Healthcare Workforce Deanery Balanced Scorecard

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Healthcare Workforce DeaneryBalanced Scorecard

September 2009
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How does the Balanced Scorecard work?
Level 1 Overview. This outlines the 4 high
level areas of focus in line with the SLA with
the DH. It shows the overall SLA line scores to
give an at a glance summary.
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Level 2 High level performance assessment for
each of the standards / targets within the 4 key
areas. RAG rating based upon actual
performance against target or SHA interpretation
of progress to date (where no performance measure
available)
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Level 3 Evidence to support Level 2 comments
and wider information on Deanery actuals,
including those issues that require detailed
discussion.
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Overview Areas of Focus for the Review (Level
1)
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1. General (Level 2)
1 .1 Learning and Development Agreements are in
place with all clinical training providers
SLA 1.1 Owner Peter Rolland
G
LDA's signed and returned by CEO's for all Acute
and Mental Health Trusts
1.2 Arrangements are in place (either directly
or via Higher Education partners and others) to
monitor the quality of training



SLA 1.2 Owner John Keenan / Peter
Rolland
G
Schedule 3 within the LDA identifies the process
undertaken for the quality monitoring of
training within the practice placement for both
medical and non medical trainees
1.3 A director-level post for overseeing
education and development is identified for all
NHS organisations from whom the SHA commissions
training
SLA 1.3
Owner Peter Rolland
All LDAs have been signed off by the Chief
Executive and we also have named LDA leads in
each organisation who have a reporting line to
the CEO.
G

1.4 JIF Skills Pledge

SLA 6.1
Owner Trish Knight
G
Northampton General Hospital expected to sign the
Skills Pledge on 15th October bringing the East
Midlands up to 100. JIF position being assessed
at the end of quarter two to ensure we come in on
budget
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1. General (Level 2)
1.5 Pre-registration training for paramedics

SLA 6.2 Owner
Peter Rolland
G
Provision exists for pre-registration paramedic
education with two higher education providers.
1.6 Training for end-of-life care available

SLA
6.3 Owner Peter Rolland /




Christine Sutcliffe



G
1.7 Staff survey for on the job training

SLA 6.4 Owner
Trish Knight
G
Staff responses to staff survey has increased by
4.3

1.8 Nationally Hosted Activity funded in line
with SLA
SLA 7.1 Owner Belinda Hales
G
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5. General (cont.) (Level 2)
1.9 Investment / Business Plan Reporting

