SCDHB Workforce Strategy and Action Plan

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South Canterbury Workforce Strategy and Action Plan

SCDHB Workforce Vision

Supporting Community Health and

Wellness with a Sustainable and

Contemporary Workforce

Table of Contents

1.

Background and Introduction ................................................................................................................................................................................................................. 3

1.1.

Introduction .................................................................................................................................................................................................................................... 3

1.2.

SCDHB Overview .......................................................................................................................................................................................................................... 4

1.3.

Workforce Challenges ................................................................................................................................................................................................................... 4

1.4.

Development of the Workforce Strategy and Action Plan ............................................................................................................................................................. 5

1.5.

Workforce Activities at South Canterbury ...................................................................................................................................................................................... 7

1.6.

Strategic Alignment ........................................................................................................................................................................................................................ 8

2.

Workforce Planning ............................................................................................................................................................................................................................... 9

2.1.

Themes for Improving Workforce .................................................................................................................................................................................................. 9

2.2.

Strategy Framework .................................................................................................................................................................................................................... 10

2.3.

Category Definitions .................................................................................................................................................................................................................... 11

2.4.

Workforce Innovations ................................................................................................................................................................................................................. 12

2.5.

Implementation Timeline.............................................................................................................................................................................................................. 12

2.6.

Prioritisation ................................................................................................................................................................................................................................. 13

3.

Workforce Strategy and Action Plan .................................................................................................................................................................................................... 14

1.

Goal one .......................................................................................................................................................................................................................................... 14

2.

Goal two ........................................................................................................................................................................................................................................... 18

3.

Goal three ........................................................................................................................................................................................................................................ 23

4.

Goal four .......................................................................................................................................................................................................................................... 26

5.

Goal five ........................................................................................................................................................................................................................................... 29

6.

Goal six ............................................................................................................................................................................................................................................ 31

2

1.

Background and Introduction

1.1.

Introduction

There are three essential elements for a sustainable future: fiscal stability; robust Infrastructure including facilities, information technology and quality and safety; and a sustainable and contemporary workforce. South Canterbury, where primary and community health services are integrated within the district health board, performs well against some of these elements, for example, it is well placed in terms of fiscal stability and has been identified as one of the better performing DHBs.

“Fiscal Stability, Robust Infrastructure

Sustainable & Contemporary Workforce”

A sustainable and contemporary workforce is the core of South Canterbury District Health Board’s

(SCDHB) vision which is, “Supporting community health and wellness with a sustainable and contemporary workforce”. This South Canterbury Workforce Strategy and Action Plan (the ‘Workforce Plan’) describes the drivers, objectives and actions for building a sustainable and contemporary workforce. This Workforce Plan should be viewed as part of the bigger picture of sustainability along with other initiatives carried out by SCDHB.

This Workforce Plan has been written for South Canterbury, not for the South Canterbury District Health Board. It recognises that in a changing health environment, the long term planning for the health workforce needs to outlive any changes in organisational structure, service delivery or delivery location. The action plan reflects the need to take clear steps forward while managing current funding limitations, by identifying resources required and prioritising actions.

The development of the Workforce Plan reflects current recommendations in terms of the provision of health care. The South Island Conceptual Framework was a source of those recommendations and states that:

• More health care will be provided at home and in the community to support long term conditions and rehabilitation, and a strong and highly developed primary care infrastructure will be a required foundation for all South Island DHBs;

• Secondary and tertiary services will need to be provided not in a linear structure but across DHB boundaries, providing services to local, sub-regional and regional populations;

• Flexible models of care, clinical leadership and new technologies will be needed to support service delivery in different environments from those traditionally recognised;

• Health professionals will need to work differently, in different settings, across different sectors to coordinate patient care and ensure a smooth transition for patients to appropriate levels of care and between providers; and

• Clinical partnerships and networks will provide forums for clinical leadership, and a partnership between clinicians and management will support the delivery of quality health services across the health continuum.

3

Many of these recommendations will be a challenge to deliver, particularly for a smaller, provincial DHB such as South Canterbury, who relies on attracting staff who often choose to live and work in larger urban areas.

The Workforce Plan guides provision of a dynamic and flexible skilled workforce that will effectively and efficiently deliver care while the above recommendations and related service model changes are implemented.

The success of the SCDHB depends on its innovation and adaptability and its exploration of collaborative working with neighbouring DHBs to provide complete health care.

1.2.

SCDHB Overview

SCDHB has a particular focus on providing strong and informed clinical leadership that delivers in terms of best practice and positive outcomes for patients. SCDHB recognises the need for a skilled and diverse workforce if they are to be successful in providing these standards of care for their residents. As such, it considers strategies to support the attraction and retention of quality staff as a priority. A key component to this is their established performance review process which aims to support career development which assists the individual and ultimately the organisation to move forward and grow. Additional support for the provision of best practice comes from the Clinical Council and Primary Clinical Governance Group which provides oversight for clinical practices and standards for the DHB.

Support of the SCDHB workforce is comprehensive and extends to include staff wellness initiatives, for example, the provision of low cost or free exercise options and personal health checks, tertiary level health and safety practice standards, a no tolerance harassment/ workplace bullying policy and work flexibility reviews

.

