Health Education England North London - Community Education Providers Network (CEPNs) and Training Hubs Primary Care Workforce Development: ...

 
Health Education England North London - Community Education Providers Network (CEPNs) and Training Hubs Primary Care Workforce Development: ...
Health Education
              England
         North London
Community Education Providers Network
           (CEPNs) and Training Hubs

  Primary Care Workforce Development:
 Investment and Activity 2018-19 Plan
Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

1. Introduction
Health Education England has an established vision to ensure that workforce planning, training and education in primary
care drive sustainable innovations to deliver a capable and flexible workforce now and in the future to serve the
population of London.

In 2018/19; HEE remains committed to supporting CEPNs to evolve in the landscape of Sustainability and Transformation
Partnerships and against the national and local priorities.

The NHS is under a significant financial restraint, and education and training systems are not an outlier to this position. You
would also be aware that the Comprehensive Spending Review (CSR) has led to a real terms reduction in the availability of
funding available to support workforce transformation activity. It is therefore vitally important that we are able to
demonstrate that all proposed activities are mapped to national, local and STP priorities.

2. Guidance and Investment Priorities

2.1 Guidance

CEPNs are networks of education and service providers based in the community. They are tasked with increasing capacity
for future workforce training in the community, and the development of the current and future workforce around the needs
of a geographically defined population. CEPNs are expected to work collaboratively with other stakeholders across North
London and reflect this in their Investment and Activity Plans. HEE continues to prioritise the development of CEPNs (or
training hubs) in order to support workforce transformation across Primary and Community Care.

CEPNs remain local; but there are a number of themes which HEE requires CEPNs to deliver against. CEPNs must deliver
against the key priorities set out in the national strategies, training hubs programme (and key performance indicators) and
must be able to demonstrate delivery which fits the themes set out in the respective STP, as the main catalyst for change
within local health and care economies.

HEE is still in the process of determining precise budgets available to support CEPNs in 2018/2019, but to avoid delays in
project setup; we are keen for CEPNs to submit Investment and Activity Plans for 2018/2019.

Proposals should be sector-wide and/or linked to specific priority service transformations

Plans must be signed off by the CEPN chair, but must also be signed off by the relevant CCG Accountable Officer or Local
Executive Director and appropriate engagement must be sought with all relevant partners. This ensures that the CCG,
accountable for the local care closer to home agendas; are fully sighted on the ambition of the CEPN as an STP delivery
vehicle. Plans should outline CEPNs’ strategies, and also outline delivery dates.

CEPNs will also need to demonstrate how the funding envelope set out above will be appropriated.

This plan should be submitted by the CEPN Programme Manager in care of the Community Education Provider Network
to lashelle.marlow@nelft.nhs.uk by Friday, 22nd June by no later than 5 pm. If you have any questions regarding the
completion of this plan, please contact us. The plan will be reviewed with an expected turnaround to agreement of one
month. Please ensure your contact details include people available to answer queries over this time.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

2.2 Priorities

The Five Year Forward View (FYFV) sets out a number of key focus areas; and many of these areas have their own dedicated
workforce strategies. CEPN activity largely fits into primary care; but we would expect to see how CEPN activity cross-cuts
into other FYFV priorities – e.g. Cancer, Mental Health and UEC.
HEE requires CEPNs to describe how HEE funding will be utilised towards the delivery of these themes in a structured way.
HEE also has a number of other regional priorities, which, although aligned to FYFV, are intentionally split out as specific
priorities. HEE also recognises specific STP priorities which CEPNs may be required to support. CEPNs should also describe
STP-wide initiatives within this plan and are encouraged to collaborate with one another.

        National Training • As Advised
        Hub KPIs

        Five Year          •     Maternity
        Forward View       •     Mental Health
        not elsewhere      •     Cancer
        classified*        •     Urgent and Emergency Care
                           •     Primary Care
                           •     Learning Disabilities
        Regional            •   Development of support workers
        Priorities          •   Upskilling current staff through increased non-medical prescribing capacity
                            •   Upskilling registered professionals and others to take on extended and advanced roles
                                in priority service areas – Cancer; the child and new-born, primary care, integrating
                                care teams, mental health, learning disabilities, long term conditions, urgent and
                                emergency care, and leadership
                            •   Supporting patient safety and person centred care - upskilling to embed person centred
                                care, proactively address patient safety risks, awareness and impact of human factors
                            •   Supporting career progression – career advice, guidance and support for transition into
                                employment and onward career development – including RTP.
                            •   Apprenticeships
                            •   Promoting prevention and population health and well-being
                            •   Prevention
        STP Priorities     • As determined by local STP workforce programme; but to include education and
                             workforce system development, resilience and sustainability, development of
                             excellence centres, and local faculty development.