Owner Paul
Timperley
The following algorithm has been
used Green over 75 of lines
reporting green, no reds Yellow
less than 50 of lines reporting yellow, max of
one red Red Over 50 of lines
reporting yellow, more than one red
A
Objective 1 Contracting
R
Objective 2 Quality
G
G
Objective 3 Provider Functions
A
Objective 4 Staff Development
G
Objective 5 Multi-professional Ethos
A
Objective 6 Partnership
G
Objective 7 Corporate Efficiency
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1. General (Level 3)
Compliance Statements
Annual Investment Plan. SHAs annual investment
plans agreed at SHA Board and Business Plan
through the Confirm Challenge process. Both
published by 31/05/09. They are based explicitly
on planning fro the delivery of services to
patients and on long term workforce need and
local financial plans.
Electronic Staff Record. Work continues to
improve the quality of the data in ESR and to
ensure we realise the benefits of its usage.
Overall position is satisfactory.
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5. General (Level 3)
Organisational Development stages
C-P Partnership development sessions designed and
delivered March 25th and June 8th 2009. Outputs
fed into C-P planning. Nine x staff update
sessions (including HQW info) delivered in May
and September 2009. Over 185 staff attendances
booked. Articles in the Deanery staff newsletter
from the HWQ Programme Office and Organisational
Development (OD) Team over various
months. Ongoing support of Deanery staff through
Developing the Deanery through You (October,
November and December 2009) for Deanery staff.
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5. General (Level 3)
Over spends at the year end are forecast in all
divisions except MADEL and NMET. The Deanery has
implemented a contingency plan to manage the
financial position back to breakeven.
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5. General (Level 3)
Revised plan now takes account of the transfer
out of the 1.797m hosted allocation for PGME
recruitment across all SHAs causing the dip in
expenditure in July. Forecast underspend per
month mainly due to reduction in GP trainee out
of hours allowance not reflected in budget
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5. General (Level 3)
Revised plan now takes account of the transfer
out of the 1.797m hosted allocation for PGME
recruitment across all SHAs causing the dip in
expenditure in July. Forecast underspend per
month mainly due to reduction in GP trainee out
of hours allowance not reflected in Budget.
Invoices received relating to 2008-09 which were
not accrued for last financial year are causing a
different expenditure profile at the beginning
of the year. Increases to placement rates for GP
practices and additional sessions agreed at UHL
or causing a change in profile throughout the
year. The drop in spend in July is due to the
receipt of the quarter 1 North GP practice SIFT
charges which were a lot less than charges
accrued in the first quarter.
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5. General (Level 3)
The plan profile has now been revised to match
the payment profile. The SGU has recently issued
a forecast over spend for the year which is not
included in the EM forecast currently.
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5. General (Level 3)
We do not have any further intelligence to date
to revise the monthly expenditure profile used in
the opening plan. In July we received credits
for the under delivery of LBR contracts in
2007-08 and 2008-09 causing an unexpected dip in
expenditure that month.
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5. General (Level 3)
The latest forecast revises the monthly
expenditure profile for the JIF training and
education project and SAS grade doctors CPD now
expected to hit later in the financial year than
assumed in the opening plan.
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5. General (Level 3)
Invoices received relating to 2008-09 which were
not accrued for last financial year are causing a
different expenditure profile at the beginning
of the year. Legal costs now expected but not
included in the opening plan are causing a change
in profile at the end of the year. Additional
posts agreed after budgets signed off by the SHA
Board causing a change in profile throughout the
year. An ongoing review of posts and the
receipt of quarter 1 salary recharges from other
organisations has led to monthly fluctuations in
costs for the first part of the year.
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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1. General (Level 3)
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2. Undergraduate Medical and Dental Education
Placement Funding (Level 2)

2.1 Sufficient medical and dental placements are
available for local medical and dental students



SLA 2.1
Owner Heidi Breed/




Gail Rose
University of Leicester 2009 Graduates - 241
University of Nottingham 2009 Graduates - 320.
Graduates from local Universities exceed places
with local foundation schools. Under the national
recruitment system graduates can apply to any
foundation school across the country. No known
unplaced graduates for 2009/10.
G
2.2 All LDAs and contracts specify the support
required by students on clinical placements and
include provisions for dispute resolution

SLA
2.2 Owner Peter Rolland



/ Jackie
Wallsgrove
Main contract LDA contains clauses relating to
service provider organisation obligations and
responsibilities to provide the educational
infrastructure and resources necessary to
support, train and educate all commissioned
healthcare professional learners. The LDA's also
contains dispute and arbitration clauses which
cover all students on clinical placement.
G
2.3 All dental placements are funded in line with
the nationally agreed dental placement rate



SLA 2.3
Owner
GY
No dental students funded by the East Midlands.
2.4 Arrangements are in place with medical and
dental schools to monitor the quality of training
against QAA and GMC/GDC standards

SLA 2.4
Owner John Keenan




/Peter Rolland
G
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2. Undergraduate Medical and Dental Education
Placement Funding (Level 2)
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2. Undergraduate Medical and Dental Education
Placement Funding (Level 2)
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2. Undergraduate Medical and Dental Education
Placement Funding (Level 2)
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3. Postgraduate Medical and Dental Trainees
Education and Employment Funding (Level 2)
3.1 The numbers of F1 and F2 placements
available match medical school output plus
nationally funded headroom


SLA 3.1 Owner Heidi Breed
Headroom does not relate to local medical school
output. Posts are allocated to the region on a
per capita basis. F1 Placements (North) - 294.
F1 Placements (South) - 174. F2 Placements
(North) - 303. F2 Placements (South) - 176.
G
3.2 Quality management arrangements are in place
to meet PMETB standards for local quality control
and to ensure that all PMETB mandatory conditions
can be met
SLA 3.2 Owner John Keenan
G
Cycle of Trust accreditation visits ongoing. QM
processes of PGSS implemented. Preparations in
place for PMETB visit to the Deanery in Nov.
3.3 All staff involved in supervision of trainees
have received the appropriate trainer training
with plans in place to identify the proportions
of trainers who have not received the necessary
training, and proposals to resolve this.


