

care & integrated care to look at how employment models can be

created for these new roles to secure their long-term pipeline.

Various workforce forums continue to be supported and

developed. In the past year the Hub has created the

establishment of a Care Collaborative Group Forum for social

care managers and firmly established North East London

Sessional & Salaried GP Forum. The Hub’s GP Education Lead

is supporting this group which we hope will yield a pipeline of

long-term committed local East London GPs.

On-going investment in late 2018 from Health Education England

(Transformation Fund) expanded the Hub’s reach into Urgent

Care, Social Prescribing, Care Homes and integration. The

collaboration in the Hub means that it is ahead of recent

commissioning collaborative changes in the health and social

care system. Despite many challenges for WF Training Hub,

outputs in Waltham Forest continue to demonstrate the

importance of strategic partnerships in Education, Transformation

and Workforce to build quality front line staff NHS needs

resilience into the health and care system.

Throughout the year the Hub has been looking at its sustainability

with the view to establish a new hosting arrangement. The

development needs of the hub to mature into a faculty ready to

take on bigger delivery pots like GP VTS led to the creation of a

comprehensive options paper looking at various borough based

integrated hosting options. With recent publication of the Long-

term People Plan and the Long Term Implementation Plan, WF

Training & Transformation Hub continues to be an innovator that

is pre-empting national policy. Workforce Planning, recruitment

and retention are a key feature of this hub with digital elements of

set to go live.

Whilst local challenges continues for the Hub as CCGs merge,

the Hub’s presence is felt at the highest level and is seen as a

transformation enabler that needs to be properly positioned to

deliver its mandate. The hard work continues with the aim to

establish a long-term strategy based on supporting Primary Care

Networks and system integration for the out of hospital and at

home agenda. The hub continues to embrace accountability

attending two Patient Reference Groups with very positive

feedback on delivery in Waltham Forest. The Hub will be working

in the coming months to base itself in the best position to support

change and transformation in coming 4-5 years in the community.

Dr Peter Carter

Training Hub Co Chair & NELFT

Director for Medical Education (MB)

Dr Anwar Khan

Training Hub GP Education Director &

Co Chair / Education

Introduction: The Challenges 2018-19 1

Population If population growth rate would be same as in period 2011-

2014 (+1.05%/year), Waltham Forest population in 2019

would be: 282 407. Officially according to the 2017 mid-year

population estimates by the Office of National Statistics,

Waltham Forest is home to a total of 275,505 people. This is

3,150 residents more than last year and a gain of 20,000

since the 2011 Census and growing.

The median age of residents is 34 years compared to the

UK average of 40 years. Current figures are however

showing that Waltham Forest has a younger than average

population with 22 per cent of residents being aged 0 to 15

compared to 19 per cent nationally. Similar to London,

Waltham Forest also has a high proportion of young

working-age adults aged 25 to 49 (43 per cent compared to

34 per cent nationally). There are proportionately fewer

people aged over 50 living in Waltham Forest (25 per cent)

compared to the UK average (36 per cent). See table 1 for

the latest population estimates by age group. The borough is

one of the most diverse areas in the country. 48 per cent of

residents are from a minority ethnic background.

Population Projections

The Greater London Authority (GLA) 2015 round of

population projections estimate that Waltham Forest

population will increase from 274,800 residents in 2016 to

a total of 291,500 by 2021, an increase of 16,700 (6%).

The fastest growing group is projected to be those aged 50

and over. GLA produced 2013 Round of Demographic

Projections (trend based, central scenario) suggest that

the borough’s population continues to rise over the next

three decades and will reach 343,100 by 2041. This seen

as a conservative figure due to current data. The

projections suggest a distinct aging pattern with largest

increase projected for the older age groups. The number of

residents aged 65 and over is likely to double by 2041 (see

table 2 below). You can find the suite of population and

household projection produced by GLA & ONS. Waltham

Forest population not only has high levels of multiple

deprivations but it is expected to grow by more than

73,000 people over the next 10 years, one of the highest

increases of any local authority in London. Summary of

key findings where Waltham Forest compares poorly or

well against England Compared to England, Waltham

Forest has high numbers of children in poverty (estimated

at 16,800 children); 23.5% of Year 6 children are obese;

there are high numbers of statutory homeless, poorer

GCSE attainment, higher levels of violent crime and high

numbers of long-term unemployed.

Local Workforce - Health & Social Care

Waltham Forest Training Hub Skills Matrix data collection

shows 38 GP Practices in 2018-19 took up the offer of

support. There are at least 800+ staff working in these

Primary Care settings alone. WF Hub Skills Matrix data

shows there are 185 GPs, 379 Administrators, 64 Nurses

(various levels), 6 Pharmacists, 27 Health Care Assistants

working in our local Practices. More work is being done in

WF to support GPN growth.

