SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

8.5.3. Workforce
Following feedback from consultation, workforce plans were developed further. Building on
the work completed before the consultation process, we have developed a detailed view of
the type and scale of workforce changes required to deliver reactive and proactive care in
the community, as described in the out of hospital strategies. There was a specific focus on
rapid response and case management services as these areas are the most essential in
enabling the shift of care and where the greatest workforce changes are required.
Developing this understanding involved defining a representative care model, defining skills,
competencies and new and enhanced roles for reactive care and case management. This
enabled us to determine staffing volume requirements against a representative service
model, and develop a workforce modelling tool for these two services, enabling CCGs to
adapt care package and staffing assumptions.
Delivering the out of hospital vision will require a significant workforce shift for the entire
community workforce – to empower patients and their carers, support collaboration across
professions and organisations (including health and social care), and better manage risk in
the community.
Reactive and proactive services form a continuum and patients will move in and out of them
depending on their needs at any time. Proactive care – including better case management –
relies on empowering patients and carers, providing a single point of contact, and dedicated
health and social care coordination. Conversely, efficiency and effective reactive care
requires multi-skilled multi-professional teams at the right scale.
We estimate that the delivery of the CCGs‟ out of hospital strategies will require
approximately 800 additional staff across NW London. To deliver the reactive and proactive
care elements of these strategies, we estimate that approximately 250-275 additional whole
time equivalents (WTEs) will be required within the community setting across NW London to
provide home-based proactive and reactive care. This figure is made up of new and
enhanced roles providing dedicated reactive and proactive care.
A number of these roles will work across both services reflecting the continuum of out of
hospital care whilst others are dedicated to providing either reactive care (e.g. rapid
response) or proactive care (e.g. case management).
These new roles will help to ensure the delivery of high quality and effective out of hospital
care at the scale required across NW London but also critically will provide our staff within
NW London with opportunities to work at the forefront in delivering new models of care as
well as career development.
These roles will hold a number of the key skills and competencies that are essential to
deliver effective out of hospital care, including ability to empower patients, individuals and
their carers; providing integrated and seamless care across health and social care; working
in multi-professional teams and the clinical skills required to deliver care to more acutely ill
patients in the community.
The new and enhanced roles are included in Figure 8.4.
8a. Development of out of hospital plans in NW London 227