We expect the plans to:

    •     Consider the current workforce: who they are and what their educational needs are to keep them up to date and
          to prepare them for new ways of working;
    •     Consider the future workforce: who they may be, and what their educational needs will be.
    •     Include plans for the recruitment, training and retention of the next generation of Primary Care staff for both
          traditional and new roles;
    •     Demonstrate how the learning needs were assessed;
    •     Ensure that the plans include fair access for the workforce across the whole of the population served;
    •     Ensure that the plans reference the activity necessary to complete the KPIs for the HEE educational hubs and any
          funding afforded by HEE

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

   •   Ensure the plans consider how the CEPN would assess the need for return to practice or nurses new to primary
       care and training for new roles will be fairly distributed.
   •   Promotion of multi-professional approaches to development of the healthcare workforce.
   •   Education and training that supports integrated working across sector boundaries, including bringing together
       staff groups across sector boundaries to learn together.
   •   Equal access to training for all staff groups, especially those that have historically struggled to access Workforce
       Development funding.
   •   Use of e-learning and simulation technologies.
   •   Patient and carer involvement in the design, delivery and/or evaluation of education programmes.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

3. CEPN Details

     CEPN Name                                       CAMDEN

     Plan Completed By                               Murat Ozcelik

     Role                                            Programme Manager

     Email Address                                   Murat.ozcelik@communitymatters.co.uk

     Phone Number                                    020 3887 63 82

     Plan Signed-Off By                              Dr Sarah Morgan

     Role                                            Camden CEPN Chair / Camden CCG Governing Body GP Partner

     Email Address                                   Sarah.morgan1@nhs.net

     Phone Number                                    0207 435 4000

I confirm that the contents of this Primary Care Workforce Development: Investment and Activity Plan are an accurate
representation of the activity that this CEPN plans to undertake with the Funding received from HEE.

In signing this document, I also recognise the obligations and responsibilities placed upon this CEPN with regard to the
Public Sector Equality Duty, part of the Equality Act that came into force in April 2011. The Trust will act in accordance with
this Duty in ensuring equal access to training opportunities and will routinely collect data in order to monitor that this is
the case.

Signature …………………………………………………………………………………………………..

Date: ……………22 June 2018……………………………………………………………………………………………

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

4. Primary Care Workforce Development: Investment and Activity
2018-19 Plan – Form

4.1 CEPN information

 Registered population size of CCG (approx.)

   270,000

 Please list your basic Primary Care workforce details

  Basic workforce details                                Numbers
  Numbers of Practice Nurses                             51 Nurse FTE, with total headcount 74 (HSCIC Workforce
                                                         existing Supply data)

                                                         49 Headcount - 4 ANP (NHS Digital March 2018 Data)

  Number of nurse mentors                                30

  Number of Admin/reception staff                        270 (NHS Digital March 2018 Data)

  Numbers of GPs                                         143 GP FTE, with total headcount 184 (HSCIC Workforce
                                                         existing Supply data)

                                                         GP providers 80, salaried 113, retainers 3, registrars 16,
                                                         locums 17; total 229 (NHS Digital GP workforce March
                                                         2018)
  Numbers of Allied Health Professionals, including
  Pharmacists
  Numbers of HCAs                                        Total DPC headcount 39 and HCA 25 (NHS Digital March
                                                         2018 Data)

 Contact details of Lead & Support Staff

 CEPN Chair: Dr Sarah Morgan, sarah.morgan1@nhs.net
 Programme Manager: Murat Ozcelik, murat.ozcelik@communitymatters.co.uk
 Project Support: Jane Stokes, jane.stokes@communitymatters.co.uk
 CCG Senior Commissioning Manager – Primary Care: Amanda Rimington, Amanda.rimington@nhs.net

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

4.2 Engagement log
Please list all the stakeholders that have been involved in the development of this activity plan.

 Name                         Position                                                   Organisation

 Sarah Morgan                 CEPN Chair                                                 CEPN & CCG
 Amanda Rimington             Senior Commissioning Manager                               CCG
 Andrew Young                 CAMDEN EXTENDED ACCESS SERVICE                             GP FEDERATION
 Antony Senner                Deputy director of Education and Development               ROYAL FREE NHSFT
 Baljinder Heer-Matiana       Senior Public Health Strategist                            C&I Public Health
                                                                                         TAVISTOCK AND PORTMAN NSH
 Brian Rock                   Director of Education and Training                         FOUNDATION TRST

 Carol Lincoln                Senior Lecturer Nursing and Primary Care                   MIDDLESEX UNIVERSITY
 Caroline Harris – Birtles    Acting Director of Nursing                                 C&I NHS FOUNDATION TRUST
 Clinton John                 Head of Clinical Education                                 UCLH
                                                                                         TAVISTOCK AND PORTMAN NSH
 Caroline Quest               Associate Director                                         FOUNDATION TRST
 Fiona Jackson                Director of Operations                                     HAVERSTOCK HEALTHCARE
 Frances Hasler               Director                                                   HEALTHWATCH CAMDEN
                              Chief Financial Officer and Director of Corporate
 Helen Jameson                Programmes                                                 UCLP
 Jo Gelona                    Head of Inpatient Therapies                                UCLH
 Jackie Kennedy               Acting Joint Head of Service                               LONDON BOROUGH OF CAMDEN
 Jo Barter                    Apprenticeship Lead                                        COMMUNITY MATTERS
 Julie Billett                Director of Public Health                                  C&I Public Health
 Karen Evans                  Practice Educator (NCL CEPNs)                              WHITTINGTON HEALTH
 Karen Timperley              Joint Strategic Commissioner                               LONDON BOROUGH OF CAMDEN
 Kate Emery                   Head of Learning and OD                                    C&I NHS FOUNDATION TRUST
 Linda Morris                 Finance Director/Deputy CEO                                HAVERSTOCK HEALTHCARE
 Lorraine Lawson              Brokerage Manager                                          LONDON BOROUGH OF CAMDEN
 Lucia Grun                   GP                                                         Haverstock Healthcare
 Mairead Roche                Practice Manager                                           Rosslyn Hill Practice
 Marcus Lewis                 Programme Director                                         Royal Free GP Speciality Training
 Rachel Leuw                  Integrated Care Programme Director                         ROYAL FREE
 Sally Mackinnon              Director of Transformation                                 CCG
 Sally Nieman                 Principal Social Worker                                    LONDON BOROUGH OF CAMDEN
 Sanjaj Ganvir                Chair                                                      Local Pharmaceutical Committee
 Sharleen Rudolf              Head of Care Navigation                                    AGE UK CAMDEN
 Vanessa Cooke                Senior Commissioning Manager                               CCG
 Vikram Dave                  Programme Director                                         Royal Free GP Speciality Training
                                                                                         TAVISTOCK AND PORTMAN NSH
 Vicky Howells                Portfolio Development and Events Manager                   FOUNDATION TRST
 Vijay Rawal                  Clinical Director                                          Haverstock Healthcare
 Amal WICKS                   Practice Manager                                           Brondesbury Medical Practice
 Ammara Hughes                GP Partner                                                 CHE Group
 Carole Grimwood              OD and HR Consultants                                      LONDON BOROUGH OF CAMDEN
 Tom Dowle                    Clinical and Operational Lead                              Camden Rapid Access Services
 Kate Lawrence                Integrated and Urgent Care Programme Lead                  CCG
 Lyan Gross                   GP                                                         James Wigg Practice

