IPR Exec Summary December 2014 IPR Executive Summary Quarter 3 2014-15 Reporting Period 1st October to 31st December 2014 IPR Exec Summary 1 December 2014 IPR Exec Summary December 2014 Table of Contents Section 1. Introduction and Executive Summary 2. Business Plan Domains 3. Performance on a Page 4. Overview of IPR Deliverables 5. Reporting by Exception Pages 3-6 Page 7 Page 8 Pages 9-11 Pages 12-15 Developing people for health and healthcare IPR Exec Summary 2 December 2014 IPR Exec Summary December 2014 1. Introduction and Executive Summary "Health Education England exists for one reason and one reason only; to support the delivery of excellent healthcare and health improvements to the patients and the public of England, by ensuring that our workforce has the right numbers, skills, values and behaviours, at the right time and in the right place" This is the Quarter Three (Q3) Integrated Performance Report (IPR) for Health Education England (HEE) covering the period from 1 October to 31 December 2014. The report measures progress against the 2014/15 Business Plan and Mandate deliverables. The IPR continues to evolve and as at Q3 there are now 163 deliverables being actively monitored and reported against. There has been a slight increase in the number of deliverables reported (there were 160 in Q2) to reflect changes agreed with Senior Responsible Officers (SROs) and to enable HEE to recognise its inyear achievements and monitor ongoing programmes of work. The projects being managed through the Portfolio Office have also been mapped to the IPR this quarter. Exception reports for deliverables where slippage has occurred are reported in Section 5. The following traffic light (RAG) system has been applied: The IPR is structured as follows:Excecutive Summary, Full IPR Progress Updates (available on-line), Business Plan Priority Commitments (available on-line), Benchmarking Charts (available on-line). The Executive Summary provides: a high-level overview of HEE's performance. This report has been structured using the HEE Business Plan Domains. Section 2 provides a description of the domains; Section 3 illustrates performance by domain and Section 4 shows a high level progress overview for each deliverable. Developing people for health and healthcare IPR Exec Summary 3 December 2014 IPR Exec Summary December 2014 1. Introduction and Executive Summary (continued) Analysis of the Quarter 3 position shows that:56 (34.4%) of our deliverables have been achieved (an increase from 20.0% in Q2); 67 (41.1%) are on target to be achieved (a decrease from 48.8% in Q2); 39 (23.9%) are making some progress although slippage is likely to occur to the original delivery date (an improvement on 48 (30.0%) reported last quarter); HEE's Business Plan identifies a number of deliverables that are considered key priorities 2014/15. Reporting of these priorities can be found in the BP Priority Commitments report. Highlights from each of the domains follow:- Domain 1: Workforce Planning 1 (0.6%) is yet to be rated as this is a new area of work (an improvement from 2 (1.3%) reported in Q2). There has been no change in the RAG status for the 4 deliverables since last quarter. The 2015/16 workforce planning process has been designed, agreed and implemented, and the final plan was submitted to the December Board in line with the agreed timetable. Although the deliverable Data Collections with HSCIC and Professional Bodies (WP1_002) remains Amber, the funding issues have now been resolved and the programme has re-started, with two proposed collections per year, commencing in Spring. The chart below illustrates the positive progress being made, and demonstrates that that the performance management approach is working: Domain 2: Health Careers 0 deliverables are rated red (no change on last quarter). Of the 17 deliverables reported against this domain none have shown a decrease in confidence of delivery. Four deliverables have been reported as being achieved this quarter. Customer Satisfaction of the National Careers Helpline (HC1_007) continues to remain very high as does the recommendations of the service to others. Regarding Access to Higher Education (HC2_014), a soft launch of strategy is in place with a formal launch planned for March. A directory of Widening Participation (HC2_015) initiatives has been developed to promote best practice, and which has received positive feedback. The interactive framework for Values Based Recruitment (VBR) (HC3_023) was delivered in October and will continue to be updated with new information, and an interim data report is being developed to track progress on Testing of VBR Values (HC3_025) which is currently reported as Amber, but is expected to be delivered by March. Developing people for health and healthcare IPR Exec Summary 4 December 2014 IPR Exec Summary December 2014 1. Introduction and Executive Summary (continued) Domain 2: Health Careers (cont.) Domain 3: Education Commissioning (cont.) Health Care Apprenticeships (HC2_011) continues to remain on plan and national standards for health care assistants (HCAs) have been announced by the Department of Business, Innovation & Skills. There is increased confidence in the delivery of the following deliverables: A life course approach to workforce planning is being developed on Safeguarding (EC1_008) which includes forum representation and informs future activity. A multi-disciplinary digital Perinatal Mental Health (EC1_009) i-Learning module is being developed, and a set of core questions and key principles have been devised for Student Feedback (EC3_096), and are being reviewed by stakeholders. HEE is on track to have the first cohort of International Medical Trainees (EC4_107) to start next September. Although the deliverables for National Careers Information (HC1_001), Health Careers Strategy (HC2_008) and Under-represented Groups (HC2_015) have remained Amber since Quarter 1, initiatives and actions have been developed in collaboration with relevant stakeholders to improve progress. Delivery of Under-represented Groups (HC2_015) is dependent on the release of quality data from HESA and the method of analysis and reporting. The update for Testing of Values (HC3_025) indicates that an interim data report will be available in early January, with a full report by March 2015 for consultation and then Executive/Geographical Director discussion and agreement. That being the case, the current Amber rating is probably a pessimistic interpretation. The Health Careers Strategy (HC1_008) deliverable was due in September 2014, however it is clearly difficult to achieve this whilst BT is in flight, and whilst Geographical Directors establish their portfolios – it probably needs a new timeline agreeing, and the form of document/strategy re-confirming (the suggestion in the update was a Strategy and separate Business Plan). Domain 3: Education Commissioning The Education Commissioning domain reports on 112 deliverables, and the overall position for this domain has improved; an additional 15 deliverables were reported as achieved, bringing the total to 41. There were 24 Amber-rated deliverables, reduced from 30 reported last quarter, and 47 Green-rated deliverables compared to 53 in Quarter 2. There have been some shifts in confidence from green to amber, which indicates that some slippage to delivery has, or is likely to occur. These include the programme of work on the Antimicrobial Resistance (AMR) strategy (EC1_051/052). The implementation is expected to be completed by March which is the delivery date, and an action plan to ensure linkages for the competent prescribing of AMR is due to be completed 1 month late. Due to an expansion of scope the workload on Minimum Standards of Mandatory Training for Health and Care (EC3_091) currently exceeds capacity, and plans are in place to recruit a project manager and seek support from the expert advisory group. The area of work on Piloting LETB Quality Metrics (EC3_093) has been placed on hold pending recruitment to the Quality Transformation post. Several deliverables have reported as Amber for 3 consecutive quarters. Collaborative work is under way with E-lfh and TEL to develop training material for Mental Health programmes (EC1_023 - EC1_027). A standard approach for reporting Attrition (EC3_083 has been agreed. The Education Training for Trainers programme (EC3_088) is awaiting the appointment of the new Commissioning and Quality Transformation teams to take this work forward. The Launch Technology Enhanced Learning (TEL) hub programme (EC3_089), is being aligned to NHS partner priorities, HEE Business Plan and Mandate, and barriers to IT are being resolved. There are several key highlights to note this quarter. The Medical Schools Council report in supporting the Assessing Aptitude for Medical Careers (EC2_072) programme recommended incorporating VBR and to consider a wide range of selection methods. All 4 health departments have agreed a UK-wide mandate for UK Foundation Programme Development (EC2_074). Developing people for health and healthcare IPR Exec Summary 5 December 2014 IPR Exec Summary December 2014 1. Introduction and Executive Summary (continued) Domain 4: Innovation through Investment Four of 10 deliverables assigned to Innovation through Investment have been delivered; these relate to Educational Research projects (II1_001/003), Development of Clinical Academic Pathway (II2_005) and Improving Technological Literacy (II3_012). Section 4 provides a high level summary of our achievements and Section 5 the exception reports for our most challenging areas. Two deliverables are being reported as on track; Sharing Good Practice and Knowledge (II3_010) and Driving Improvement and Developing Current Workforce (II3_011). Three deliverables have been reported as Amber; Slippage on Embedding Best Practice (II2_007) is being addressed by defining core responsibilities and forming a task and finish group. HEE is meeting with regulators to discuss