Developing a Pre-Consultation Business Case

Developing a Pre-Consultation Business Case For Cumbria Success Regime

2018-04-10T22:25:25+00:00

The Cumbria Success Regime (CSR) was formed in December 2015 to improve the quality and efficacy of the health and social services in North, West and East Cumbria. NWE Cumbria is a unique area owing to its geography and remoteness, making both the planning and delivery of health services very challenging.

The WRaPT team supported the Cumbria Success Regime and its constituent organisations to understand the workforce requirements for the financial year 2020/21 by utilising a data-driven approach facilitated by the WRaPT tool.

There were two key aims of this project:

1. To determine the number and type of staff North Cumbria University Hospital Trust (NCUHT) and Cumbria Partnership Foundation Trust (CPFT) required to deliver the services outlined in the preferred option of the Pre-Consultation Business Case (PCBC) for the work streams defined below:

  • Elderly and Long Term Conditions
  • Emergency Care
  • Internal Medicine
  • Obstetrics and Gynaecology
  • Ophthalmology
  • Paediatrics
  • Community Teams North
  • Eden ICC

2. To provide a functioning workforce model that the trusts could use to perform further activity based workforce modelling as required.

WRaPTs involvement

The WRaPT team set out to support the workforce work stream using the standard WRaPT methodology. This consisted of establishing information sharing agreements across all 5 organisations, developing a workforce baseline for each individual work stream and engaging the clinical work streams to understand how they proposed to transform their services.

Following these meetings the team performed detailed activity analysis to support services articulate how they wanted to change the way they deliver patient care in order to determine the impacts of new models of care on the size and skill mix and cost of the new workforce.

The WRaPT team determined the workforce required to deliver this care in the future by understanding:

  • The current state for each service
  • The future vision of each service
  • The methodology and assumptions for the workforce modelling
  • The current workforce, the future workforce and the number needed to recruit for each work stream by staff group and band

Results

The WRaPT modelling found that combined aims of the clinical work-streams would enable the system to deliver more care in the community. The work-streams aimed to achieve this with a change in skill-mix that is in line with the available workforce in Cumbria. This involved:

  • Improving the utilisation of medical staff ensuring they spend more their time performing high value tasks
  • Developing the capability of the un-registered workforce to deliver more care in the community
  • Integrating clinical care across acute and community services
  • Developing staff to deliver care outside of their traditional roles
  • Increasing the use of volunteers to support the care of patients

WRaPT demonstrated the impact of new roles in the workforce across a range of services and specialities, which included:

  • The potential savings (circa £1.5m) of Advanced Nurse Practitioners taking on the role of the premium pay Medical Registrars in West Cumberland Hospital
  • Quantifying the impact of a reduction in premium pay staff and a change in skill mix on the financial position across the health and social care economy. This resulted in recurrent savings of circa £55m
  • Demonstrating the impact of the various options for the consolidation of acute services on the medical and nursing workforce

In summary

The WRaPT team was able to successfully support the Success Regime by:

  1. Supporting the pre-consultation business case in creating a data driven model across the health and social care economy for measuring the financial impact of addressing the financial challenge.
  2. Enabling the clinical work streams to articulate their ideas for the use of new roles in the workforce.
  3. Using a range of top down and bottom up modelling techniques to support both the strategic and service level discussions about how to effectively transform services.
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