SLA 3.3 Owner Sue
Carr
G
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3. Postgraduate Medical and Dental Trainees
Education and Employment Funding (Level 2)
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3. Postgraduate Medical and Dental Trainees
Education and Employment Funding (Level 2)
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3. Postgraduate Medical and Dental Trainees
Education and Employment Funding (Level 3)
As defined in A Guide to Postgraduate Specialty
Training in the UK The Gold Guide  there are
three key elements that will allow GPStRs to
progress as a GP Specialty Registrar (GPStR). 
These are annual planning, appraisal and
assessment.  These three elements join together
to form the basis of the Annual Review of
Competence Progression (ARCP).   All GPStRs are
required to undertake this process in order to
progress through the training and gain their CCT.

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3. Postgraduate Medical and Dental Trainees
Education and Employment Funding (Level 3)
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3. Post Graduate Medical Education (Level 3)
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3. Post Graduate Medical Education (Level 3)
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3. Post Graduate Medical Education (Level 3)
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3. Post Graduate Medical Education (Level 3)
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4. Non-Medical Education Training (Level 2)
4.1 Long term commissioning plans for Nursing,
Midwifery and AHPs have been agreed with HEI
partners and are in place


SLA 4.1 Owner Peter Rolland
G
Long term commissioning plans for Nursing,
Midwifery and AHPs have been agreed with HEI
partners and are in place by way of contract
tolerance levels
4.2 Year on year variations in commissions are
justified against long-term national and local
workforce needs


SLA 4.2
Owner Peter Rolland
Year on Year Variations in Commissioning
justified against long-term national and local
workforce needs, through annual commissioning
process involving the leads, SHA workforce leads
and specialist professional advisors taking into
account workforce requirements and trend
analysis leading to a commissioning plan.
G
4.3 Arrangements are in place to monitor student
and employer satisfaction with NHS commissioned
programmes

SLA 4.3
Owner Peter Rolland
G
4.4 All relevant contracts comply with the
national benchmark price as at 31st March 2009



SLA 4.4 Owner
Peter Rolland
G
All relevant contracts comply with the national
benchmark price as at 31st March 2009 (with the
exception of De Montfort University who are less
than BMP)
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4. Non-Medical Education Training (Level 2)
4.5 Funding for student grants is passed to SBU
on the 1st working day of each month based on the
appropriate share of national costs

SLA 4.5
Owner Peter Rolland
Contracts and Learning Development Agreements are
in place with service and education provider.
Payment is consistently made.
G
4.6 Investment of funding provided for
preceptorship for nurses.



SLA 4.6 Owner Peter Rolland




A
4.7 Plans are in place to take account of move to
registration at graduate level for nursing



SLA 4.7 Owner Peter
Rolland
G
Plans are being developed with higher education
institutions to take account of move to
registration at graduate level for nursing.
4.8 Investment plans show evidence of sufficient
commissions for Healthcare Scientists



SLA 5.1 Owner Peter Rolland
G
Investment plans show evidence of sufficient
commissions for Healthcare Scientist
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4. Non-Medical Education Training (Level 2)
4.9 Workforce plans contain development of
commissioning arrangements and infrastructure
planning to deliver Modernising Scientific
Careers agenda subject to consultation
SLA 5.2 Owner
Peter Rolland
A
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4. Non-Medical Education Training (Level 3)
The graph illustrates the value of tuition and
salary support for the new student 2009/10, and
the total Learning Beyond Registration budgets
available for 2009/10
The graph illustrates the number of new
commissions for non-medical professional
healthcare programmes by WTE count for year 09/10