curricula content including leadership to contribute to the scoping exercise for the Work with Leadership Academy (II2_008). The slippage of the Genomics and Bio-informatics programme (II3_009) is being managed through the development of an education and workforce planning strategy which is to be shared with appropriate stakeholders to better understand future needs. Domain 5: Corporate Enablers Of the 20 deliverables reported against the Corporate Enablers domain, 5 have been delivered. There is also increased confidence in delivery of the revised HR and OD service Model (CE2_019) and the Beyond Transition work programme (CE2_020). Financial Balance (CE3_034), Administration Costs (CE3_035), Staff Attendance (CE2_030) and Corporate Website Development (CE2_023) are all on track to meet the delivery dates. As a result of staff shortages the Development of the Estates Strategy (CE2_016) has failed to deliver at Quarter 2 and at Quarter 3, and consequently it risks the Implementation (CE2_017). A facilities management lead has been appointed and the Estates Strategy is due to be submitted to the Executive Team in February. Retention of talent (CE2_031) is a priority for HR leads across HEE, although Beyond Transition has meant that this is difficult to stabilise at this point in time. With the end of BT, there is a good opportunity to re-confirm the target and set expectations for the geographies and LETBs. Developing people for health and healthcare IPR Exec Summary 6 December 2014 IPR Exec Summary December 2014 2. Business Plan Domains The deliverables in the IPR IPR Progress Progress Update Update Report Report Identifying how many staff are needed, with what skills, values and behaviours to meet patients needs both now and in the future. To do this we work with our LETBs to understand local needs, alongside national bodies to understand more specialist areas, so that we know how many education and training posts to fund. Recruiting and attracting the right people to funded education and training programmes, so that our future workforce has the right skills, values and behaviours, using NHS Careers, value based recruitment, return to practice and widening participation. have been structured using the following domains:- Using our financial and contractual levers with universities and the money we provide to Trusts to ensure that our students and trainees receive a high quality and safe training experience that equips them to deliver high quality care both now and in the future. To obtain the best value for money from the investments we have made in new staff, and to ensure our existing staff have the right skills, values and behaviours to deliver service transformation, we work with LETBs and partners to support continuing training and development of the workforce, including nonprofessionally qualified staff. We have a range of broader functions at both local and national level that help support the delivery of HEE’s key objectives including: Strategy, Performance and development, Human Resources (HR) and Organisational Development (OD), Corporate Finance, Estates, Internal and external communication and Corporate services. Developing people for health and healthcare IPR Exec Summary 7 December 2014 IPR Exec Summary December 2014 3. Performance on a Page An overview of HEE's performance against all 163 deliverables as at Quarter Three 2014/15 is shown below: * The figures in the charts represent the number of deliverables by RAG for each domain Developing people for health and healthcare IPR Exec Summary 8 December 2014 IPR Exec Summary December 2014 4. Overview of IPR Deliverables There are 163 deliverables identified from HEE's Business Plan and Mandate that have been reported against in this quarterly report. Developing people for health and healthcare IPR Exec Summary 9 December 2014 IPR Exec Summary December 2014 4. Overview of IPR Deliverables (continued) Developing people for health and healthcare IPR Exec Summary 10 December 2014 IPR Exec Summary December 2014 4. Overview of IPR Deliverables (continued) Developing people for health and healthcare IPR Exec Summary 11 December 2014 IPR Exec Summary December 2014 5. Reporting by Exception An exception report has been produced for the following deliverable(s) to show where the Mandate delivery dates have not been met or there is an indication that slippage against the Mandate delivery date is likely to occur. The reasons for this are understood and managed as follows:Title CE2_016 Estates Strategy developed CE2_018 One HEE CE3_031 Budget Distribution Model RAG Start Date Implications of non-achievement Description of issues causing re Details of action being taken Staff shortages between June and November in estates and facilities led to a delay in the development of the strategy. Relevant staff, an Estates & Facilities Management Lead, appointed in November 2014. The Estates Review reported to the Executive Team in June 2014 was refreshed December 2014, with a view to them receiving the Estates Strategy in February 2015. 