Page 1 Our Vision – to Improve the Health & Wellbeing of our Communities Item Number: 539 PRIMARY CARE CO-COMMISSIONING COMMITTEE MEETING Meeting Date: 24 April 2019 Report’s Sponsoring Governing Body Member: Carolyn Liddle Report Author: Sally Brown 1. Title of Paper Workload and Workforce Planning Tool- APEX Insight 2. Strategic Objectives supported by this paper: (check those which apply) ☒ To create a viable & sustainable organisation, whilst facilitating the development of a different, more innovative culture ☒ To commission high quality services which will improve the health & wellbeing of the people in Scarborough & Ryedale ☒ To build strong effective relationships with all stakeholders and deliver through effectively engaging with our partners ☐ To support people within the local community by enabling a system of choice & integrated care ☒ To deliver against all national & local priorities incl QIPP and work within our financial resources 3. Executive Summary: The importance of managing demand for primary care appointments and the available workforce has been increasingly challenging over the last 5 years. The NHSE Five Year Forward View https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf and in the NHSE Long term Plan https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf reference is made to work force planning tools. In particular with the development f Primary Care Networks and additional role reimbursement for social prescribing community link workers, clinical pharmacists, physiotherapists, paramedics and physician associates. HCV STP during 2018-19 procured the APEX Insight workforce planning tool for all GP practices. Due to delays in confirming there were no encryption issues in managing data the software has not yet been rolled out by eMBED. This has now been resolved and a project plan and delivery plan has been agreed with practices, APEX Insight and eMBED with work progressing. Practices are to be enabled by July 2019 with onsite training from APEX Insight. The attached appendices explain the tool and plan for implementation This tool will also provide PCN and CCG data on the number of primary care contacts with patients (face to face, telephone, home visits etc ) and will help inform a whole system approach to planning services across primary. Community and secondary care.
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Page 1
Our Vision – to Improve the Health & Wellbeing of our Communities
Item Number: 539
PRIMARY CARE CO-COMMISSIONING COMMITTEE MEETING Meeting Date: 24 April 2019 Report’s Sponsoring Governing Body Member: Carolyn Liddle
Report Author: Sally Brown
1. Title of Paper Workload and Workforce Planning Tool- APEX Insight
2. Strategic Objectives supported by this paper: (check those which apply) ☒ To create a viable & sustainable organisation, whilst facilitating the development of a different,
more innovative culture
☒ To commission high quality services which will improve the health & wellbeing of the people in
Scarborough & Ryedale
☒ To build strong effective relationships with all stakeholders and deliver through effectively
engaging with our partners
☐ To support people within the local community by enabling a system of choice & integrated care
☒ To deliver against all national & local priorities incl QIPP and work within our financial resources
3. Executive Summary: The importance of managing demand for primary care appointments and the available workforce has been increasingly challenging over the last 5 years. The NHSE Five Year Forward View https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf and in the NHSE Long term Plan https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf reference is made to work force planning tools. In particular with the development f Primary Care Networks and additional role reimbursement for social prescribing community link workers, clinical pharmacists, physiotherapists, paramedics and physician associates. HCV STP during 2018-19 procured the APEX Insight workforce planning tool for all GP practices. Due to delays in confirming there were no encryption issues in managing data the software has not yet been rolled out by eMBED. This has now been resolved and a project plan and delivery plan has been agreed with practices, APEX Insight and eMBED with work progressing. Practices are to be enabled by July 2019 with onsite training from APEX Insight. The attached appendices explain the tool and plan for implementation This tool will also provide PCN and CCG data on the number of primary care contacts with patients (face to face, telephone, home visits etc ) and will help inform a whole system approach to planning services across primary. Community and secondary care.