T he exceptional work provided by staff is remunerated as fairly and as consistently as possible, linking it to the principles of performance, employee competency development and organisation affordability.

South Canterbury has a relatively small population at 55,540 people (2009). The health workforce that serves this population consists of around 960 employees who fill approximately 570 full time equivalent positions. The workforce includes allied health, medical, nursing, support, management and administration personnel.

The majority of this workforce is of NZ European background (592), followed by ‘other’ background (302), Māori (39), Asian (21) and Pacific (10) peoples. This distribution is not in keeping with the local South Canterbury population with a particular under representation of Māori which make up 11% of the local population. Some of the workforce data is indicative only due to organisation and reporting changes occurring over the three year time period.

1.3.

Workforce Challenges

Over the past three years, SCDHB has collected data in order to determine the make-up of its workforce, some of this information is described above. Data collection occurred across primary, secondary, community and NGO services. However, data collection for primary and NGO services has been limited and more needs to be known to better plan for the future needs of this workforce. In general, the characteristics of the workforce remained stable throughout the three year period. We assume that the picture described by the data collected is an accurate representation of the SCDHB workforce.

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The data has evidenced some important areas for exploration and development for SCDHB. Of primary concern for future workforce planning is the high percentage of the SCDHB workforce that is older than 50 years of age. At present nearly 40% of staff are 50 years old or over and the average age of the workforce is 45.98 years; this is in keeping with the national DHB average age of 44.2 years. Not one profession is an outlier for this statistic and this fact may contribute to the high ratio of part time employees at SCDHB as older employees move to more flexible and less time intensive working options. At present approximately 33% of the workforce are full time employees.

The challenge is to support this aging workforce, keeping essential experience within the DHB, while also attracting local young people to health careers with

SCDHB which will, it is hoped, decrease the reliance on the international workforce to help fill vacancies and increase the number of fulltime employees. The reliance on international staff is thought to be the result of a shortage of trained health professionals in New Zealand. The recent discussions with SCDHB staff have also indicated a weakness in establishing effective engagement with the local youth population that encourages the uptake of careers in health. Additionally, there is difficulty competing with international markets in generating interest and recruitment to SCDHB across all health professions and throughout NZ. A perceived benefit of having a greater number of full time employees is the feeling of staff ownership of the service and of service development, both of which are essential to running an excellent health care service.

The observation of an aging workforce is reflected in the local community where, like in many DHBs, the population is aging. South Canterbury has the highest proportion of people aged over 65 years of DHBs in the South Island, with 19% in 2009, and with an expected increase to 29% in 2026. This will continue to increase demand for South Canterbury health care services and while job vacancies have trended downwards over the last year, SCDHB cannot be complacent about this trend and must look beyond numbers to meet the demand for services. Additionally, ‘real funding’ for SCDHB services has decreased, placing greater pressure on services to deliver high quality and cost effective services in order to meet the health needs and population demand in future.

Finally, DHBs in provincial areas are often difficult to recruit to and SCDHB is not an exception. With fifty percent of its population living rurally and with its population not predicted to grow significantly in the coming years, the rural issue will remain a constant and will need addressing. This relative isolation is not necessarily a ‘pull factor’ for many professionals and with a general tendency towards specialisation across health, the generalist nature of care in this region is somewhat against the tide of clinical practice expectations and professional development goals. There is an identified need for innovation in service design and post/ position development that creates a unique value proposition for professionals and which enables specialisation to run alongside generalisation in practice. It is hoped that this type of innovation will bring specialist services closer to the people of South Canterbury and reduce SCDHB’s reliance on regional support.

1.4.

Development of the Workforce Strategy and Action Plan

A pragmatic approach was taken to planning by continuing to plan for current needs with consideration for known trends while retaining flexibility to respond to changing service delivery. It is recognised that though their remains ambiguity about the future model of service delivery and outcomes of the Regional Service

Planning are not yet know, the workforce to service South Canterbury community is still needed. Flexibility has been worked into the planning process with three yearly reviews and updates of the strategy.

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The groundwork for the development of the Workforce Plan was conducted over a series of three workforce planning workshops. With a strong focus on gathering input from frontline staff, the planning workshops aimed to engage all staff across the management hierarchy.

The first workshop aimed to develop a clear picture of the current workforce and identify issues from which to plan more effectively for future states. Attendees were presented with workforce data and heard from leaders of primary and secondary care who discussed the current workforce environment and future trends.

This enabled effective discussion regarding the South Canterbury workforce and led to the development of a comprehensive SWOT analysis. This analysis was later collated into workforce themes which informed the following workshop. Attendees were also presented with additional information from key strategic documents to help focus their thoughts. The CEO presented guiding principles to the planning process and led the team in developing a 10 year vision for the South Canterbury workforce.

Workshop two informed the working group of the predications for future services in South Canterbury in terms of possible implications of the South Island Regional

Service Planning process. This facilitated the identification of six Sustainability Goals addressing the themes identified from the SWOT analysis and helped initiate the development of the workforce supply action plan. Focus was both general, across all occupational groups, as well as specific, within occupational groups. The role of Workforce New Zealand was presented and ten national innovations were considered and included in the plan for further exploration. A number of actions to strengthen the Māori workforce have also been included.

