NHS Providers Network Meeting - HR Directors New Models of Care: Workforce Implications Udara Ranasinghe, Partner Guy Bredenkamp, Partner Employment & Pensions Group

Overview of today’s session The new models Devolution Vanguards Workforce models Barriers and opportunities Q&A

New Models of Care & Devolution

New Models of Care

Modern Maternity Services

Primary and Acute Systems (PACS)

Specialised Care

Devolution Cities and Local Government Devolution Bill Allows Secretaries of State to transfer duties and

powers from public bodies to local authorities Royal assent likely by Christmas Wholesale transfer or delegation? An alternative to new care models and S.75 for health &

social care integration OR could sit above/alongside new models of care

Vanguards

Vanguard sites (1) 29 vanguard sites identified in March 2015 3 categories: Primary and acute systems / PACS Enhanced health in care homes Multi Speciality Community Providers / MSCP

8 urgent and emergency vanguards announced in July 2015

13 acute care collaborations announced in September 2015

Vanguard locations

http://www.england.nhs.uk/ourwork/futurenhs/5yfv-ch3/new-care-models/

Workforce Models

Organisation A Organisation B

Service delivery Service delivery

Workforce Model 1: Status Quo

Organisation A Organisation B

Status Quo Pros Minimal change Easy to implement

Cons Ability to deliver a tangibly different service? May result in duplication and inefficiencies

Chosen “host” organisation

Partner

organisation TUPE transfer

Workforce Model 2: TUPE to “host”

Organisation A Organisation B

TUPE to “host” Pros Legal responsibility and de facto control in the same hands Legal certainty (underpinned by contract) Achieves efficiencies Permanent change

Cons Consultation necessary Morale/industrial relations Inflexibility Harmonisation issues Pensions

Partner organisation (1)

Partner organisation

(2)

Secondment

Workforce Model 3: Secondment

Secondment Pros

Easy to implement if contracts allow Flexibility Staff remain with same employer Can be temporary

Cons

Legal and de facto control split De facto TUPE? Return of staff Implementing efficiencies Pensions

Organisation A Organisation B

New Corporate Entity

Workforce Model 4: New Corporate Entity

New Corporate Entity Pros Control and responsibility can be united or split

depending on choice Blank slate – pick and choose

Cons More elaborate structures Industrial relations TUPE? Pensions

Barriers or opportunities?

Changing terms and conditions

of employment

Achieving mobility

Barriers or opportunities?

Competition for staff

Leadership

Case study 1

Northumbria Healthcare NHS Foundation Trust ("Northumbria") created a single legal entity, Northumbria Primary Care Limited (“NPC”) to integrate primary and acute care systems for Northumberland.

Case study 1 Key features: Bespoke support packages Management support: quality governance and compliance,

payroll management, financial services, human resources and organisational development and estates maintenance

Full support: providing full clinical service under the practice's primary care commissioning contract by way of a sub-contract between the practice and NPC, with the consent of NHS England

Workforce issues?

Case study 2 30+ organisations, community groups and lay partners

worked together to develop a vision for Whole Systems Integrated Care (WSIC) across North West London (NWL).

Key features: Whole Systems Commissioning Agreement Integration Agreement Accountable Care Partnership ("ACP") Agreement Service Contracts Integrated Services Schedule

Workforce issues?

Case study 3 A GP Federation collaborated with an NHS Trust, NHS

Foundation Trust, third sector organisation and corporate joint venture to provide an integrated, multi-disciplinary musculoskeletal ("MSK") service.

Key features: The GP Federation agreed to hold the head contract with the

Commissioners Sub-contracting of obligations to partners in the collaboration Governance arrangements

Workforce issues?

Q&A

Want to know more? Contact:

Udara Ranasinghe uranasinghe@dacebeachcroft.com 020 7894 6727

Guy Bredenkamp gbredenkamp@dacbeachcroft.com 0191 404 4076

Visit:

www.dacbeachcroft.com/integrationhub