Skills for Care Summary of Adult Social Care in Waltham

Forest overview of employment information of the

domiciliary care workforce in Waltham Forest CCG area,

2018 shows in Waltham Forest area, there were a total of

4,400 adult social care jobs in 2017/18 across the local

authority and independent sectors. Of these, 41% (1,800

jobs) were within domiciliary care services. All 1,800

domiciliary care jobs were within the independent sector.

Around 87% (1,600) of domiciliary care jobs in Waltham

Forest CCG were direct care roles. This includes senior

care workers, care workers and support and outreach

roles. A further 9% (150) were managerial roles, including

senior managers and registered managers.

See table 1 below for the latest population estimates by age group.

Table 1 – Mid-2015 population estimates by broad age group

Source: Office for National Statistics

Waltham Forest Focus 2018-19 2

Local and Regional Strategic aims

Waltham Forest Training Hub is clear that it must work in

alignment with national Workforce Strategies- Interim People

Plan supporting new roles across Primary Care Networks but

also taking into account local strategic workforce

transformation aims. North East London Training Hub Alliance

has been formed to support this strategy.

Health Education England Priorities North East London

2017 -19 & Alignment with GPFV & LTP Workforce Strategy

The original strategic directives for NEL continues to be very

pertinent:

1. Retention of workforce

- GPs, Nurses, Admin, New roles 2. Clinical skills development

- MDTs, Pharmacists, Nurses, GPs, Medical Assistants 3. Apprenticeships and widening participation

- Health & Social Care Careers Pathways and new roles - New employment models / new models of care

4. Primary and secondary care interactions -Urgent Care, Integration and Social Care etc.

5. Empowering carers and communities 6. New ways of working 7. ‘Recognize, Rethink, Reform’ for Nursing

- 10 Point Plan local Implementation

Clinical Commissioning & Intergraded Care - Borough

Council 2017-19 Local Commissioning Outlook:

Commissioning Strategic Plan (CSP) & Primary

WF Hub/CEPN continues to feature in the borough’s local

CSP. The annual business review of CCG Commissioning

states WF CCG is committed to Education & Training for the

system, “WF CCG will continue building on established links

with HENCEL, the London Education and Training Boards and

the local Community Provider Education Network to ensure

local workforce is trained with skills that meet the needs of the

local health economy”. These local markers include:

1. Improve primary care services to deliver better health outcomes for our local population

2. Improve patient access to and experience of primary care services

3. Ensure effective community engagement to help support the delivery of patient centered care

4. Maximize clinical engagement, ensuring strong leadership across all primary care services

5. Embrace technology and ensure that the primary care infrastructure is fit for purpose and support patients to self- manage

6. Enable practices to work collaboratively to support the delivery of integrated Care.

Building A Sustainable Workforce

With recent regional change, Waltham Forest Hub has in the last

12 months reviewed activities to reaffirm as well as establish its

principles to secure longevity. The local hub has worked hard with

its stakeholders to using a strategy paper to review next steps.

CCGs are the fourth attempt at increasing the involvement of

clinicians in the planning and commissioning of local services.

Commissioning was introduced into the NHS in the early 1990s,

when the purchasing of healthcare services was separated from

their delivery. Since then there have been several changes to the

structure of NHS commissioning organisations and their

population coverage, reflecting the tension between balancing

commissioning at scale and remaining responsive to local needs.

Refined Principles WF Training Hub in 2018-19:

1. Putting People/Patients at Centre of Care through

workforce transformation

2. Workforce & OD delivery support for Primary Care

Networks (PCNs)

3. Continuing to value and develop all front staff

4. Acknowledging on-going relationships and

partnerships across normative boundaries i.e. social

care, managed network of care.

5. New models of care collaboration to advance

innovations and improve analysis i.e. Patients Health

watch, Commissioning.

Priority areas for improvement for WF Training Hub: 1. Reporting growth and transformation – visibility

2. Organisational Development – retaining and growing

staffing levels during difficult transitions

3. Establishment of new employment models for new

roles

4. Evaluation – to inform continuous improvement, and

improve our case for funding (QI)

5. New hosting model/ arrangements achieved

6. Taking an Organisational Development perspective

on the outcomes we’re trying to achieve e.g. being

open to challenging traditional roles and hierarchies.

WF CEPN Priorities agreed against 2018-19 Investments (Transformation Fund, Operational Plan, Nursing, Network Development)

1. WF Hub as local enabler for STP & LTP

2. WF Hub as driver of local deliverables

3. WF Hub leading Primary Care Collaboration

4. WF Hub leading Integrated Care Collaboration

5. WF Hub as a Workforce Systems digital innovator

6. Education & Training Champion

7. Increasing/Maintaining GPN numbers

Impacts: WF Hub Collaborative Investments 3

Investment 2018-19 WF Hub total investment from HEE was an income of £437,000.