The final workshop focussed on filling gaps and making recommendations for prioritisation. Additional comments, in the form of interviews, from some of those unable to attend were presented during this final workshop and helped inform the development of the action plan. The working group determined appropriate objectives which they believed can be managed within existing resources and included objectives that will require additional resources.

Throughout this workshop process two supporting documents were completed:

• SCDHB Workforce Data – workforce numbers, ethnicity, gender, age, and retention.

• SCDHB Workforce Information – a SWOT summary, SWOT interviews with key leaders, interviews with Clinical Directors, and an interview with CEO, Chris

Fleming.

These documents supported the development of the Strategy and Actions and will continue to inform the workforce planning process over coming months.

Overall, there was good engagement with attendees, with the working group contributing significantly to the goals, objectives and actions of the first draft

Workforce Plan.

The draft plan was shaped by further discussions with the Senior Leadership Group, Clinical Council and the Primary Clinical Governance Group to confirm the vision, goals and objectives for Workforce Strategy. Further work was completed on prioritisation, resourcing, person responsible and timeframes for Action Plan.

The resulting Workforce Plan covers the whole of the DHB, across services, across disciplines and across community, primary and secondary care. The plan retains a focus on the needs of the workforce, specifically, recruitment, development and future planning around an aging workforce. Some particular issues that they have identified are the high proportion of part timers, their reliance on overseas trained staff, lack of career path and finding a balance between specialisation and the need for generic skills. In South Canterbury’s provincial environment there is value in recruiting and retaining generalist positions.

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1.5.

Workforce Activities at South Canterbury

There are a number of workforce activities that are already underway, including:

Activity Responsibility Frequency

Career expo SCDHB Annual

Certificate in health studies: a course supported by

Otago Polytechnic and SCDHB offers an entry pathway to undergraduate health degrees

Aoraki Polytechnic Annual

Undergraduate placement support SCDHB As requested

Target Group/Occupational Group

Year 12/13 students for entry into all occupational groups

Nursing, Midwifery and Allied Health groups

Nursing and Midwifery cohort programme – relationship with Otago Polytechnic and CPIT to support locally delivered undergraduate programmes of study

SCDHB, Otago

Polytechnic, CPIT

First year of practice programmes

Resident Medical Officer (PGY1) training programme

SCDHB and HWNZ Annual

SCDHB and HWNZ Annual

Participation in DHB Resident Medical Officer and

Nursing recruitment road shows nationally and internationally

SCDHB in collaboration with other DHB’s

Annual

Medical, Nursing, Midwifery and Allied Health

Nursing and Midwifery

Nursing and Midwifery

Medical staff

Medical and Nursing

Competency assessment programme (return to nursing) SCDHB

Targeted web based recruitment micro sites established to target recruitment of Medical and Nursing staff

SCDHB

Annual

Ongoing

Nursing

Medical and Nursing

Postgraduate education – support and funding for formal continuing education

SCDHB and HWNZ Biannually

The purpose of the workforce plan is to capture existing activity and expand and plan for the future.

Nursing, Midwifery and Allied Health

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1.6.

Strategic Alignment

The national health workforce environment is currently in a state of change. Leadership in workforce development now sits with Health Workforce New Zealand

(HWNZ) and their partner organisations. Te Rau Matatini will be partnering with HWNZ in providing leadership for Māori. The three mental health workforce organisations Te Pou, The Werry Centre and Matua Raki will come together under HWNZ and continue to focus on the needs of the mental health workforce.

The role of Future Workforce NZ ended in August 2010 though Health Careers continues for now. It is expected that HWNZ will continue to build on the work completed by Future Workforce NZ and that the workforce framework remains relevant in the interim.

Alignment with workforce planning at a national level was facilitated by conversations with Cathy Cooney as lead for DHB workforce planning and with Sue

Laurence Innovations Manager for Health Workforce New Zealand. The Future Workforce NZ framework for workforce development was adapted for the South

Canterbury strategy.

A number of national initiatives were explored including the Incubator Programme that has been has been established in the Hawkes Bay DHB to give Hawkes Bay secondary school pupils insight into health careers. Also the Gerontology Nurse Specialist in Primary Health Care that is currently being piloted with six General

Practices in Auckland to provide health screening for the over age 75 well population to help identify those at risk.

The Workforce Plan seeks to align with the following strategic documents:

• District Annual Plan 20010-2011

• Draft Aoraki PHO Workforce Development Strategic Plan

• Future Workforce Our Health Workforce Today and the Future, April 2009

• Annual Plan 2010-2011, Health Workforce New Zealand

• Health Workforce Information Base Data Report, 30 September 2008

• South Island Regional Health Services Plan 2010

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2.

Workforce Planning

2.1.

Themes for Improving Workforce

Six primary themes or drivers emerged during both the workforce planning workshops and consultation with a range of workforce representatives from across

SCDHB. Goals were developed in response to these themes.

Theme Goals

Theme one: Community health needs and education of health professionals are disconnected. Low number of local young people attracted into the workforce. Low number of Māori and Pacific workforce.

Goal one: To attract South Canterbury youth to choose a health career that meets the future health workforce needs.

Theme two: A mix of local staff and overseas staff. Difficulty sourcing key specialised staff.