01 Apr 2014 30 Sep 2014 Delay to the development of an estates strategy has a knock-on effect in implementing the strategy 01 Apr 2014 30 Sep 2014 HEE values the importance of all staff Pause to ensure output from staff engagement on working within a values and behaviour 'one HEE' is captured and included in values and framework to ensure that delivery on behaviour framework mandate objectives is achieved in a manner which upholds the wider values of the NHS constitution. Output from 'one HEE' engagement exercise is being assessed against draft model to ensure alignment. 01 Apr 2014 31 Dec 2014 Any historical inequities in budget distribution to LETBs is maintained particularly within the future workforce area of spend. Firstly, finance staff attention has been diverted onto a number of other important issues, including providing information to support our settlement for 2015/16, and providing analysis and support for the 'beyond transition' process. Secondly, there were concerns expressed about the availability, consistency and reliability of data that would underpin any fundamental changes. Resolution of the data issues will take longer than time allowed in the annual planning cycle. The Chief Information Officer that is proposed as part of 'Beyond Transition' will considerably improve data consistency. Similarly, the revised Financial Management Team is better placed to take this work forward and ensure progress in time for 2015/16 budget setting. 01 Apr 2014 30 Sep 2014 Potential to not maximise value for money from our investment in education activities is delayed. The finance staff attention has been diverted onto a number of other important issues, including providing information to support our settlement for 2015/16, and providing analysis and support for the 'beyond transition' process. The creation of one finance team following implementation of 'beyond transition' will enable workload to be managed across a greater resource. Amber Amber Amber CE3_032 Measures of Amber value for money in E&T Delivery Date Developing people for health and healthcare IPR Exec Summary 12 December 2014 IPR Exec Summary December 2014 5. Reporting by Exception (continued) Title Start Date Delivery Date Owner EC1_050 Scoping 01 Apr 2014 the AMR strategy 30 Sep 2014 Janice Stevens EC3_088 01 Apr 2014 Education training for trainers and educators 30 Sep 2014 EC3_089 Launch Technology Enhanced Learning (TEL) hub 30 Sep 2014 01 Apr 2014 RAG Implications of non-achievement Description of issues causing re Details of action being taken Amber Reputational risk to HEE if it does not deliver or engage with other organisations doing work in this area. Establishment of HEE working group taking forward this work in response to the action plan agreed by the HEE executive was delayed initially due to a lack of resources and subsequently because of difficulties in co-ordinating the diaries of the co-chairs. First meeting of working group set up to scope actions for HEE has now taken place. A specialist antimicrobial pharmacist is being recruited to help drive this work forward in 2015. Amber Reputational risk to HEE if it does not deliver or engage with other organisations doing work in this area. A bid to the Resource Management Group for additional resources to support this work was unsuccessful. The work is therefore being integrated with other DEQ programmes including Phase 2 work on Better Training Better Care and the Human Factors work. Work has been suspended, pending the appointment of the new Commissioning and Quality Transformation teams within DEQ who are expected to take this work forward. The hub will enable the effective share and spread of TEL technologies and techniques UK-wide, a core objective of the programme. The impact of non-achievement cannot be measured at this stage though there is no alternative option which will have the same reach and accessibility as a central hub. Commissioning and development stages of the hub put on hold due to increased user research required as part of Government Digital Services (GDS) guidelines (digital by default discovery phase), uncertainty around the HEE innovation hub and links to the TEL hub and pending completion of the HEE digital road map. Detailed user research to meet GDS requirements is now complete. This encompassed user needs survey, desk research, analysis of events, meetings and conferences and a variety of focus group and testing sessions. Business case drafted for submission to HEE Digital Assurance Group then GDS team. Hub development to start January 15. Wendy Reid Wendy Reid Amber Developing people for health and healthcare IPR Exec Summary 13 December 2014 IPR Exec Summary December 2014 5. Reporting by Exception (continued) Title Start Date Delivery Date Owner EC4_105 International office plan 01 Apr 2014 31 May 2014 Steve Clarke RAG Amber HC1_001 National 01 Apr 2014 Careers Information 30 Jun 2014 HC1_002 Developing a