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

4.3 Activity Plan
Detail how the CEPN intends to spend the primary care workforce development funding allocation. When completing this
template, please take into account staff from all professional groups and, where possible, indicate where a multidisciplinary
approach has been taken to address identified workforce development needs. In order for these plans to be approved, it
must be demonstrated that all staff groups have been considered. A RAG rating column has been added to help prioritise
training. As budgets are currently unknown it is important to illustrate what the key priorities are should less funding
become available and which are those activities which will be undertaken should more funding become available.

Rating:

Red – high priority (must have)

Amber- medium priority (should have)

Green – low priority (nice to have)

 1. Overarching Transformation themes

 Demonstrate how the CEPN will continue to embed activity in the following areas.

     a.   Retention of at risk groups. Supporting recruitment and retention of i.e. GPs, Nurses, Practice Managers
     b.   Carers and communities
     c.   Clinical skills
     d.   Primary and secondary care interactions
     e.   Apprenticeships and widening participation
     f.   New ways of working

 Description of priorities which are CEPN specific and not set out above

 Community Education Provider Network in Camden developed over the years in such a way that it is no longer just
 defined with the activities it delivers, but one of the key drivers of workforce transformation and thus an enabler of
 change. It truly acts as a network of key stakeholders representing primary, secondary, community and social care
 settings as well as voluntary sector organisations.
 Although some of its activities are time-bound due to the way they are funded, where possible and appropriate, CEPN
 works towards mainstreaming these activities in order to continue to respond to the overarching transformation
 themes.
 The transformation themes listed above are embedded in everything CEPN does, including understanding the STP
 ambitions, translating these to the local area, and supporting the delivery of programmes that are funded and delivered
 by stakeholder organisations. For instance, in addition to the delivery of CEPN activities that are mainly funded by the
 HEE, CEPN also acts as the workforce work stream for the Local Care Strategy, which is Camden’s response to the STP
 priorities. This ensures that workforce planning and development is fully aligned with the Local Care Strategy and the
 STP.
 There are a number of activities that were delivered through the transformation funding, targeting “at risk” groups ,and
 many of these will continue.
 Retention of at risk groups:
     •    NCL QI Network: Camden CEPN will continue to facilitate engagement with the NCL wide QI Network, and
          ensure that local QI projects share their learning with others in NCL to maximise collaboration. Camden CEPN
          would like to invest in increasing QI capability and capacity aligning with the development of QISTs, in
          addition to what may be available from NLP Workforce Workstream.
     •    Newly qualified professionals network – The network identified key education and training needs for newly
          qualified professionals, and these have been commissioned with the budget available. These were:

