THE MODERNISATION AGENDA 2015–2025
What are the implications for workforce development?
Friday 14th February 2014
Dr Patricia Oakley
Director, Practices made Perfect Ltd.
Teaching and Research Fellow
Public Policy and Management
King’s College, London
FOCUS ON THE FUTURE – THE STRATEGIC
REFORM AGENDA AND IMPLICATIONS
FINANCIAL ADJUSTMENTS
1. The Depression – 30/34
:
c. 50 months
2. 1st Oil Shock – 73/76
:
c. 40 months
3. 2nd Oil Shock – 79/83
:
c. 48 months
4. DotCom Bust – 90/93
:
c. 36 months
4. Banking Bust – 08/?
:
Projected c. 120+ months
New Reality – Tight Fiscal Regime;
Real Incomes;
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Size of State
The Next 30 Years

Care of the Elderly – physically well and mobile, socially engaged
and psychologically content.

Chronic Disease Management including Mental Health and Carer
Support.

Specialist Surgical and Therapeutic Interventions.

New Science: Pharmaco-Therapeutics and Genetics, Molecular
Imaging and Diagnostics.

Building technologies and flexible designs underpinned with realtime information e.g. Electronic Transfer of Prescriptions, Digital
X-ray, Just-in-Time Training Programmes.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
BIG SCIENCE COMING TO YOU SOON
RCTs, Cash Flow, Research  New Ways of Working
 Genetic Profiling and Therapeutic Targeting.
 Proton Beam Therapy and Novel Treatments.
 High-speed informatics and cooling technology.
 Stem-cell based research and new science.
 Prosthetics, regeneration and bio-engineering
developments.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Supporting Getting Old and
Managing Long Term Conditions
Build a fabric of dense social networks
within which good quality health and social
care interventions are delivered in a timely
and sensitive way.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Supporting Getting Old and
Managing Long Term Conditions
 Support for family, friends and community selfhelp groups.
 Support for collectivising events and activities.
 Support for patient-focused charities and
enabling groups.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
New Service Design Assumptions
 Assertive Public Health Strategies and Public Engagement.
 Technology-supported Homes and Communities.
 Early Health Risk Screening, Diagnostics and Interventions.
 Advanced Pharmaco-therapeutics and Genetic Profiling.
 Technology-supported Clinical Decision-making and Work
Designs.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
New Service Design Principles
Hospice
@ Home
Service
Single-people enabled
Homes and Campuses
Hospital
@ Home
Service
“High Street” Screening
and Diagnostic Centres
(high science and technology)
Community
Activity Centres
and The Gym
Re-enablement,
Rehabilitation and
Resettlement Centres
GP Well-being Practices and
Managed Care Centres
(Cancer, Stroke/Cardio, Mental Health)
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Trauma Centres
Urgent Care Centres
Planned Care Centres
Nursing and Care Homes
Step-down/Convalescent Homes
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
“The Place in the Middle”
Regional
Trauma
Services
High Street
(including children’s
trauma service)
Local Care Services
Social Care Services
(including mental health and
planned care services)
•
Hospice and Hospital
at Home Services
Community Pharmacy
and Medicines Services
•
Minor Injuries and “Off-legs”
Front Door Services.
•
Planned Care and
Rehabilitation Services.
•
Outpatients and Long Term
Care Support Programmes
including Self-Care Workshops
and Self-Help Networks
Support Programmes.
GP Surgeries and
Out of Hours Services
Community Nursing and
Midwifery and Therapy
Services
? The Home Tests?
? The Gym Tests?
? Point of Testing
Services?
? Local Diagnostic Services?
? Local Imaging Services?
? Local Genomics Services?
Convalescent, Observation
and Place of Safety Beds and
Services.
•
Urgent
Care
Services
Paramedic/Blue
Light Service
Services
(including children’s
urgent care service)
Maternity &
Neonatology
Care Services
Genetics
Services
Cancer, Cardiac,
Stroke
Care Services
End of Life Services.
(includes current A&E “minors” service)
Mental Health
Care Services
(inpatients)
Social &
Probation
and Police
Services
? Regional Diagnostic Services?
? Regional Imaging Services?
? Regional Genomics Centres and Predictive Analytics Services?
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Supporting Getting Old and
Managing Long Term Conditions

Service commissioning development.

Tariff and rewards payment development.

Service reviews and development of service networks.

Policies to reduce integrated service delivery hurdles.

Policies to build robust QA and inspectorate processes.
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© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Focus on the Future – The Wheel Turns Again
Possible Streamlined Public Service Architecture*
• Dept. of
Health and
Independent NHS
Social Care
Board and its Regional
Permanent
Directorates
Secretary
Service
• Chief Executive.
and
Commissioning
Chief
• £ Controller.
Agencies
Medical
• Commissioning
Officer.
• Local Authority and Primary
Director.
• National Specialist Care Trust Service
• Medical Director
Commissioning
Commissioning Agency:
Group e.g.
− economies of scale
• Nursing Director
Transplant
service commissioning;
Programmes,
− Public Health
Proton Beam
? Chief Officers
Programmes;
Therapy and
− “residual” services
“Orphan”
commissioning.
? Workforce
Drugs.
Director.
• Clinical Commissioning
• Clinical
Groups – Managed
? R&D
Senates’
Agencies for majority of
Director.
Guidelines and
local people’s needs.
Advice.
• GP-Patients Commissioning
Partners:
• New “NICE”.
− Individual Choice;
− Co-Payment Choice;
− Means-Tested
Services.
£
£
Workforce
Regulators
Independent
Reconfiguration
Panel
£
Pay Review
Bodies
Care
Quality
Commission
Monitor-Market
Regulator
Service Providers Network
• Foundation Trusts and Academic
Health Science Centres.
• Social Enterprises.
• Companies.
£
• Partnerships.
£
Local Education Training Boards
Workforce – Human
Resources Development
Workforce – Strategic
Planning and E&T
Investment
• Deanery Schools, HIECs
and All SCs.
• Assessment Centres.
• Leadership and
Organisational
Development Consortia.
• Recruitment and Payroll
Agencies.
• Workforce Planning and
Information Consortium.
• Education and Training
Commissioning
Consortium.
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Health Education England
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk
Professionalism in Healthcare Staff
“Professionalism” Goals: Good, Safe, and Accurate Patient Care
Good, Safe and Accurate
Patient Care
? Who sets them?
Practice Standards
and Quality Assurance
? Who develops metrics and
QA methodology?
? Who inspects?
? Who builds E&T specification and
Curriculum?
? Who validates teaching programmes?
Education and Training
and Supervision
? Who develops teachers and supervisors?
Staff’s Behaviours, Attitudes, Aptitudes,
Skills and Knowledge
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? Who develops and QAs the clinical placements?
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: office@practices.co.uk