This combined operational costs. It also includes the pooled

funding income raised by the skills matrix pilot round 3 at £40k –

this is a new fee set in place to get sites to invest in their Training

Hub and pool funds (£50 per head for the FY).

Description Source Income

GPN Placements x8 + new HEE £289,000

Operational Investment HEE £100,000

Nursing Hub Transfer HEE £10,000

Skills Matrix - Pooled Community £38,000

Additional In-year Placements HEE/ STP Variable

Total at end of FY (capture) £437,000

Investment Impacts – ongoing North East London (NEL) and the North Central London (NCL)

Sustainability and Transformation Plans (STPs) have had

significant focus on the care closer to home agenda. In order to

deliver on the visions set out in the STPs, Health Education

England (North Central and East London) made available

£250,000 transformation fund to each hub in 2017-18 to enable

consistent improvements in primary care education and training

and additional operational funding to help maintain this. This

investment continues to impact the local system with

implementation into 2018-19. Where funded projects where unable

to gain traction, with local collaborative engagement this was

reinvested into the wider Training Budget for all skills matrix staff

or for the expansion of projects i.e. support for growing Clinical

Pharmacists or Portfolio GPs.

Various workforce related projects like Care Academy Apprentice

Pipeline, and upskilling projects including service re-design training

support for Pharmacists and Quality Improvement of Staff in

Primary Care. However the Training Hub also where possible,

continued to add value including the support for digital

enhancements and cross sector working with health watch.

2014/15 2015/16 2016/17 2017/18 2018/19

Total population 265,800 269 000 274,800 275,505 275,505

Total number of trained nurse mentors in general practice N/A 26 33 36 35

Total number of sign off mentors (inclusive of GPNs) N/A 26 33 36 35

Number of pre-registration nurse placements in the geographic area now covered by the Hub (how many nurses have been trained)

N/A 2 2 2 4

Number of postgraduate nursing placements in the geographic area now covered by the CEPN (inclusive of GPN and Advance Nurse Practitioners)

N/A

6 5 8 10

Total number of Physician Associates in primary care (only fill if applicable to your area)

N/A

N/A

11

TBC(4-7)

4

Number of apprenticeships in the geographic area now covered by the CEPN (health providers only – excluding Trusts who report separately)

N/A

N/A

0 (197

Potential Placements identified)

2

10

Number of school pupils undertaking work experience in primary care

N/A

N/A

N/A

15

19

Total number of medical student placements filled in primary care N/A

N/A

N/A

N/A

N/A

Total number of placements for medical assistants (General Practice Assistants/Super Administrators) filled in primary care

N/A

N/A

N/A

87

N/A

Total number of pharmacy students in primary care N/A

N/A

4

4

TBC

Total number of pre-registration pharmacists N/A

N/A

N/A

-

3

Total number of Clinical Pharmacists in primary care (post graduate learners: new category 17/18, only fill if applicable to your area)

N/A

N/A

N/A

6

8

Total number of placements for Paramedic Practitioners filled in primary care (post graduate learners: new category 17/18, only fill if applicable to your area)

N/A

N/A

1

N/A

N/A

Number of multi-professional learning opportunities as a proportion of all training running in the area (target minimum 50%)

N/A

400+

800+

2000

2000+

Number of multi-professional training places offered in the geographic area organized and/or facilitated by the CEPN

N/A

300+

1200+

2000+

2675

How many new roles have been created e.g. Nurse Associate, Physician Associates, Care Navigator, Medical Assistant, Other (for those where appropriate). It would be extremely helpful for you to specify numbers for each new role created if not referenced above

N/A

N/A

110 (NAs)

2 (CN) 11 (PA) 87 (MA trained)

110 (NA)

4 (NAs) 2 (PA)

4 (MAs)

Notable Impacts: Retention - Professional Forums

WF Training Hub now supports 7 Core professional workforce

forums/hubs for learning – GPs, NEL Salaried GPs, Nurses,

Pharmacists, Practice Managers, Care Managers, NEL

Physicians Associates and there is work buildup 1 more – for

Health and Social Care Support Workers. The Hub has

continued to support where possible the growth of these very

strong hubs that have 30-50 strong attendance rates of

sharing helping staff to see themselves as sustainability

enablers. These Hubs are strengthen by having on the Ground

Clinical Leadership from Dr Munir-Ali-Zubair and Ruth

Amartey.

These hubs are a well-recognized with the additional central

training opportunities that comes with them for peer learning

and collaboration. Through the GP Portal and the use of

online tools like Eventbrite and soon The Digital Training Hub

WF Training Hub has been able to offer a suite of multi-

disciplinary and specialist clinical leaning for our staff. An

external consultant commented, “This is one of the biggest

CEPN Events I have ever seen”. The quality improvement

has become more and more personal as peers and teaching

staff meet regularly to discuss clinical & workforce challenges.

