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
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.
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.
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.
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.
4
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.
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.
5
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.
6
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
7
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
8
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.
9
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
10
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
11
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.
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
12
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.
13
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
16
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
17
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.
18
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
19
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
20
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
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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
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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
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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.
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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
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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
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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.
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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
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
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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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