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

             o   COPD Management
             o   Dermatology
             o   Diabetes Management
             o   Mental Health – Services Available and Signposting
             o   Motivational Interviewing and Health Coaching
        The learning from this network has been that newly qualified professionals find it difficult to engage in multi-
        professional networking activities, due to the day-to-day work pressures and release from practices.
        Therefore, going forward, we would like to engage VTS to deliver multi-professional learning activities with
        them. This has been already piloted through a session with community pharmacists, focussing on the role of
        community pharmacists and practice based pharmacists. In order to progress this, we would like to;
             o   Carry out a survey with all VTS and newly qualified GPs (1 st and 2nd year)
             o   Deliver 3 Multi-Professional Learning Events specifically responding to the findings of the VTS and
                 Newly Qualified GPs survey, ensuring engagement with other professional groups including
                 pharmacy, nursing, and social care
    •   Reducing Pressure in General Practice project (Self-Care information and sessions) – last year self-care sessions
        were delivered for patients and an information folder was produced. The folder will continue to be used by
        general practices, and 4 additional sessions will be delivered jointly by a GP and a pharmacist. Additionally, a
        video has been produced utilising CCG funding, which will be made available widely for patients and service
        users.
    •   Understanding the New Face of Primary Care Project – in addition to Multi-Professional Learning Group
        (MPLG) sessions, an infographic was produced outlining the key features of new roles in primary care:
        physician associates, nursing associates, medical assistants and practice based pharmacists. This infographic
        will continue to be used by general practices to inform their staff, but also will continue to be disseminated
        within the network.
    •   Retention Support Programme funded by HEE is aiming to work in collaboration with both federations in
        Camden to recruit 6 NQGPs and develop sustained systems to support NQGPs in future. Our aim to align this
        programme with any further funding that will be made available through HLP in tackling retention issues.
    •   Furthermore, Camden CEPN will continue to engage with the NCL Super Training Hub, aligning activities and
        ensuring efficiencies across both CEPN and Super Hub activities as recruitment and retention is one of the
        priorities for the Super Hub.
    Clinical Skills development is supported by CEPN through activities including:
    •    Mental Health Programme – this included the mapping exercise carried out with the STP Mental Health and
         Prevention leads, CCG Mental Health Commissioners and Mental Health Trust education leads to understand
         what training is already commissioned , what the current gaps in provision are and how these link with the
         STP plans. It is agreed by the Steering Group to commission suicide prevention and mental health first aid
         training programmes.
         Furthermore we were successful with our bid to UCLP to provide Children and Young People Digital MH
         training programme across NCL. Camden staff had the opportunity to attend 4 sessions in total.
         We will continue to align the activities to the STP Mental Health and Prevention work streams as well as with
         the training activity commissioned through CCGs.
    •    “Transforming the way we consult: testing Group Consultations in practice” as a new way of delivering both
         planned and unplanned primary care. This approach can be applied in primary and specialist care. They can
         support a whole range of clinicians to consult in a different more rewarding way. The project is aligned to
         CHIN and QIST development. The Programme across Camden, Islington and Haringey included 28 services,
         practices. We aim to continue providing support to the service areas and practices engaged in the current
         programme and offer further training to those practices part of local neighbourhoods aligning the activity
         with the integrated network (CHINs) development.
    •    Camden CEPN has been actively working to increase the number of non-medical prescribing capacity in
         Camden. Last year, we have organised prescribing update courses for existing non-medical prescribers.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

Primary and secondary care interactions focussed projects include:
    •    Access to Secondary Care training aims to open up secondary care training to primary care staff. The specific
         training activities that are provided within secondary care are opened up to primary care staff. The training as
         identified by the primary care nursing and care home leads in local areas across Camden, Islington and
         Haringey include:
             •    Tissue Viability
             •    Wound Management
             •    Phlebotomy
             •    Vaccination techniques
             •    ECG taking
             •    ECG reading and interpreting
             •    Leg Ulcer Management
             •    Foot check training
         We are aiming to develop the programme further by exploring possibilities for trusts to open the clinical
         training to the primary, care home and home care sectors. There are a number of areas that needs to be
         considered in developing such arrangements including supply and demand, preparedness of the systems
         within the secondary care, capacity to manage the potential demand in primary care and care homes and
         home care, preparedness within the organisations and staff groups to engage. There is a need for some of
         this conversation to be fed in to NCL wide conversations and linking with the MAST work.
Apprenticeship and widening participation:
     •   NCL wide “Learn and Earn programme” is being delivered through CEPNs. The programme includes
         traineeship programme which develops 4-week work experiences in GPs and Care Home settings as well as
         developing opportunities for visiting secondary care organisations to develop a whole system understanding
         of the trainees. Apprenticeships that are developed through the programme targets existing staff members,
         providing a career development pathway through enhanced apprenticeships (including additional clinical skills
         training required by the GPs and Care Homes) We had 41 starts in 17/18 across NCL and we will continue
         work with Primary Care, Care Home, Social Care leads to further develop the existing programme.
     •   As part of widening participation activity Whittington Health classroom has been established across Camden,
         Haringey and Islington CEPNs. The resource was opened to Enfield and Barnet and used by schools as well as
         traineeship programme. Over 300 young people have been taking part in clinical skills and emergency skills
         sessions.
         Alongside the Whittington Classroom we have ongoing engagement with the Local Authority schools and
         employment teams, colleges and universities. We will be aiming to develop a set of online training tools to
         increase capacity and understanding of apprenticeships by key frontline staff members, including careers
         advisors, careers coordinators, and apprenticeship leads. Furthermore, we would like to deliver two
         workshops targeting the key frontline staff members, to share learning and good practice.
Carers and communities projects includes Group consultations as mentioned above.
As part of the delivery of CEPN transformation projects, we have jointly produced a wiring diagram that demonstrates
which CEPN projects contribute to which STP work streams.

Key activities to be delivered in 2018/19:

Please set out key activities to be delivered which link to the CEPN and high level timescales for delivery. Please include
information where relevant on how this builds on activity of previous years and any partner organisations involved
(where applicable).

    1.   QI Capability and Capacity (Camden, Haringey and Islington Cross-Borough)
         This project will deliver education and training activities to increase advanced level quality improvement
         capability and capacity locally to support the development of neighbourhoods and Quality Improvement
         Support Teams (QISTs).

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

         The training will be developed in a tailor made approach, ensuring that it specifically responds to the need and
         demand on the ground linking in with projects such as retention support programme, GPN preceptorship
         programme and fellowships.

         The participants in this project will also be linked with the NCL wide QI Network, so that their learning can be
         applied to existing QI Projects and better collaboration between existing projects and the development of
         QISTs can be achieved.

         Delivery Timescale:
             o Sep-Oct 18- Engaging stakeholders including neighbourhood (CHIN) leads, CCG QIST development
                  leads, GP federations
             o Oct-Nov 18- Identifying training needs and demands, identifying suitable courses and/or engaging
                  training providers to develop tailor-made courses
             o Jan-Mar 19- Course delivery and participant feedback
             o Apr 19 – analysis of participant feedback

    2.   Improving recruitment and retention of newly qualified and trainees (Camden, Haringey and Islington Cross-
         Borough)
         This project will deliver 3 multi-professional learning group (MPLG) events specifically targeting newly qualified
         GPs and trainees. The focus areas will be determined by trainee and newly qualified GPs through an online
         survey, which will improve CEPN’s understanding of development, training and support needs, barriers as well
         as expectations and interests of trainee and newly qualified GPs.