Continued support for Training Hubs will secure a framework

in which this work can be expanded to support the wider

system in an integrated framework.

The Training is driving up the quality of care closer to home

across the health and social care system. The arrival of

Primary Care Networks It will also mean that workforce

transformation can happen at scale in larger numbers with our

local community providers. Waltham Forest has extended it

reach with the support for Sessional GPs and will be doing

work this FY to support some of these GPs to take on

permanent contracts and partnerships in North East London.

Notable Impacts: Primary Care Networks

Primary care networks build on the core of current primary care

services and enable greater provision of proactive,

personalized, coordinated and more integrated health and social

care. Primary care networks will be based on GP registered

lists, typically serving natural communities of around 30,000 to

50,000.

WF Training Hub was able to feed into the PCN narrative very

quickly. The Skills Matrix helped the local system demonstrate

that in WF, The Hubs was already established. The response to

NHSE included that the coverage of Training support to Primary

Care was such that the gap was only in the recruitment and

retention of new roles, something that would be supported by

GP Federation in collaboration with the Training Hubs. There

are now discussions taking place regarding Commissioning

Hubs in NEL to take forward the work to support PCN

development. The Training Hubs in partnership with its local

networks will be pivotal to the establishment and success of

roles being retained and recruited locally.

Notable Impacts: Nursing Strategy - GPNs 4

To date Waltham Forest has used transformation funds and

additional GPN funding to support the recruitment of 24 New to

General Practice Nurses, 4 Associate Nurse Apprentices and

another 4 support on ANPs. This has been done with 0 attrition

whilst the Nurses learn which an amazing achievement is. The Hub

has worked with system partners via its Nursing Super hub Sub-

group to continue realize additional system nursing goals identified

in HEE’s Nursing Workforce 10 Point plan an:

1. Raising profile of general practice nursing

2. Extending leadership roles to interested local ANPs

3. Increasing number of pre-registration nurse placements

4. Establishing and supporting preceptorships

5. Improving access to return to practice nursing in primary

care (we have the only one in NEL London)

6. Embedding prevention strategy via new models of care

7. Improving retention

8. Developing a career pathway for New to General Practice

Nurses (GPNs) and Health & Social Care Workers

(HSCWs).

9. Supporting return to work schemes for practice nurses

10. Supporting access to Educational Training

Waltham Forest is participating in a number of schemes across

all these areas. We have two Nurses on the NEL Leadership

Course, over 25 education specific opportunities for Nurses per

year including a thriving Nurse Forum often talked about in other

boroughs. We continue to deliver system support including the

placement of Associate Nurses in Primary Care where we

currently have 4 students enrolled. The hub continues to support

Advanced Nurses and Independent Prescribers to develop and

become strong local advocates and Practitioners.

WF CEPN Nurse Clinical Lead Ruth Amartey and Nurse

Facilitator Catherine Edmonds have been is instrumental in the

sustainability of this Programme. The have both ensured there is

a hub and spoke learning and support model in WF. They ensure

placement settings are adequate for new learners and support

Nurse Supervision where there are gaps. This framework means

when new nurses come into Waltham Forest they are greeted

with a Lead Nurse, training, consistent access to opportunities

including the chance to become leaders. We have built up the

space so that there is a clear pathway for Nurses who come into

Primary Care. The lessons applied has meant that WF Training

Hub has built a reputation for well managed recruitment

frameworks, process and tools that minimizes the risk of a Nurse

leaving not only the various programmes but the borough itself.

As a result WF is retaining 70% of Trainee Nurses to work locally

with some of them taking up positions where older Nurses have

retired.

Key Retention elements in Waltham Forest

- The development of a formal Induction Process for

various roles

- Successful Supplementary training year round (e.g.

Ear care, sexual health and contraception and travel

health)

- Newly designed systems and toolkits (e.g. tailored

welcome packs for both trainee and practice)

- Set / recommended salaries candidates.

- Having a clear post-qualification employment route

Notable Impacts: Rotational Nurse

Since April 2017, we have been working with Barts & NELFT to test

out various rotations to look at how pipelines for roles in the

community setting can be improved so that sites get more rounded

professionals. These roles sit across health and social care settings

with a number of strategic and systematic initiatives including

personalised Workforce Planning Toolkit and a New Roles Catalogue

introducing a new type of workforce and competencies to

community/primary care providers.

Task & Purpose of Rotations (Retention & Attrition)

We continue to design both observational and working rotational

placements across both Health and Social Care sites to secure

strategic direction and successes of Nursing Associate role for East

London, by exposing trainees to “open door opportunities” to them

post qualification. Nursing Super hub for BHR & WF led by NELFT

NHS Foundation Trust bravely considered rotations mini-rotations

across Primary and Social Care settings in partnership with local

stakeholders.

Rotations elements being looked at for scale

• Induction for every cohort – taking trainees through range of

teams that work across primary and community services.