Goal two: A sustainable future workforce with the necessary skills, thus achieving a balance between local and international workforce.

Theme three: Locating more services in the community. Recent coming together of Primary and Community Division. Little known about primary, community, aged care sector and NGO workforce.

Goal three: Well co-ordinated services and workforce management across primary, community, aged care and NGOs.

Theme four: Predominantly rural/geographic isolation in South Canterbury.

Service Reliance on regional support. Smaller population group to service.

More generalist work on offer than specialist.

Goal four: Developing a sustainable continuum of care for rural/provincial residents within a regional environment.

Theme five: Increased demand for services and decreased real funding.

Increasing age of South Canterbury population. Need for innovation and flexibility.

Goal five: To identify and implement the most cost effective models of care and workforce to meet the needs of an aging population.

Theme six: The older age of the workforce with later retiring age. High ratio of part time staff.

Goal six: South Canterbury will provide an environment that supports an aging workforce to actively contribute to the health needs of the community.

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2.2.

Strategy Framework

The following matrix structure guided the planning process using the four workforce supply categories as defined by Future Workforce NZ and the six key themes identified by the working groups. This workforce planning then informed more detailed action planning in specific occupational groups. The diagram below depicts the strategy planning process utilised by the South Canterbury working group for both primary and secondary workforce.

Demand

Workforce Data

Anecdotal

Information

Strategic

Alignment

System Change

Enablers

Sourcing and

Recruitment

Employment and

Retention

Theme One

Theme Two

Theme Three

Theme Four

Theme Five

Theme Six

Training and

Development

Allied Health Personnel

Management and Administration

Medical Personnel

Nursing Personnel

Support Personnel

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2.3.

Category Definitions

Four key workforce supply categories provide a framework for the activities that are to be implemented under this Workforce Plan. These are shown below, along with the occupational grouping categories used throughout the process. Specific activities to achieve these goals are detailed in the relevant section of the

Workforce Plan.

Workforce Categories

1.

2.

Demand

System change enablers

Service priorities

Models of care

Innovation

Networks & relationships

Policy/legislation & regulation

• Planning/ information

• Environment scanning

• Research/ evaluation

3.

Sourcing and recruitment

O

• Leading, participation & partnership

• Staff welfare/healthy workplaces

• Career pathways

• Employment agreements

• Rewards/ recognition

5.

Training and development

Continuing education

• Competency maintenance & development

Building a knowledge sector & learning environment ccupational groups

1.

Allied Health Personal e.g.

• Information Technology

• Reception

• Managers

• CEO

3.

Medical Personnel

4.

• Junior doctors – House Surgeons

• Senior doctors – Senior Medical

Officers

Nursing Personnel

• Nurses

• Midwives

5.

Support Personnel e.g.

Aligned education & migrant supply

Market presence

• Recruitment/ retention profile

• Career framework

4.

Employment and retention

• Physiotherapists

2.

Management & Administration e.g.

Radiologists

Clerical support

• Maintenance

• Orderlies

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2.4.

Workforce Innovations

The following innovations were identified as opportunities for South Canterbury and will be explored during plan implementation:

• Positions spanning primary, community and secondary care

• Registrar-led clinics for minor skin lesions

• Prescribing in community (Diabetes Nurse)

• Community management of warfarin

• Assistant role in theatre to increase capacity

• Nurse practitioner roles and expanded RN practise roles

• Gerontology nurse specialist in primary health care

• Team Competency Reviews

• Physician assistant

• Strengthening role of General Practioners with a special interest.

2.5.

Implementation Timeline

The process of implementing the actions described in this strategy will take place from December 2010 to December 2020. Implementation is designed to roll out over ten years, with the Action Plan being reviewed and updated three yearly. It is acknowledged that actions planned for the short term will be more specific than actions planned to be completed in the mid to long term. Implementation is designed to roll out actions over four main phases:

Phase Description

Pre-strategy Development of the Workforce Strategy

Phase I

Phase II

Implementation of short term priority actions

Timeframe

August 2010 – December 2010

July 2011 – June 2012

Implementation of medium term priority actions July 2011 – June 2013

Phase III

Phase IV

Implementation of medium term priority actions July 2013 – July 2016

Implementation of long term priority actions July 2016 – July 2020

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2.6.

Prioritisation

Initial discussion considered actions where implementation could proceed now, those that required developments prior to the action proceeding, and actions that would provide opportunistic uptake (i.e. If and when funding opportunities arise). This was followed by prioritisation which occurred based on the perceived cost verses benefit of a given action by use of a PICK Chart - matrix of low to high payoff and easy to hard difficulty.

Actions were prioritised according to the following key:

• Possible – Actions with low payoff and easy difficulty

• Implement - Actions with high payoff and easy difficulty

• Challenge - Actions with high payoff and hard difficulty

• Reject – Actions with low payoff and hard difficulty

Accountability for implementation of the Workforce Plan will be achieved by incorporating the actions into relevant Work Plans.

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3.

Workforce Strategy and Action Plan

1.

Goal one

To attract South Canterbury youth to choose a health career that meets the future health workforce needs

System/change enablers 1.1

To promote the full range of health career opportunities to South Canterbury (SC) youth, including, but not limited to, medical and allied health professions, analyst positions such as clinical coders, assistant posts such as health care assistants and health protection positions.