         Therefore, as well as helping CEPNs deliver MPLGs that respond to need and demand, the survey will also help
         CEPNs to understand local issues in relation to recruitment and retention, and could support the development
         of a local retention strategy. This will also link with and feed into the Primary Care Strategy, currently being
         refreshed through Health and Care Closer to Home work stream.

         Each MPLG will have representatives of at least one other professional group, in order to facilitate better
         understanding of the whole system. E.g. community pharmacists, GPNs, social workers.

         The project will work closely with federations and VTS.

         Delivery Timescale:
             o Sep-Oct 18- Engaging stakeholders including VTS leads and GP federations
             o Oct 18 – Development of survey and agreeing on dissemination with VTS leads and GP Federations
             o Oct-Nov 18 - Online survey with trainee and newly qualified GPs collated
             o Dec 18 – Analysis of survey results
             o Jan-Mar 19 – MPLGs delivered in response to the survey results

    3.   Group Consultations (Camden, Haringey and Islington Cross-Borough)
         This project will build on the group consultation training that was delivered last year, and specifically target up
         to 4 practices and/or neighbourhoods that have not yet had an opportunity to take part in last year’s training.
         The training will link in with the development of neighbourhoods (CHINs), and explore using group
         consultations as an approach to engage a group of practices, focussing on an area that responds to identified
         population needs (e.g. COPD, diabetes etc.).

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

         As part of this, areas might consider targeting particular disadvantaged population groups.

         Delivery Timescale:
             o Sep-Oct 18 - Engaging stakeholders including GP federations, neighbourhood leads, public health
             o Nov 18 – Engaging training provider and publicising training
             o Jan-Mar 19 – Delivery of training and setting up group consultations

    4.   Improving knowledge and understanding of health and social care apprenticeships and work
         experience/tasters activities amongst key frontline staff (Camden, Haringey and Islington Cross-Borough)
         NCL Health and Social Care Employment Steering Group discussed and agreed that staff working directly with
         young people and their families to provide them with careers advice and guidance do not have access to most
         up-to-date information regarding apprenticeships and work experience/tasters within health and social care
         sector, and the links between these staff groups (including schools, colleges and local authority based staff)
         and the health and care sector need to be improved. This project will respond to this issue by delivering an
         online toolkit for these key frontline staff to access to better understand how apprenticeships and work
         experience/tasters can be facilitated within health and care sector, and by organising a workshop for these
         staff groups to better link them up with key stakeholders from the health and care sector.

         Delivery Timescale:
             o Sep-Nov 18 – Development of the online toolkit
             o Dec 18- Jan 19 – Engaging local authorities, schools’ and colleges’ careers coordinators and advisors,
                  and independent careers advisors to consult on the online toolkit and make changes accordingly
             o Feb 19 – Launch the online toolkit
             o Feb-Mar 19 – Delivery of workshop

Planned Expenditure (please be as specific as possible. Please provide a breakdown of the planned expenditure against
these priorities, with reference to the above activities.

Topic/ theme            Types of education or    Target staff groups      Estimated cost          RAG Rating (priority
                        training e.g. course,                                                     level)
                        toolkit etc.

QI Capability and       Course                   GPs, Nurses, Practice    £11,000                 R

Capacity                                         Managers,
                                                 Pharmacists

Improving               Survey                   Newly qualified GPs      £12,100                 R

recruitment and
retention of newly      Training                 Trainee GPs
qualified and
trainees

Group Consultations     Training                 GPs, Nurses, care        £11,000                 R

                                                 navigators
                        Support

Improving               Toolkit                  General Practices        £5,500                  A
knowledge and
understanding of        Workshops

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

health and social                                Trust apprenticeship
care apprenticeships                             leads
and work
experience/tasters                               Careers advisors
activities amongst
key frontline staff

2. GP Forward View – Future Workforce

Demonstrate how the CEPN will respond to the needs of the future workforce through the below. We would like to see
evidence that all areas have been considered but acknowledge there may not be comprehensive plans for each.

    a.   Increasing medical student placements
    b.   Increasing nurse placements
    c.   Increasing pharmacy student placements
    d.   Increasing apprenticeship placements
    e.   Increasing numbers of medical assistants
    f.   Increasing the number of nursing associates
    g.   Increasing the number of general practice nurses, as well as delivering the ten-point plan for general practice
         nursing
    h.   Increasing the number of Physician Associates
    i.   Increasing the number of clinical pharmacists in general practice
    j.   Other roles – please describe

Description of priorities which are CEPN specific and not set out above

The infrastructure for engaging primary care for student placements needs some work before the number of
placements can be improved to desired levels. This includes how the additional pressures and workload that student
placements create can be managed, and how the financial incentives could support clinicians and other staff members
to be able to support placed students without compromising their day-to-day clinical duties.

It is important to acknowledge that the supply of workforce is enabled by three things: new graduates, returning
practitioners and recruitment from other areas. Although much of this activity will be driven centrally, local
preparedness is also going to be key, and this is where CEPN will play an important role. We need to build the capacity
with the general practice to be able to have placements for the undergraduates, apprentices, newly qualified
professionals, returners etc. Primary Care needs to acknowledge that if they want primary care to be the first choice of
destination, it needs to have much greater exposure for undergraduates. As we know that professionals often continue
to work in the settings that they are exposed to and trained in.