• Associates are encouraged at induction to take part fully when

in their settings

• Cohorts of 8-15 placements per cohort are being looked at for

hub and spokes in 2019-20

How to recruit settings / get local involvement:

Settings were contacted to become official hosts and signed up.

Settings engaged with the scheme do so by

• Returning a signed agreement

• Signing an Honorary contract on conduct during participation

• Being open to a visit from Nurse Leads to look at the setting

suitability

• Supervisors being open to improving their support skills

• In total about 22 sites continue to work with us Health and

Social care to host 6 Practices, Medicines Optimisation Team, 6

Care homes, 6 Social Care teams

Some of the Lessons being learned

• Rotations are a great way to help staff see and experience

whole systems

• It is likely for Waltham Forest to use the rotations hub and

spoke from HEIs as a way of bringing in at all times in the year

new staff where GPN placements are deemed not viable

• Social care welcomes engagement and wants to be part of

wider pipeline initiatives so we need to build on this willingness

5

Notable Impacts: Training = Retention

WF training regime is systematic. The Hub uses data it

collects regularly to ensure that the quality of the offer for staff

for their CPD is that this is enhanced. WF Hub continues to

collaborate widely and is preparing to go more digital in the

coming months with the initial introduction of The Digital

Training Hub and then video, webinars etc. Altogether, 2292

registered and 2490 attended in total. Individually, amongst

the 96 sessions, registrations were greater than attendance for

47% of the sessions, 46% sessions had lower registrations

than attendance, and registered equalled attendees for a

small proportion of 7%.

Feedbacks have now been used to look at future training

quality and improvements including brining more modern tools

like digital registrations and automated attendance to

sessions for delegates. A majority of the Thursday Education

sessions are targeted towards GPs, Nurse and HCA training

are focused, while Skills Matrix 2018/19 covers a range of

both targeted and multi-disciplinary programmes.

We are now working hard to get the Digital Hub up and

running so that processes we once did manually to record

uptake is done electronically. The Skills Matrix has continued

to result in a Curriculum learning circuit for a range of local

health and social care professionals. Using evaluation is key

to future improvement of the learning quality which we know if

kept at a high level will help local retention of staff.

Full Deep Dive Education Report 2018-2019 Available

Reflections: Lessons Learned 6 Leading By Example

Dr Munir Ali-Zubair (GP) and Ruth Amartey (Nursing) have

continued to be a great strength for WF Training Hub. As

the day to day Clinicians on the ground challenging

education content, championing analysis of sessions, hub

development and investment into skills across the

workforce, their work is impacting leadership. Their Educator

skills is growing and they are now highly south after to take

forward strategic work from Physicians Assistants,

International GP Recruitment, Commissioning advise.

Commissioners have been tagging WF Hub Operational

Meetings as the place to come if they wish to sound off

workforce models of care. Education Leads, have now

stepped into more strategic and sustainability leadership

roles regionally. Being a Training Hub Clinical Lead is

potentially a development track for aspiring young clinicians

who want to have an Education portfolio career locally.

Having both CCG and NELFT Clinical Education Leads

steering the Hub’s overall direction but also having the

Nurse Clinical Lead sitting at the Nursing Super-hub level

has meant that we were already working in Alliance in

Integrated formation before STPs or Health & Care alliances

for integrated care came into play formally. Their experience

in the last four years means they can be called on to support

the development of future workforce strategies building on

lessons learned.

Working at Scale: Physicians Associates

WF Hub took is the Preceptorship programme lead for North

east London. We have designed a programme to support

this new role. Recently reporting the role into NHSE Leads,

it is deemed as a progressive and forward thinking Hub that

is seeing then future of the role’s need to be socialized into

the primary care and wider workforce. NEL STP asked WF

to lead. The Preceptorship presently takes recent graduates

into a space where they are learning with their peers and

senior clinicians on how to navigate and embed their role.

This project shows how dynamic Training Hubs can be

across the system to retain new roles in the local area. WF

is also working very closely with Barts and NELFT to support

Nurse Preceptorship as well. One feedback is as follows,

“The second preceptorship programme was the first one I

attended and it was very helpful, particularly discussing

cases. I will be looking forward to attending the future ones.

Especially, the case based discussions was helpful.” We are

hoping this model will help national programmes.

Working at Scale: One Workforce

Then Digital Training Hub is here and will be launched in

November to first the Primary Care Workforce then wider

joined-up sustainable Learning Management System (LMS).

Based on the Skills Matrix, WF is lead the way in NEL with

its use of Bluestream Academy to enhance learning and

compliance for primary care but also social care. All NEL

Hubs apart from Newham. WF CEPN envisaged in its 2016

Sustainable CEPNs Options Paper two scenarios that would

involve future systems mergers and possible at scale

working future Workforce via HR systems and programmes

that cross natural provider boundaries. Our Skills Matrix has

demonstrated that a sustainable federated buy –in LMS

model from primary care and social care providers into one

LMS system is possible.