Our Vision – to Improve the Health & Wellbeing of our Communities
For further information please contact: Name: Sally Brown Title: Associate Director of Primary Care ☎: 01723 343660
4. Risks relating to proposals in this paper: There is a risk that not all practices will have the capacity and capability to maximise use of the tool and the data provided. Plans are in place to look at providing some support to data analysis and that practices (owners of data) will be encouraged to sign Data Sharing Agreements at practice, PCN, Federation and CCG levels to allow local workforce plans to be developed. 5. Summary of any finance / resource implications: The funding for the software and 12 month licence per practice is from HCV STP. Project delivery for each HCV CCG has varied and NHS SRCCG received £4,500 which has been allocated to practices (£368) for the “APEX ready” work so that the information provided in reports is meaningful and comparable between practices. Options to fund an additional year’s licence 2020-21 are being explored from the PCN development monies. 6. Any statutory / regulatory / legal / NHS Constitution implications: None 7. Equality Impact Assessment: N/A 8. Any related work with stakeholders or communications plan: The PCDG has shaped the project brief and delivery plan 9. Recommendations / Action Required The PCCC is asked to note the update on the delivery of the workload and workforce tool to practices. 10. Assurance The Business Committee will receive reports on project delivery and workforce reports will be brought to PCCC. The data from the workload reports will be reported to A&E delivery Board
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APEX INSIGHT.Workload and Workforce Planning for Primary Care
Empowering GP practices to transform Primary Care
The role of Primary Care is changing across the NHS in response to challenges posed by
increasing patient needs, ageing populations, pressure on all NHS budgets and a shortage of
key skills. Most localities are expecting GP led services to play an increased role in local care
systems as more activity is delivered in community and integrated care settings. To be
sustainable in this new model, Primary Care will need to adapt quickly to continue providing
high quality, safe and sustainable care.
Apex Insight offers Practices a comprehensive workload analysis and workforce planning
capability (software and support) to make informed decisions about the future. Practice-level
information can be consolidated at Locality, Federation, CCG and STP level to inform strategic
planning and system-wide solutions to these challenges.
Data extracts update
overnight & allow you
to see the impact of
changes as they
happen
Automated
Updates
To create evidence-
based plans that
practices can own,
commit to, and trust
Reliable
Platform
Data can be
aggregated for
system-level decision
making & service
design
Scalable
Plans
Training & ongoing
support from our
experienced
healthcare
consultants
Expert
Support
APEX
Identifying viable transformation
opportunities by looking at workload
- Detailed analysis of performance and
productivity
- Extended Access monitoring, reporting and
payment processing
- Capture and analysis of avoidable contacts
- Highlighting quality improvement initiatives to
support GP Practice development
- Ongoing monitoring of clinical activities
INSIGHT
Developing robust and sustainable
workforce plans
- Accurate assessment and oversight of current
resilience
- Modelling of alternative skill mixes and
different clinical capabilities
- Predicting future demand and workforce
based information tailored for each practice
- Comprehensive scenario planning and
sensitivity analysis
"Very detailed and highly useful, relevant information."
Practice Manager
"I will use it specifically for workforce planning. We have a growing patient list so clinical capacity is a priority for us."
Practice Manager
No patient identifiable data is utilised in either system
- Our data service removes patients identifiable data,
pseudonymising the dataset before transferring it
outside of the GP practice’s Clinical System
Practices and Enterprises control all data sharing
- No data will be shared with other practices or
organisations without consent from the practice, who
remain the Data Controller
GP practices control the level of staff demographic
data that they would like to use
- Insight provides the option for practices to include
information about their current workforce (e.g. names
of staff, workforce roles, cost information etc.)
- Practices can chose whether to include personal
information about their workforce.
DATA SECURITY AND INFORMATION ACCESS
Apex and Insight are securely hosted cloud software solutions.
We will explain our Data Processing Agreements to each practice and enterprise. Practices
and Enterprises control who can access their information and can consent to different levels
of data sharing with other organisations at their discretion.
5.1 Finance ......................................................................................................... 7 5.2 Project team .................................................................................................. 7
5.3 Reporting ...................................................................................................... 8 5.4 Risks and issues ........................................................................................... 8
1 Introduction This project brief provides a full and firm foundation for the initiation and ongoing management of a project. The project brief forms the ‘contract’ between the Project Team and the Programme or Project Board.
2 Project purpose and objectives
2.1 Background
Apex Insight offers practices a comprehensive workload analysis and workforce planning capability (software and support) to make informed decisions about the future. Practice-level information can be consolidated at Locality, Federation, CCG and STP level to inform strategic planning and system-wide solutions to these challenges.