CEPN has been instrumental in maintaining a business case that underlines the benefits of student placements for the
health and care system. We will continue to build and maintain the business case to support student placements,
encouraging that the link between service planning (new care models), financial challenges & considerations and
workforce is acknowledged within the sector. We are committed to share our experiences and develop a systematic
approach in NCL.

In aid of this effort, CEPNs have been engaging with GP Trainers, in order to increase their understanding of what
CEPNs deliver, and how they can better engage with these networks to maximise benefits. Similarly, we have been
working with our HEI partners to facilitate an engagement between general practices and HEIs to increase the number
of student placements. Additionally, we have been working closely with the local authority and other partners to offer
young people visits and work tasters to encourage them to work in health and social care.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

Recently Camden CEPN started to work with colleagues in Barnet and HEE, to explore how medical student placements
can be increased. The learning from this approach will be shared widely within NCL to ensure it informs future
strategies and approach.

Apprenticeships

Earn and Learn project was delivered utilising the transformation funding, in order to increase the traineeships and
apprenticeships across primary and social care settings.

The activities around the apprenticeships are also aligned with the GPN 10-point action plan.

Medical Assistants

We are a partner in the NCL Medical Assistant pilot project, and are currently training 27 existing staff members in
Camden to become medical assistants.

As part of the medical assistant pilot, each area is mapping how the work aligns with CHIN and QIST development, with
the view that these can be used as central resources for CHINs.

We are also exploring how we can use apprenticeships as a model going forward for medical assistants. In recognition
that the central evaluation of medical assistant pilot projects will be finalised in November 2018, we would like to carry
out a feasibility study to look at using apprenticeship as a sustainable model to train future cohort of medical
assistants. This will look at similar apprenticeships standards, additional training requirements, cost effectiveness as
well as time commitment requirements.

Nursing Associates

Camden CEPN is involved in the NCL Nursing Associates pilot project, as well as the new Nursing Associate
Apprenticeship Programme, which aims to increase the engagement within primary and social care.

GPN Scheme & 10-point action plan

CEPN has been instrumental in delivering the GPN scheme using HEE funding. Camden has had 7 starts in Jan 17, and 8
in Jan 18. Camden CEPN aims to recruit 2 further GPNs in Jan 19.

Unfortunately, there is an issue of retaining these nurses after the scheme comes to an end. There are discussions
within CEPN to understand how we can improve retention for this cohort.

We contributed to the development of the Nurse preceptorship framework and workbook, which is aligned to the
Capital Nurse preceptorship framework. Preceptorship activities are continued to be delivered, and where possible
aligned with newly qualified professionals network.

Student Nurse Placements

Through the NCL Super Hub, student nurse placements are coordinated across Islington, Camden and Haringey. Linked
to this, there is activity which supports mentorship capacity within the primary and social care settings, which is crucial
for the success of placements, as mentioned above.

Physician Associates

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

We are currently working with HEE and Royal Free to build on the successful physician associate programme that is
delivered in East London, in partnership with QMUL university. We are aiming to increase the number of placements
within NCL, which we hope will lead to an increase in numbers of physician associates in primary care.

Clinical Pharmacists

We are working with our clinical pharmacists based in primary care. Currently there are 8 pharmacists in Camden, but
we are expecting this to increase to up to 15 in the next 6 months. CEPN is facilitating a network for the clinical
pharmacists, and will continue to do so. We would like the CEPN to continue to facilitate these peer-to-peer clinical
pharmacist network and provide them with a small amount of funding to support management of Long Term
Conditions.

Key activities to be delivered in 2018/19:

Please set out key activities to be delivered which link to the CEPN and high level timescales for delivery. Please include
information where relevant on how this builds on activity of previous years and any partner organisations involved
(where applicable).

    1.   Apprenticeship model feasibility for Medical Assistant training (Camden, Haringey and Islington Cross-
         Borough)
         This project will build on the existing medical assistant pilot project, and explore if future cohorts could be
         delivered through an apprenticeship model, for sustainability. This will include
          • Finding apprenticeship standards that have similar/relevant skill-sets
          • Identifying the gap between the apprenticeship standards and what medical assistant training should
               include, and defining additional training requirements
          • Engaging apprenticeship training providers to find out if the additional training requirements could be
               included in the training they deliver
          • Engaging with key stakeholders (General Practices and GP Federations) to identify time commitment
               (additional on-the-job training, ongoing support, mentoring, release from practice)
          • Exploring how this role could be developed as a back office role, working across practices within
               neighbourhoods
          • Establish if there is business case, and disseminate business case to key stakeholders for consideration
         Delivery Timescale:
              o Sep-Oct 18- Desktop research
              o Oct 18- Defined additional training requirements
              o Nov-Dec 18 Liaison with apprenticeship training providers
              o Jan 19 Engaging stakeholders
              o Jan-Mar 19 Developing business case
              o Mar 19 – Disseminating business case to key stakeholders

    2.   Clinical Pharmacists Network
         This project will continue to facilitate the Clinical Pharmacist Network, and provide them with a small amount
         of funding to deliver training on management of Long Term Conditions.