The Hub has 95% buy in from WF Practices and wider

primary care like the GP Federation and Community

Enhanced Services adopting our Skills Matrix Learning

Management system (LMS). The Pilot has yielded returns of

40k in the last year alone just from primary care subscribers.

Board CEPN members have been steering workforce

transformation discussions around sustainability through a

tabled paper by the WF Hub Lead and this model is showing

that if working at scale, more can be done to pool funds for

delivery. The Digital Training Hub will be launched in

November formally. This will be an online-based integrated

portal which will streamline all your training, education and

eventually workforce processes. It will eventually be rolled

out to Social Care Providers Features will include:

Booking training

Webinars/Live video lessons

Automating processes like e-certificates

Instant registrations

Workforce planning dashboard for Site Managers to

help you keep track of staff learning and appraisals in

real-time.

Automatic electronic certificates for online and face-to-

face learning

Training passport/ID transferable across other

NHS/social care sites i.e. Barts, Care Homes, etc.

Mobile app where you can do training anytime

anywhere

WF digitization will usher in a transformation of the past

moving into new ways of working. It however needs more

support across the STP to enhance the offer.

Impacts: Network Legacy & Sustainability 7 Innovation 1: Digital Training Hub Launched April 2016 as a pilot, WF CEPN partnered with End of

Life Care Lead, Practice Managers & Care Homes Manager

Lead at the CCG to extend the Education & Training offer to

Front Line GP Practices & Care / Domiciliary Care Staff. The

Skills Matrix is now an established sustainable training hub for

staff in Waltham Forest. Practices & Care Homes pay a nominal

fee and in return gain access to Bluestream (Online Training)

and Face to Face Training commissioned by CEPN. 2017-2018:

37 Practices & 7 Care Homes signed up to the Skills Matrix.In

order to ensure WF CEPN commission training that is both

essential and requested, a Training Needs Analysis was carried

out for the following staff groups:

Nurses

HCA’s

Practice Managers

Care Home Staff

Pharmacists

Additional to the TNA, a Training Return Form was sent to all

sites on the Skills Matrix Agreement to fill out. This was to find

out what Training is needed by each member of staff (i.e.

Receptionists). So far we have had 36/37 practices return their

completed document. These Training Return forms have been

collated to create a Master Tracker which lists all the Staff

Members & Details in Practices in WF. This tool however is

currently managed manually. This is now transformed into a

digital processes we are launching in November. Testing has

begun. The Hub is finally here and has been tested on

transferring learning passport across Barts and Primary Care

settings.

The Digital Training Hub was presented as a concept at HEE’s

2019 Education Conference. It gained a lot of interest from

regional Training Hubs. Once live hubs like Barnet, Newham

and BHR are open to exploring potential partnership. WF Hub

has agreed to share and show what it is doing as

implementation progresses into 2020 and has agreed with

Newham to potentially work on the iterative build. However as a

digital platform, WF Hub will also seek more support for the

build at an STP and national level.

Innovation 2: Primary Care Networks Workforce Planning Toolkit WF has enhanced this with an analytics tool and has continued

to invest in the development of a Workforce Planning toolkit for

primary care which it is hoping will be later used for content for

an automated LMS system. The view of this toolkit now shows

Practice Network Workforce Data as well as highest top 5

spend areas including LTCs across PCNs and Practices will be

getting a Toolkit in the summer to support their workforce

planning needs including a learning session on the ongoing

benefits for having workforce planning as a core human

resources skill as a Practice Manager. In 2016, WF CEPN

wanted to have an “audit in action” and decided to build into a

new audit a profiling tool which combines workforce data from

the Matrix & Primary Care with live and current workforce data

for Practices. In order to have an “audit in action”, NHS Digital

and Practice by Practice data was used in combination with the

Matrix training data to present the Practice with their own

numbers for reflection. This is a tool and method that can easily

be scaled to support and secure Training Hubs to PCNs.

Innovation 3: Roles Catalogue Update The catalogue was created to complement the above Workforce

Mapping Toolkit and has continued to be enhanced and shared

across the STP. There are many new roles and Apprentice

standards being developed for Primary Care. There is also the

impending Apprentice Levy which is proving challenging to

providers in terms of explaining and understanding practicalities

of the benefits. Primary Care staff continue to not have a single

or regional local means of accessing information on national

and regional workforce transformation in layman's terms i.e.

salary, standards, training providers and accessing

Programmes. Looking at the toolkit we created for Workforce

Planning, WF realized it also needed another tool that would

help Practices understand the new roles better but also see how

easily they could be implemented to compliment workforce

needs at Practice Level.