Sourcing and recruitment 1.2

To develop a recruitment strategy targeting SC youth.

1.3

To promote and facilitate the taking up of professions that are difficult to recruit to.

Employment and retention 1.4

To limit barriers to education.

14

Action Prioritisation Related Activity Responsible Timeframe

Objective: 1.1 To promote the full range of health career opportunities to South Canterbury (SC) youth, including, but not limited to, medical and allied health professions, analyst positions such as clinical coders, assistant posts such as health care assistants and health protection positions

1.1.1.

Develop a communications and engagement

strategy, that targets students (secondary and tertiary) and the unemployed, including the following strategies:

• Determine levels of interest and potential barriers from current staff and with relevant

SC youth in relation to employment in health care careers

• Promote the professions brand to attract staff

• Utilise generation specific communication modalities to promote careers, e.g. twitter and Facebook to open communication lines, for promotion

• Develop an 0800 number to match youth career queries to local staff for 1 on 1 personal contact to engage on a preceptorship principles i.e. share stories, development of mentoring and career planning

Priority 1 An overarching communication plan will be developed

Develop template surveys

Plan survey/visits with local Career Guidance Teachers

Present at relevant functions at SC schools/ universities

Arrange speakers and displays at schools as requested

Continue with Careers Expo/Inzone bus

Organise a profession specific open day aimed at youth

National initiative, support locally

Part of communications plan

Determine financial and staffing needs

Determine appropriate rosters

Engage role models/standard scripts

Workforce Advisor

HR team

Workforce Advisor

HR Advisors

HR Advisors

Workforce Advisor

Workforce Advisor

Workforce Advisor

2011/2012

December 2011

December 2011

December 2011

Ongoing

2011/2012

Scoping by

December 2011

Programme

June 2012

15

Action Prioritisation Related Activity

1.1.2.

Build on existing relationships with tertiary education providers in order to promote health careers through:

Priority 1

• Knowledge exchange events – e.g. presentations, case studies, partnership possibilities.

• Develop an online forum to discuss common issues e.g. pupil development and support into employment

Responsible

Continue to engage with local, regional and national education providers

SDU

To be scoped and developed

Workforce

Advisor

Objective 1.2: To develop a recruitment strategy targeting SC youth

1.2.1.

Develop an enduring localised ‘incubator’ programme aimed at SC youth at the

Priority 1 contemplative phase of education options that will lead to health career under graduate qualifications (year 9&10 or primary school)

1.2.2.

Actively engage with Kia Ora Hauora Māori Health

Careers Programme

Priority 1

1.2.3.

Hold a work day/s for local youth in health settings

Priority 1

1.2.4.

Support student job search placements in whatever opportunities the SCDHB can formulate

Priority 2

1.2.5.

Explore funding opportunities to create part time health positions for youth e.g. Clinical associates/ hospital aid while still at school

Priority 3

Timeframe

Ongoing

Scoping by

December 2011

Programme

June 2012

Refer 1.4.1 with focus on local scholarships and adaptation of programme

Workforce

Advisor

(programme coordinator)

Scoping by

December 2011

Programme

June 2012

Establish relationship with provider

Establish support from Clinical/Service Managers and target specific roles

Workforce

Advisor

Workforce

Advisor

Continue to support existing student placements and explore wider job search placement opportunities

HR/Workforce

Advisor and SLT

This requires scoping and development Workforce

Advisor and SLT

December 2011

December 2011

June 2012

June 2012

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Action Prioritisation Related Activity Responsible Timeframe

Objective 1.3: To promote and facilitate the taking up of professions that are difficult to recruit to

1.3.1.

Await National direction for stair-cased career pathways into health

Priority 3 Support National process

Objective 1.4: To limit barriers to education

1.4.1.

Develop an incentivised incubator programme, through health/education and local trust partnerships, offering undergraduate scholarships including Māori and PI placements

Priority 1

1.4.2.

Develop career options for potential older under graduates, particularly for Māori and Pacific

1.4.3.

Island through incentivised part time work placements

Utilise relationships with tertiary education providers (see above) to:

• Develop new education pathways or reinforce current pathways

• Identify barriers to education - determine short term goals, the ‘quick wins’, and medium and longer term approaches

Priority 1

Priority 2

Assist with developing criteria and operation of scholarships

Determine funding options including Fundraising trust(s)

Fund and manage additional resource

SDU

Workforce

Advisor and

Maori

Health/CEO/Trust

Determine earmarked roles for placements e.g. both non clinical and clinical

Workforce

Advisor

Explore options for incentivising Maori Primary Care practitioners for example GP, Practice Nurses

GM Maori and

Clinical

Leadership roles

Support common curriculum development in conjunction with

Tertiary Institutions and DHBs

Barriers to education require focus on what are barriers perceived by staff, some may be a historical view. Survey staff to investigate perceived barriers and address them as able.

HR, SDU

June 2012

Scoping by

December 2011

Programme

June 2012

Scoping by

December 2011

December 2011

Current process

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2.

Goal two

A sustainable future workforce with the necessary skills, thus achieving a balance between local and international workforce.