         Delivery Timescale:
             o Oct 18 – Network meeting
             o Nov 18 – Trainer(s) engaged
             o Jan – Mar 19 – Training delivered
             o Mar 19 – Network meeting

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

Planned Expenditure (please be as specific as possible. Please provide a breakdown of the planned expenditure against
these priorities, with reference to the above activities.

Topic/ theme            Types of education or    Target staff groups      Estimated cost          RAG Rating (priority
                        training e.g. course,                                                     level)
                        toolkit etc.

Medical Assistant       Feasibility              General Practice         £2,750                  A

Apprenticeship                                   admin staff
Feasibility

Clinical Pharmacist     Peer-to-peer learning    General Practice         £7,610                  A
Network                                          Based Pharmacists
                        Course

  3. GP Forward View - Nursing

  Demonstrate how the CEPNs will respond to the priorities set out in GPN 10PP

Description of priorities which are CEPN specific and not set out above

Camden CEPN supports the development of nursing, through its membership to NCL Super Hub. NCL Super Hub reports
back to the CEPN with key updates, and all its activities are developed and delivered in response to CEPN priorities and
with full engagement of CEPN.

One of the key drivers of NCL Super Hub work is the GPN 10 point action plan:

    1.  Raise the profile of general practice nursing and promote as a first destination career
    2.  Extend leadership and educator roles
    3.  Increase the number of pre-registration placements in general practice
    4.  Establish inductions and preceptorships
    5.  Improve access to ‘return to practice’ programmes
    6.  Embed and deliver a radical upgrade in prevention
    7.  Support access to educational programmes
    8.  Increase access to clinical academic careers and advanced clinical practice programmes, including nurses
        working in advanced practice roles in general practice
    9. Develop healthcare support worker (HCSW), apprenticeship and nursing associate career pathways
    10. Improve retention

Activities supported through NCL Super training hub are part of CEPN recruitment and retention framework, and
respond to the above listed GPN 10-point action plan themes, including:

    •    NCL Nursing Associates pilot (including primary and social care employers)
    •    Development of NCL Nursing Associate Apprenticeship Programme
    •    Traineeship/Apprenticeship and widening participation activities (including HCA and care home staff career
         pathways)
    •    Training needs analysis

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

    •    Mentorship database and mentorship training
    •    Clinical Supervision
    •    Preceptorship sessions
    •    Library access
    •    Student Nurse placement including community groups and voluntary sector organisations
    •    GPN recruitment and ongoing support
    •    Feasibility study for rotational roles
    •    Care Certificate Programme (Assessors trainings)

Furthermore, NCL Super Training Hub is linking with HEE and Capital Nurse colleagues to ensure wider alignment on
policies. This included:

    •    Alignment of NCL Apprenticeship policy to primary and social care, which is shared with other areas in London
         through HEE;
    •    Alignment of NCL work experience policy to primary and social care; and
    •    Alignment of Capital Nurse preceptorship policy.

CEPN also contributes to the Primary Care Strategy refresh through the NCL Super Hub.

Additionally, as referred to earlier, Camden CEPN has delivered the Access to Secondary Care Training, which opened
up some training that is delivered within secondary care, to primary care nurses and HCAs, as well as care home based
staff.

Key activities to be delivered in 2018/19:

Please set out key activities to be delivered which link to the CEPN and high level timescales for delivery. Please include
information where relevant on how this builds on activity of previous years and any partner organisations involved
(where applicable).

In 2018-19, the following activities will be prioritised by NCL Super Hub
    •    Care Homes Training Needs Analysis and alignment with STP social care work stream
    •    NCL wide library access
    •    Promoting GPN updates
    •    Facilitating a sustainable model for care home training
    •    Working towards securing access to ESR (Electronic Staff Record)
    •    Identifying the current mentors and the extent to which they are able to use their mentoring skills
    •    GPN recruitment
    •    Student nurse placements
    •    Preceptorship
    •    Alignment with Trainee Nursing Associate Apprenticeship programme

We have also started discussions with the secondary care training providers to explore how we can mainstream the
“Access to Secondary Care Training”. We are negotiating that secondary care providers allow a few places in each
relevant training course to be given to primary care nurses and HCAs free of charge. These discussions are at an early
stage.

All these activities will be delivered using funding available to NCL Super Hub, and therefore no additional contribution
from the CEPN is required.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

Planned Expenditure (please be as specific as possible. Please provide a breakdown of the planned expenditure against
these priorities, with reference to the above activities.

Topic/ theme             Types of education or     Target staff groups       Estimated cost           RAG Rating (priority
                         training e.g. course,                                                        level)
                         toolkit etc.

4.Five Year Forward View

Five Year Forward View Priorities where relevant to Primary Care – Maternity; Mental Health; Cancer; Urgent and
Emergency Care; Learning Disabilities

Description of priorities which are CEPN specific and not set out above

We have been working closely with STP work streams and other CEPNs in the NCL footprint to deliver the priorities that
respond to the 5YFV.

