SCW was asked to deliver an insight-driven primary care programme to PCNs within the Buckingham, Oxfordshire & Berkshire West (BOB) Integrated Care System (ICS). This required the development of a workforce programme to support the participating PCNs with the identification of interventions that would deliver maximum impact and ensure that targeted care could be delivered to the population over the next 3, 5, and 10 years.
Recruiting the right staff and retaining them has always been a challenge in Primary Care. This has proven even harder in the pandemic.
In June 2021, the BOB ICS looked to implement an online workforce planning tool to help PCNs with their workforce planning. SCW’s initial commission was focused on supporting the delivery of the tool’s rollout plan. Through engagement with front line managers and leads across the system, it became apparent that PCNs were at very different stages and required a different kind of support. We asked the questions 'What does good workforce planning look like?' and 'How can we support and drive workforce planning with data and insight?'.
BOB ICS wanted to support General Practice to ensure that patient care is delivered efficiently and effectively. The aim was to ensure that General Practice recruitment strategies and workforce plans would be informed by their population needs rather than the demands of vacancies. Using the data to identify the roles which would:
- make the most impact for their patients,
- address populations health needs,
- strengthen workforce retention, PCN development and leadership.
We developed a bespoke PCN programme working with a cohort of early adopter PCNs. By utilising nationally available quantitative data in conjunction with qualitative data gathered through exploratory conversations, we were able to build an assessment of workforce planning ‘maturity’ for each participating PCN.
This assessment was then enhanced by insights and recommendations tailored to each PCN in the programme. Our team of subject matter experts across primary care (from PCN level through to system and national levels), data analytics, capacity modelling, matrix assessment, recruitment, and OD training structures, identified pragmatic solutions to current and future workforce challenges.
Each PCN was assigned a principal SCW lead to support them through the programme. Leads undertook a series of exploratory calls to identify themes, using thematic assessment approaches to interpret and make sense of the information obtained. Concurrently, the SCW data team collated national and locally available data sourced from national indicators (DES, QOF, IIF), population health data and national workforce reporting service (NWRS) data. The combined end result provided the PCN with a holistic workforce planning approach, including a data pack providing the insight to ensure workforce planning could meet its population and workforce needs for 1, 3 and 5 years into the future.
Addressing the challenge of translating the data and the PCN Insights into meaningful information to inform the workforce strategy was key. This was tailored to each PCN and therefore needed to consider all local influencing factors ensuring the interpretation of data and information was focused, and supported action-focussed discussions.
The innovative approach involved accessing and integrating a range of data at a more detailed level than had previously been explored. The data was used to assess the needs of the PCNs, comparing the skills already available against what was required. Each of the roles covered by the ARRS scheme was mapped to national performance indicators and subsequently linked to population needs. Matrix assessment tools were developed alongside recommendations on how to progress through the levels identified in the matrix.
The unique insight, provided by our overarching holistic approach, was then used by each PCN to inform their PCN workforce strategy. A further insight paper was provided to the ICS, to inform their systemwide workforce strategy.
By changing the traditional approach of workforce planning to one with a focus on population and performance data-driven insight, participating PCNs have been able to identify innovative solutions to their workforce challenges. Working with 7 PCNs covering a population of circa 305,200, the bespoke data packs have been used to inform and identify targeted interventions ensuring impactful workforce planning and recruitment including maximising the use of the ARRS roles available.
The data analysis was tailored to each individual PCN allowing a specific focus on the patients’ needs based on their conditions and health requirements. This approach enabled the design of specific workforce strategies to improve access to primary care services, improving health outcomes and reducing health and access inequalities.
A really excellent experience. I'm certain the report will inform our strategic planning for the next year as we move away from a Dr-first system. Primary Care Network Manager
A number of PCNs have already requested that this process is repeated next year to capture progress and summarise the new areas of focus identified based on the latest results. This will allow for the development of an ongoing action plan for creating an increasingly sophisticated approach to workforce planning.
From a system perspective, the programme supports the NHS Long Term Plan published by NHS England by enabling PCNs to develop their workforce strategy based on detailed and accurate data at a PCN and ICS level. It encourages a review of ways of working and identification of safe, efficient, and accessible service priorities thereby improving patient outcomes and experience.
The sharing of best practice and lessons learned across the PCNs ensures that strategies can be continually refined to ensure the best possible primary care services available.
I wanted to highlight how well I thought the call and report went. I found the outputs to be really useful for what our plans are and reinforced the plans we already have in place considering our population. Very informative and reassuring. Primary Care Network Manager
Further benefits will become clear once the changes implemented have been tracked and evaluated over the forthcoming year. The hypothesis is that:
- Participating PCNs will become more proactive in their approach to workforce planning.
- Patient satisfaction will increase as access to primary care services becomes easier due to the workforce strategy implementation.
- Patient outcomes will improve due to faster access to services.
- The practice teams, both clinical and admin, should feel less pressure due to the support of the additional PCN roles.
The approach taken here for primary care could also have benefits for other services across the system working within a demand and capacity environment.
It has been an exciting journey supporting the PCN and ICS teams who have provided amazing and positive feedback.
An excellent initiative, for which I'm very grateful. General Practitioner
Really really helpful! This reiterates what we thought we knew. We will definitely be interested in doing this again next year if this is available. Medical Director
The session was really informative and highly useful. General Practitioner