2.1 Objectives
Objectives (SMART)
Deploy a practice license of Apex Insight to the 12 practices of Scarborough & Ryedale CCG
Deploy a practice license of Apex Insight to two extended access hubs (one in Scarborough and one in Ryedale)
Deploy one Enterprise license across all practices within the CCG This work includes:
Support to practice engagement meetings as requested by the CCG
Deployment and configuration of Apex, and training the practice’s nominated leads in the use of Apex
Deployment and configuration of Insight, and training the practice’s nominated leads in the use of Insight
Deployment of Enterprise level Apex (Enterprise level planning responsibilities to be confirmed by the CCG once practices have deployed Apex Insight)
Deployment of Enterprise level Insight (Enterprise level planning responsibilities to be confirmed by the CCG once practices have deployed Apex Insight)
Training and development of CCG and practice staff in the use of the Enterprise tool and its application as a workforce planning tool.
Employment of an analyst (for a period to be determined) to support practices and the CCG in the use of the Apex Insight tool, ensuring the benefits are fully realised.
Provision of a technical helpdesk for user support over the 12 month license period for each practice and the Enterprise license.
3 Strategic business case The role of Primary Care is changing across the NHS in response to challenges posed by increasing patient needs, ageing populations, pressure on all NHS budgets and a shortage of key skills. Most localities are expecting GP led services to play an increased role in local care systems as more activity is delivered in community and integrated care settings. To be sustainable in this new model, Primary Care needs to adapt quickly to continue providing high quality, safe and sustainable care. It has therefore become increasingly important to understand the capacity and demand of primary care providers when developing plans across the health and social care system and to date there has not been a robust system to collect this information from primary care. There are three key areas where the Apex Insight tool could bring immediate benefits:
Developing a workforce strategy at hub and CCG level which will feed into HCV STP plans working with HEE
Provide information for system transformation plans about capacity, demand and ned for primary care services
Inform business cases for additional resources
3.1 Expected benefits and dis-benefits
Benefits (outcomes perceived as positive)
Apex
Allows detailed analysis of performance and productivity
Allows ongoing monitoring of clinical activities
Highlights quality improvement initiatives to support GP practice development Insight
Provides accurate assessment and oversight of current resilience
Allows modelling of alternative skill mixes and different clinical capabilities
Provides future demand and workforce based information tailored to each practice
Provides comprehensive scenario planning and sensitivity analysis
Dis-benefits (outcomes perceived as negative)
Perceived additional administrative burden by practices as they take on the support and administration of a new system
Concerns over future funding of licenses as a possible extra cost pressure
4 Project definition
4.1 Scope
In Scope
The following 12 practices in the Scarborough & Ryedale CCG will deploy and use Apex Insight:
Sherburn and Rillington, Eastfield Medical Centre, Derwent, Filey, Central Healthcare, Scarborough Medical Group, Ayton, Brook Square, Hackness
Road, Ampleforth, Hunmanby, Castle Health
The CCG will have access to the Apex Insight Enterprise tool for planning purposes
Selected staff will be trained in the use of Apex Insight
Additional resource will be employed to support the use of the Tool as required
Out of Scope
4.2 Milestone Plan
Deliverable Indicative timescale
Deployment of Apex Insight tool to all 12 Scarborough and Ryedale CCG Practices Including training)
March 2019 to May 2019
Deployment of Enterprise level workforce planning tool (Including training)
May 2019 to June 2019
MOU drafted and signed off March 2019 to May 2019
Practices ‘Apex ready’ April 2019
Benefits realisation May 2019 to August 2019
Post project review October 2019
4.3 Interfaces and dependencies
Internal
GP IT refresh project – all practice computers will be upgraded to Windows 10 between March and December 2019. Computer refresh activity will need to be effectively coordinated with uploading of Apex Insight onto selected practice computers. Workforce work stream - Apex Insight will act as an enabler for many of the projects within the workforce work stream Primary care strategy and delivery plan – the benefits to be gained from a fully implemented Apex Insight tool will support and compliment the development of the Primary care strategy
External
4.4 Constraints
Limited practice resources – deployment of Apex Insight at practice level will require a nominated lead to be available to work with the supplier during the deployment process. It is recognised that practice staff resource is limited, but is the only local resource available
5 Approach As the developers and suppliers of Apex Insight, PA Consulting and Edenbridge Healthcare will provide the majority of the project management. During the deployment process the Primary Care Apex Insight lead will work closely with the suppliers, acting as the key interface with the CCG and practices and also providing the project team with appropriate local guidance during the deployment process.