System/change enablers

Sourcing and recruitment

2.1

Develop a flexible and robust workforce and a healthy workforce culture.

2.2

To support the workforce with effective IT and knowledge management skills and tools.

2.3

To maximise recruitment of NZ residents to SCDHB.

2.4

To develop and support the roll out of a SCDHB recruitment strategy.

Employment and retention 2.5

To create optimum work opportunity whilst studying and after graduation.

2.6

To strengthen the orientation and induction processes to ensure new employees are well supported.

Training and development

2.7

To support and enhance retention of staff.

2.8

To enhance job satisfaction by supporting innovation in practice.

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Action Prioritisation Related Activity Responsible Timeframe

Objective 2.1: Develop a flexible and robust workforce and a healthy workforce culture

2.1.1

Implement a workforce plan which supports Priority 1 Initial plan completed, implementation underway future health planning and review three yearly

2.1.2

Review service delivery and seek innovation opportunities that create efficiencies for example:

• Operational models that work to maintain a balance within a service and regionally and a nationally where appropriate in terms of generic and specialist activity

• Explore possibility of a Registrar programme

• Support the ongoing development registrars in Primary & Community Services of

Priority 2

SLT – leadership of

DONMAH and

GM HR

Undertake regional health workforce census, including skills analysis to develop a staged plan. This to include:

Steering group with NGO and PCS District Health Board representatives

Identify priority areas and action

Active participation in all regional and national service delivery model reviews according to the agreed South Island Health

Service Plan work plan (outlined in SCDHB Annual Plan) e.g. locum programme in Primary & Community Services

Workforce

Advisor

SLT – leadership according to agreed activity

Explore opportunities where provision of Secondary Services registrars may be feasible

GP registrars in place

GM SS

GM P&C

Underway

June 2102

Ongoing

2012/2013

2.1.3

Formalise a succession planning framework Priority 3 HR 2012/2013 Key role succession planning and risks identified

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Action Prioritisation Related Activity Responsible Timeframe

Objective 2.2: To support the workforce with effective IT and knowledge management skill and tools

2.2.1

2.2.2

Instigate HRIS and other system tools to develop/gather present and future workforce and performance data

Undertake programme to ensure staff have IT skills relevant to their position

Priority2 Regional HRIS solution

Implement e-Recruitment/vacancy management system

Implement e-Performance Management System

Focus on computer skills in 2011 especially with the implementation of the new CIS scheduled for roll out

CIS project and

SDU/HR

Professional development for managers related to advanced applications such as excel and access

HR team in collaboration with SI HR teams/IT

July 2013

December 2011

End June 2012

Objective 2.3: To maximise recruitment of NZ residents to SCDHB

2.3.1

Develop a local and national marketing plan using evidenced “pull factors” such as life skills, schools, affordable properties

Priority 2

National and local initiative. Some initiatives underway. This will require further scoping and development

HR/Workforce

Advisor/Comms

Current process

2.3.2

Support provision of undergraduate training and expand opportunities for trainee rural experiences

Priority 2 Continue to support undergraduate training for medical students, nursing, GP practice placements, Paediatric Interns and Physiotherapy students

All departments

Objective 2.4: To develop and support the roll out of a SCDHB recruitment strategy

2.4.1

Display and reflect SCDHB values in workforce planning i.e. in recruitment processes.

Priority 2 Add value branding to the relevant HR forms/letters HR and Comms

Current process

July 2011

2.4.2

Reflect forecasting models developed by HWNZ and use to guide and inform SCDHB recruitment strategy

Priority 2 Utilise forecasting models as available from HWNZ DONMAH and

GM HR

Current process

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Action Prioritisation Related Activity Responsible

Objective 2.5: To create optimum work opportunity whilst studying and after graduation

2.5.1

Assess opportunity for part-time, volunteer or other flexible working arrangements

Priority 1 Investigate Family Friendly and IT facilitated working from home options

HR

Timeframe

Scoping by June

2012

Objective 2.6: To strengthen the orientation and induction processes

2.6.1

Review and strengthen induction process Priority 1 DONMAH,SDU,CDs with HR support review process and provide template

SDU, HR, CD’s and

Departments

Once organisational review is complete, integrate Primary and

Community Services into orientation resource PCS and HR

Objective 2.7: To support and enhance retention of staff to ensure new employees are well supported

2.7.1

Strengthen links with Education sector in order to Priority 2 Support and participate in regional activities maximise learning opportunities for staff

DONMAH,

GMHR and

Clinical leadership

December 2011

December 2011

Current process

2.7.2

Strengthen workforce satisfaction strategies Priority 1 Support action plans of survey key area Champions

Conduct follow up survey

Survey

Champions and HR Team

HR

June 2012

2012/2013

21

Action Prioritisation Related Activity

2.7.3

Continue to encourage and support Māori in post registration study both in clinical and management fields

Priority 2

Responsible

Focus on Maori workforce with extra support from HWNZ in post registration study currently. Need to review those who identify as Maori and target them.

SDU, GM

Maori

Objective 2.8: To enhance job satisfaction by supporting innovation in practice

2.8.1

Develop intra and inter-service relationship building initiatives which supports partnership particularly working across services

Priority 3 This will require further scoping and development to enable planning and potential funding requirements.