Integrated Learning Management System for North East London

Hubs currently have an awareness of the knowledge, skills and

attitudes needed to meet health needs (or support the health) of

the population within the network area. They are able to do data

collection about the number of primary and community

professional and “lay workers” within the network area and

collaborate to build up a view on future demand for these roles

from employers, to support both local and regional workforce

planning. They are able to analyze what the training needs of

these groups are in partnership with network providers so that

detailed training assessments can systematically address issues

with the workforce as they emerge and change over time.

WF Hub has tabled a paper to counterparts and regional leads to

consider at scale Digital Training Hub. This Hub represents a

grand opportunity to deliver a self-sustained system for the region

integrated with primary care and social care. The conversations

about this continues.

Using Data & Analysis to deliver OD Change

Since 2016 WF Hub has used investments to build up sustainable

workforce support tools for primary and social care partners. The

ongoing development of sustainable tools and their use has also

benefited various stakeholders within and outside the Network.

The tools and methods are user friendly, practical, systematic and

can be easily tailored to suit local or at scale needs.

If integration is going to be a success, WF Hub is determined to

use data analysis to better position its stakeholders in workforce

transformation as it begins to help soften and shift professional

boundaries. In January 2015, the CEPN was invited to work in

partnership with Skills for Health to develop an integrated working

plan in one themed service area; Long Term Conditions. WF GP &

Nurse Education Leads are using this data to improve education

sessions in real time and do deep dives on impact across

commissioning and patient services.

Since 2016 the CEPN has become increasingly relied upon within

the CCG to confirm data for Primary Care but also other teams

wanting to understand what training had taken place to influence

changes in services but also outreach to workforce professionals.

Enhanced data about the local General Practice workforce was

also recently used to shape Waltham Forest's CEPN & Primary

Care joint work in delivering a Workforce Planning Toolkit for

Primary Care. Data is transforming the way we are planning

workforce implementation with stakeholders and showing the

Hubs credibility. It recently delivered for Primary Care a coherent

response to workforce transformation across the system.

WF Hub is focused on identifying and filling “real” Workforce gaps

in Primary Care rather than using a scattergun approach and

continues to work with in house CCG’s in- house Research

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Consultant to measure impacts training is having across

commissioned services and where these metrics could be better

identified for future commissioning programmes. The partnership

has recently seen the publication of a Patient Record sharing

Benefits Study. The training impact will be has been published

and is available.

Scalable, Sustainable Workforce: Joined up Working & Workforce Pipelines Strategy

The Transformation fund has being instrumental in supporting the

direction for all Providers to reflect on the impact of the

Apprenticeship Levy. The report into the primary care and

provider landscape has shown that scale can be achieved if the

right tools to support this and willingness is there. WF Hub has

partnered with Lifetime health Education Institutions to scale new

roles numbers in health and social care can happen if larger

providers take seriously the challenge to work with smaller

providers in educator transactions to create a real Apprenticeship

economy. If the private sector is using this to its advantage, health

and social care can also do the same. In the same way WF Hub

has been able to work at scale delivering 100 Nurse mini-rotations

in 2017-18 and is about to deliver experience weeks and more

Nurse Rotations into Primary Care. There are major hurdles i.e.

infrastructure/ systems for health and social care, however these

are not insurmountable done in stages.

The Hub and its neighboring Hubs are now also at the table

working with Barts, ELFT and NEFLT to champion rotations from

Acute into Primary Care which will begin to have an impact on the

direction of funding as well.

Future Investment into WF Hub

The CEPN continues to maintain high impact value to support to

continue its Network Impact. However current funding is not

sufficient to continue at pace investment of time.

Future Investment Outlook

1. Digital Transformation enhancement and scale where

match funding is available is key to the future

sustainability of the hub.

2. Local staff is needed to continue to coordinate the Hubs

activities. It often becomes difficult to scale when staff

come and go too frequently. This may mean that the

Hub changes it hosting model.

3. This Hub continues to invest in excellent, committed

Clinical Leads bring to the Network.

4. Professional peer forums is incredibly important to WF.

Multi-disciplinary working and learning especially in the

advent of PCNs and integrated care systems.

5. Social Care & Voluntary Sector as key workforce

transformation partners continue to need more

investigation and investment.

6. Mental Health is an area WF continues to want to

develop and support.

7. Volunteer sector support needs to continue and grow

with system based learning opportunities.

Future Direction

WF Training Hub has spent the last 12 months looking at its

hosting model and sustainability in light of systems changes.

Network development continues to strengthen with work now

taking place to engage with Social Care & Voluntary Sector as

key workforce transformation partners having been involved

with mini-rotations and work experience weeks. Part of WF Hub

strength is its growing credibility to develop lasting systems that

deliver change through enabler innovations it has created.

There are conversations as to what the collaboration scope

should be. A real teamwork culture across different

geographies is emerging with conversations that span beyond

the projects being jointly commissioned as Hubs build their

Alliance to look at work areas.