The Primary Care project lead will also be working on a number of other local aspects of the project, including the provision of funding to support practices get ready for deployment and the recruitment of an analyst post to help with benefits realisation.
Benefits realisation will be managed by the project lead and will continue on after deployment of the Apex Insight tool and the Enterprise element.
Three months after implementation a post – project review will be undertaken to assess whether the project objectives have been met.
5.1 Finance
Funding requirement Cost Source
Cost of Apex Insight licenses for 1 year (2019/20) at £1500 per practice
£18,000 NHSE
Project support for implementation across all practices
£4,500 NHSE
Analyst post for 6 months to support benefits realisation
tbc
5.2 Project team
The key roles within the project management structure are as follows:
Role Name Organisation
Apex Insight Primary Care Project Lead
Jenny Loggie SRCCG
Associate Director of Primary Care
Sally Brown SRCCG
Project Support Andrew Platt SRCCG
Information Governance Lead
Robert Irwin SRCCG
Head of Digital Debbie Westmoreland SRCCG
Role Name Organisation
Delivery Team - Insight Michael Dillon PA Consulting
Delivery Team - Insight Matthew Price PA Consulting
Delivery Team - Apex Allison Homer Edenbridge Healthcare
Delivery Team - Apex Dillon Sykes Edenbridge Healthcare
5.3 Reporting
Report/Update Who Frequency
Update meeting Attended by members of the above project team
Monthly
Written update report from PA Consulting/Edenbridge Healthcare
Sent to Primary Care Project Lead
Fortnightly
Project update report from Primary Project Lead
Primary Care Co-Commissioning Committee
Every two months
5.4 Risks and issues
Risk Rating
H/M/L
Mitigation
There is a risk that inconsistent descriptions of practice appointment activity make Enterprise level planning difficult.
12
Agreed standard terminology that will be applied across all 12 practices.
There is a risk that limited practice leadership capacity will delay deployment timescales.
9
Delivery team to be flexible in offering meeting dates around the availability of the nominated practice lead.
There is a risk that practices will not share their data to enable Enterprise level workload analysis and workforce planning. This would impact the value of Apex Insight to the wider primary care system.
9
CCG to proactively engage practices in the value of sharing data to enable system level workforce planning
There is a risk that practices will not engage.
8
Communication from CCG about the value of Apex Insight and how it will be delivered. Regular reporting to CCG to escalate concerns about practices that do not wish to engage.
There is a risk that assumptions about list size and activity growth
8 Collaboration between CCG, PCH, and clinicians to provide
Risk Rating
H/M/L
Mitigation
as well as the impact of local transformations are not accurately reflected in Enterprise level workforce plans.
assumptions that are plausible, agreed and owned by local system.
MP
M
MP
M
AH
M
M
AP/JL
JL
Practice Managers M
JL/AP/SB
M
Agree who will 'employ' the analyst post
Advertise and recruit to post
Train analyst
Deploy analyst M
Communicate key delivery milestones to all practices
*See PA Knowledge mobilisation plan for further breakdown of this section
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Deployment of APEX Insight
Deployment of the Tool into all practices *
Benefits realisation
Identify APEX Insight leads at each practice
Draft and approve proposal to fund APEX Insight leads
Deploy APEX Insight leads
APEX ready' resource deployed
Draft MOU
MOU signed off by practices
Review and understand Enterprise level capability
Work with practices to agree a common workforce planning approach
Develop monitoring and reporting approach
Recuit and deploy analyst
Get agreement to fund and employ an APEX Insight analyst
Develop scope of role
Analyst to begin working with practices
Draft and grade job description
Communications
Draft and deliver a further communication on the benefits of APEX Insight to all