Health Careers Website 31 Dec 2014 01 Apr 2014 Implications of non-achievement Description of issues causing re The risks of not having developed the future plan for the International Office are minimal. Work still continues of the flagships projects. In the medium to long term a strategy will need to be developed. The future plan for the International Office has Now the issues with IPGMTS have been not yet been finalised due to the team resolved the future plan will be finalised. focusing on resolving the issues with the International Postgraduate Medical Training Scheme (IPGMTS), which is our flagship project. Jo Lenaghan Amber Jo Lenaghan Amber Implications of slippage to the delivery date of December 2014 are minimal as DH gave already agreed continuing with the exisiting website arrangements until March 2015. This will ensure continuous service delivery. Details of action being taken Launch of the website is now expected to be end of March 2015. The significant testing undertaken in Quarter 3 has meant more development is needed to make it fit for purpose. A Cabinet Office assessement will also be needed before the website is able to go-live which will impact on the launch date. Agreement from DH to continue the existing website arrangements until June 2015 is being sought to ensure continuous service should there be further slippage. Clarification on the assessment needed is also being sought. Launch of the website is now expected to be end of March 2015. The significant testing undertaken in Quarter 3 has meant more development is needed to make it fit for purpose. A Cabinet Office assessement will also be needed before the website is able to go-live which will impact on the launch date. Agreement from DH to continue the existing website arrangements until June 2015 is being sought to ensure continuous service should there be further slippage. Clarification on the assessment needed is also being sought. Developing people for health and healthcare IPR Exec Summary 14 December 2014 IPR Exec Summary December 2014 5. Reporting by Exception (continued) Title Start Date Delivery Date Owner HC2_008 Health careers strategy 01 Apr 2014 30 Sep 2014 Jo Lenaghan II2_007 Embedding best practice 01 Apr 2014 WP1_002 Data collections with HSCIC and professional bodies 01 Apr 2014 RAG Amber 31 Jul 2014 Nicki Latham Implications of non-achievement Description of issues causing re Details of action being taken The initial draft of the strategy will become out-of-date and achieving some of the deliverables will become more difficult. It could also impact on the delivery of other projects such as the widening participation strategy an talent for care. The strategy has been superseded by Beyond Transition and the SRO plans to discuss it with the four geographical directors in January to better understand their level of involvement in a national careers strategy and its delivery. Following the SROs conversation with four geographical directors, the strategy is likely to require redrafting and may need to be split into two documents - a short strategy and a business plan. Discussions are also taking place on how a national careers service and LETB services can work together. None at this point Programme of organisational change and competing demands causing some national and local capacity issues and challenges in knowledge access across teams. Task and Finish groups for delivery of the Research and Innovation strategy established in December 2014 and initial meetings held January 2015. Research and innovation operating model being agreed as a part of wider organisational change, with a proposal to define and resource core national and local responsibilities. Task and Finish Groups for delivery of the Research and Innovation Framework are now up and running and developing work plans of which deliverable II2_007 is one. Revised Workforce Information Architecture (WIA) timetable means that first collection of data from primary care and independent sector will be available to support 2015 planning round (rather than second as originally planned). This means the opportunity to address data quality issues will be reduced. The WIA project was expected to be financed by DH Grant In Aid to HSCIC; this funding source did not materialise. Insecurity of funding resulted in delays in implementation of the programme. (Chartered Society of Physiotherapy) CSPled project milestones are determined by CSP. Funding for WIA has now been secured for 2014-15 (shared between DH, HEE and NHS England) and programme has re-started. The collection is scheduled to be on a twice-per-year basis so is re-focused on the Spring collection rather than the Autumn. Amber 30 Sep 2014 Jo Lenaghan Amber Developing people for health and healthcare IPR Exec Summary 15 December 2014 IPR Exec Summary December 2014 Contact Health Education England at:- www.hee.nhs.uk hee.enquiries@nhs.uk @NHS_HealthEdEng www.facebook.com/nhshee 16
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