Workforce

Advisor

Explore the development of DHB regional innovation awards that provide opportunity to profile areas and recognise excellence. This could be incorporated into a social event

2.8.2

Develop improvement reporting process Priority 3 Current Equip 4 and other Quality processes

Develop DHB regional innovation awards that provide opportunity to profile areas and recognise excellence. This could be incorporated into a social event

GM Quality and Risk

Timeframe

Ongoing

2012/2013

2012/2013

22

3.

Goal three

Well co-ordinated services and workforce management across primary, community, aged care and NGOs

System/change enablers 3.1 Ensure appropriateness of services and the workforce.

Sourcing and recruitment 3.2 Ensure that recruitment initiatives address service and workforce need.

Employment and retention 3.3 Ensure a workforce with the capacity to provide well coordinated services.

Training and development 3.4 Identify gaps or difficulties with service provision in order to determine training and development needs across these sectors.

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Action Prioritisation Related Activity

Objective 3.1: Ensure appropriateness of services and the workforce

3.1.1

Identify services that should be delivered in a particular setting and ensure skilled staff are available to support the services

Priority 1 HR assist in identification of competencies and ongoing recruitment

As part of the census to identify skills and thereby any skill gaps for example dementia.

Explore options for access in order to support the achievement of health targets, for example incentivise businesses to support workforce to meet health targets through competition etc

Responsible

HR and PCS

Timeframe

December 2011

3.1.2

Undertake a census of primary and community workforce (as per NMDHB) and services (incl. providers) and update into an electronic format

Priority 1

3.1.3

Support programmes that develop the workforce in being comfortable relating to Māori patients

Priority 2

Workforce advisor to work in partnership with PCS to undertake census and analysis

Diversity training programmes for key population groups

Investigate the expansion of the current existing Tikaka Maori programme

Explore cultural safety training for primary and community

Workforce advisor and

PCS

GMPCS,

SDU/HR

PCS

/Education

Coordinator

December 2011

2011/2012

Objective 3.2: Ensure that recruitment initiatives address service and workforce need

3.2.1

Target youth to generate health career interest such as primary, community and aged care

Priority 1 Career expo. Include information of PCS in all marketing efforts HR and PCS

Investigate use of targeted projects in the aged care setting which encourages generational mixing for example the Eden project

Strategy,

Planning &

Accountability

3.2.2

Promote community roles to a range of existing staff to allow transfer from secondary to community services and community to secondary

Priority 1 Support staff identifying desire to change area of practice and schedule a training plan to increase skill and knowledge required to work in new areas

SDU

June 2012

Current process

24

Action Prioritisation Related Activity Responsible

Objective 3.3: Ensure a workforce with the capacity to provide well coordinated services

3.3.1

Utilise a forecasting tool for workforce Priority 2 Refer 2.4.2 DONMAH and

GM HR

3.3.2

Support and develop peer support networks – horizontal and vertical

Priority 3 Support the continuation of the networks currently operating within SCDHB and develop others

Clinical

Leadership roles

Objective 3.4: Identify gaps or difficulties with service provision in order to determine training and development needs across these sectors

3.4.1

Work with education sector to look to future training needs

Priority 3

3.4.2

Undertake a stocktake of training and development activities and make available to staff

Priority 3

Continue established relationships and networks with education providers

SDU/HR

Publish local and regional training available SDU and

Regional L&D

Departments

Timeframe

Ongoing

Current process

Current process

Yearly

25

4.

Goal four

Developing a sustainable continuum of care for rural/provincial residents within a regional environment

System/change enablers 4.1 Explore how to support the mobile workforce providing multi-site services including peer support, and travel for patients.

Sourcing and recruitment 4.2

Achieve sustainability through targeted recruitment that addresses forecasted rural needs.

Employment and retention 4.3

Manage identified reasons for resignation or unsuccessful recruitment.

Training and development 4.4

Enhance training in order to support a better continuum of care.

26

Action Prioritisation Related Activity

Objective 4.1: Explore how to support the mobile workforce providing multi-site services including peer support, and travel for patients

4.1.1

Implement a robust and integrated IT system including single patient record, telemedicine

Priority 3 Captured in SDCHB IT Plan

Responsible

Objective 4.2: Achieve sustainability through targeted recruitment that addresses forecasted rural needs .

4.2.1

Align workforce recruitment strategies with predicted rural health need e.g. in terms of skill set and capacity

Priority 2

4.2.2

Identify the profile of health care providers (why do people work here and what makes them stay) in this area and focus recruitment endeavours towards this target group

Priority 3

Recruitment Strategy targeted for professional groups

Staff survey

Objective 4.3: Manage identified reasons for resignation or unsuccessful recruitment

4.3.1

Identify reason for resignation e.g. through exit interviews

Priority 2 Ongoing current activity. Investigate electronic surveys

4.3.2

Determine recruitment strategies for recruitment into remote rural areas

Priority 2

HR/SLT

HR

HR Team

Communicate lifestyle options

Sabbatical/exchange House Surgeons overseas

SI rotation at different DHBs for House Surgeons

Trainee placements for GPs

Rural Incentive Scheme

Explore sustainable models of service delivery, for example

Twizel District Nursing Service/

PCS and HR

National initiatives

PCS

Timeframe

Current process

2012/2013

Current process

Ongoing

27

Action

4.3.3

Strengthen peer support networks across the region, connecting isolated clinicians into networks e.g. District Nurse