Hubs are a group of primary and community care organisations

that come together as a group of like-minded providers to collabo-

rate to bring about major workforce, education and training and

create an education shifts. As a precursor in the moving tide to-

wards Accountable Care Organisations & Systems, WF Hub

continues to demonstrate how this can be done through Network

Collaboration and the building up of common tools to establish

systems.

Waltham Forest Training Hub will continue to collaborate with

External & Internal Networks and Groups to meet local workforce

requirements (such as specific skills shortages), including the

9

development of new bespoke programmes to meet specific local

needs (this would include developing educational programmes

based around integrated care pathways and new roles reflecting

care pathways). Going forward, Primary Care Strategic

Commissioning, Digital, Integrated Care, STP Workforce, Barts &

NELFT partnership will be working with Waltham Forest Hub to

undertake local coordination of education and Workforce

programmes.

Hubs need to be positioned as the local

educational voice across PCNs and Intergraded

Care

Develop Education & Workforce against new

Models of Care.

Support the identification and delivery of local

workforce needs.

Through planning, educate workforce as to what

changes may be needed.

Collaborate with various stakeholders from sectors

related to Health & Social Care.

Look at approaches that will foster an environment of

life- long learning across the workforce.

Together, all groups will ensure improved economies of scale,

reduced administration costs, minimize duplication and deliver

trans- formation of front line staff behavioral change in both

primary care and acute services. WF Hub will also aim to ensure

the workforce is fit for purpose for tomorrow’s challenges by

working together to develop local people and their learning giving

them opportunities to live and work locally. We enter new models

of care implementation phases.

Waltham Forest Hub will use current window of opportunity to

embed the work and set options around scalability, sharing where

it can its successes locally at the CCG & wider STP level. On-

going investment in Waltham Forest Hub has led locally to the

emergence growing integrated alliances. The visibility of the WF

has really taken shape as a transformation enabler. This Hub is

advising commissioners on new models of care. Waltham Forest

Hub encourages new relationships between stakeholders

encouraging them to develop a burst of new ideas, methods and

tools to move forward best practice for integrated models.

Training Hubs/ CEPNs continue to emerge as central catalysts

in Workforce Education, Research, Training and Strategic

Development across local health and social care borough

areas. Hubs continue to have the the ability to cross

Organisational boundaries - health, social and voluntary care

leading to the possibility of at scale working and integration

with singular provider organisations.

Appendices

Please note some project delivery can be reviewed from last year’s Annual Report Here

Project Documents Availability

Care Academy: Care Academy Apprentices Pipeline Delivery Report & Presentation

Apprenticeships Report Skills for Health: CEPN & Provider Side 2 Reports – One for Primary Care One for Barts / Providers

Urgent Care : Enhanced Pediatric Skills 2 Interim Reports

Urgent Care : Ambassadors (Health Watch Partnership) 1st Report 2016

Optimum Birth Pilot: Home Birth Pilot Full Reports 2016-17

Sustainable Training Hubs Options Paper Updated Document – 2019

Associate Nurse Mini-Rotations – Health & Social Care Interim Report

Receptionist & Admin Report Full Report – being used by Primary Care (Impact)

Upskilling Domiciliary Care Staff using Significant Seven Programme Available in last year Annual Report

Mental Health First Aid Training Available in last year Annual Report

Better Care Together – Integrated Care Hybrid Roles Managed Network of Care Design

Multi-Disciplinary Training MDTs

Primary Care Leadership Development Programme / Quality Improvement

Pharmacy Training & Development

Workforce– Care Homes Strategy (Planning & Mapping)

Henry

Multi-disciplinary Training (Patient Centered)

Diabetes Care Investment

Physicians Associates Preceptorship

Managed Network of Care Workforce Transformation

Attached in this report – Delegate Analysis

Full Curriculum Plans 2018-2019 can be requested

Martials and report available

Report available

Henry Workforce Development Report

Let’s Learn together

Waltham Forest Nurses, Diabetes Care

Available ( will be shared on microsite in September)

Interim Report Available

Innovations

Digital Training Hub – Skills Matrix Model Go Live November 2019

Primary Care Networks Modelling – Workforce Planning Toolkit

Rotations Toolkit

Roles Catalogue

Availability:

www.ICSTrainingHub.com – access to site on request

Networks view available on request for Hub Managers

Available ( will be shared on microsite in September)

Available ( will be shared on microsite in September)

Projects Pending End FY Reports / Project Update

Social Prescribing Collaboration Pending

Positive Behavior Support (PBS) for people with learning disabilities Pending

Get Fit Stay Fit Pending

Keep In touch...

Waltham Forest Training Hub, Kirkdale

House, 7 Kirkdale Road

London

E11 1HP

0203 688 2624

www.WFTraninghub.com

wfccg.wfcepn@nhs.net