Prioritisation

Priority 2

4.4.1

Explore pathways and expanded roles such as

General Practitioners with a Special Interest

(GPSI), Nurse Practitioner (NP), Clinical Nurse

Specialist (CNS), Allied Health (AH), joint appointments for clinicians across primary and community

Priority 2

Related Activity Responsible Timeframe

Email network established to allow information flow between areas especially re education and meetings

Working more closely with the Primary Nurse Advisor to strengthen linkages into Primary Care

PCMO, CMO and DONMAH

Explore IT solutions for virtual meetings

Locum initiative with Primary & Community Services Explore the development and implementation of rotational rosters for isolated clinicians whereby they rotate into urban clinical areas periodically

SCDHB IT

PCS

Objective 4.4: To enhance training in order to support a better continuum of care .

Determine roles and appointments on trial/pilot basis SLT and

Service

Managers

July 2011

June 2011

2011/2012

28

5.

Goal five

To identify and implement the most cost effective models of care and workforce to meet the needs of an aging population

Employment and retention 5.1 To provide a workforce capable of meeting the needs of the aging population.

Training and development 5.2 To meet the increased workforce demands while maintaining appropriate skill mix.

29

Action Prioritisation Related Activity

Objective 5.1: To provide a workforce capable of meeting the needs of the aging population.

5.1.1

A watching brief for the South Canterbury environment in relation to assistant roles and their potential scope and contribution to care model

Priority 2 National Pilot Programmes

Responsible

SCDHB

Timeframe

2012/2013

Objective 5.2: To meet the increased workforce demands while maintaining appropriate skill mix.

5.2.1

Educate and up-skill workforce to provide appropriate aged care

Priority 2 A number of training opportunities already exist i.e. ACE training for Care Assistants. Need to invest in staff to attend and achieve this.

SDU and

Strategy,

Planning &

Accountability

5.2.2

Identify roles that could be undertaken by nonregulated staff and develop training specific programmes

Priority 2

5.2.3

Explore expanded practice roles with HWNZ e.g.

Nurse Specialist – particularly in GP practices/Primary Care Clinical Pharmacist

Priority 2

Develop clear guidelines on the use of assistants in the organisation.

Support National Projects

SLT and SDU

DONMAH and

PCS

2011/2012

2011/2012

2011/2012

30

6.

Goal six

South Canterbury will provide an environment that supports an aging workforce to actively contribute to the health needs of the community

System/change enablers 6.1

Identify key vehicles that will support a change in attitude towards the aging workforce and that remove barriers to remaining employed and active in health care.

Employment and retention 6.2

Provide open and useful support to staff as they begin to change their working lives.

Training and development 6.3

Provide opportunities to support the vital on-going inclusion of the older workforce.

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Action Prioritisation Related Activity

6.1.4

Continue to support and develop the staff wellness programmes – “Health 4 U”

Priority 2 Ongoing as per focus areas identified

Responsible Timeframe

Objective 6.1: Identify key vehicles that will support a change in attitude towards the aging workforce and that remove barriers to remaining employed and active in health care

6.1.1

Determine the needs of the aging SC workforce e.g. working with the Senior Leadership Team,

Public Health and the local community

Priority 1 Use tools/resource providers to determine needs of aging work force

Workforce advisor

June 2012

6.1.2

Establish organisational direction for initiatives Priority 1 June 2012

6.1.3

Ensure consideration of the Health and Safety environment with attention to work intensity and manual handling

Priority 2

Use tools/resource providers to determine needs of aging work force

Workforce advisor/HR

Project for Manual Handling Advisor HR team May 2012

HR team Ongoing

32

Action Prioritisation Related Activity

Objective 6.2: Provide open and useful support to staff as they begin to change their working lives

6.2.1

Develop a support programme that assists older

• staff as they alter their work plans including:

• Initiatives that identify staff needs and implement strategies such as post-sharing and roster systems

• Options for other roles that will continue to utilise experience and knowledge

Options for transitioning current staff into alternative roles

Flexibility with FTE and Rosters

Priority 2 PCS will support an organisational approach

Includes 6.1.2

Develop Policy and Procedures

Establish needs from exit interviews/structured surveys

Develop alternative career paths

Improve roster systems capability

Responsible Timeframe

HR, SLT and

Service

Managers

2012/2013

Objective 6.3: Provide opportunities to support the vital on-going inclusion of the older workforce

6.3.1

Provide ongoing professional development and career progression/ transition options such as:

Priority 2 PCS will support an organisational approach

Strengthen development as part of performance management process

• Updating staff with relevant new technology

• Utilise staff professional development reviews to identify future roles and future training needs for this workforce

Develop formal frameworks/pathways

Work with the SI Regional Learning and Development group in investigating uses of IT for education opportunities and assisting staff to utilise same

Invest in technology tools which demonstrate reduced cost and improved service delivery

Work with Managers to ascertain common needs of staff from their Performance Appraisals and target training to meet these needs

All Managers December 2012

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