Camden CEPN acts as the workforce work stream of the Local Care Strategy, which responds to the STP priorities
through a defined programme of work. Within this, Camden CEPN is responsible for developing and delivering a local
workforce strategy that is capable of supporting delivery of the models of care within the Local Care Strategy. This
programme also responds to the gaps identified within the 5YFV:

    •    Health and wellbeing: increasing the focus on preventing ill health
    •    Care and quality: Finding and resolving variations in care and health outcomes
    •    Finance and efficiency: Improving financial efficiency and investment

The CEPN has been working with projects within the Local Care Strategy, by identifying the workforce implications and
requirements, and responding to these in a system-wide approach. The overarching workforce implications can be
summarised as:

    •    Increased number of practice based clinical staff – in acknowledgement of the limitations of the supply, our
         approach to this includes looking at functions (rather than roles) within primary care, and exploring upskilling
         existing workforce to take on additional duties, new roles
    •    Upskilling for new working models – the LCS programme is yet to define the pathways for new working models
         completely, but once the business cases are finalised we will review the workforce implications and plan the
         upskilling plan accordingly
    •    Opening up secondary care training to primary care staff – this has been referred to before in relation to HCAs
         and nurses. We are working with the LCS programme to identify the courses needed, and additional staffing
         groups. Our discussion with secondary care training providers in relation to mainstreaming access to
         secondary care training will contribute to this. There are already a number of opportunities (e.g. fellowships,
         GP retention support programme) which we would like to maximise.

Camden CEPN has been working closely with the STP workforce work stream, to understand fully the workforce
implications in relation to the priority areas. The STP direction of travel will have a significant impact on where care is
delivered in the future, and therefore will require transformation of the workforce in primary and community care.

CEPN has delivered a number of education and training activities in mental health, specifically targeted at primary and
social care.

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

Additionally, we are working in collaboration with the Multi-Professional Advanced Clinical Practitioners and
Independent Prescribers Task and Finish Group, which aims to fully utilise the advanced skills of this workforce to
contribute to the STP clinical work streams, with a particular focus on Urgent and Emergency Care, Planned Care,
Prevention and Mental Health.

One of the key focus areas for CEPN is Admission Avoidance, particularly of people with Long Term Conditions.
Discussions with key stakeholders identified a particular area for development for London Ambulance Service
paramedics, especially in relation to:

    •    How to recognise clinical risk and severity of condition of patients experiencing and exacerbation of their LTC
         (for whom an ambulance has been called
    •    Understanding what services and skills are available in the community to support these people
    •    When and how to either (a) refer to appropriate primary and/or community services, or (b) convey to hospital.

Paramedics are trained as “emergency practitioners” but a large part of their workload is long-term condition
management (LTC)/exacerbations of chronic disease and primary care. There is currently a mismatch between the
training of LAS staff and the actual patient cohort. This results in patients being unnecessarily conveyed to hospital,
leading to avoidable stays in hospital and delays for LAS handover and in achieving the 4 hour standard.

Achieving clinical and financial sustainability of the emergency care system will rely on a strengthened understanding
within paramedics of existing community-based services for people with LTCs and greater support for them to avoid
conveyance when not clinically necessary.

Therefore, we would like to aim for;

    •    Enhanced capabilities of the ambulance workforce, including improved decision making and clinical
         assessment skills for paramedics
    •    Increased confidence in paramedics referring to GPs and using Appropriate Care Pathways (ACPs)
    •    Reduction in the conveyance rate and hospital admissions, particularly for people with Long-Term Conditions
    •    Increased capability of the newly appointed LAS Advanced Paramedic Practitioners (APPs), which they can
         then cascade to Band 6 paramedic colleagues

We recognise that investing in the training of paramedics with the above listed outcomes will have a significant
impact to admission avoidance.

Key activities to be delivered in 2018/19:

Please set out key activities to be delivered which link to the STP and high level timescales for delivery. Please include
information where relevant on how this builds on activity of previous years and any partner organisations involved
(where applicable).

    1.   LTCs and Admission Avoidance Training for paramedics (Camden, Haringey and Islington Cross-
         Borough)
         This project will see the delivery of training sessions, as well as on-the job (ambulance based) training and
         support targeted at paramedics, with priority for new Advanced Paramedic Practitioners (APP).

         Training sessions will be held every three months (four sessions in total), focusing on particular LTCs and
         systems (e.g. respiratory). One session will focus specifically on upskilling the new APP workforce in Camden so
         they understand all the key services available for admission avoidance (with a focus on LTCs), bringing
         together clinical leads from Ambulatory Emergency Care, Early Pregnancy Unit, Rapid Response Admission
         Avoidance, Trust-based ‘hot’ clinics and others to share information about their services, types of patients

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

         they accept, and referral pathways (learning exchange across admission avoidance/urgent & emergency care
         in the system).

         These APPs are anticipated in the future to provide support and development of the GP/Primary Care
         workforce, so their understanding of how LTCs can be managed at home, and when and how to access urgent
         and/acute services to support them, will be key for supporting them with this, as well as educating and
         supporting paramedic colleagues.

         The on-the-job/ambulance-based education and support for LAS clinicians with priority for new APPs
         education will be led by a local GP, who will ride-out on shifts with the ambulance crew. During these ride-out
         shifts, he local GP, with local experience and knowledge will;
             • Discuss with each crew each patient that is not a blue light emergency
             • Discuss enhanced history and examination to aid in assessment.
             • Joint decision making and support in using ACP’s/alternatives to the ED and supporting them in making
                  referrals and then getting feedback of the outcomes of these patients. This is done in the hope that
                  they can replicate in the future without direct support.

         These shifts will focus on APPs but also expanding to wider paramedic group, until APPs are confident in their
         skills and knowledge, and can start cascading the learning to other paramedics themselves (and reaching directly
         to Band 6 paramedics).

         There will be a total of 16 ride-out shifts by GPs with the ambulance crew.

         Delivery Timescale:
             o Sep 18 – Engagement with LAS and other stakeholders
             o Oct 18 – Feb 19 Delivery of training sessions
             o Oct-Nov 18 8 ride-out shifts
             o Feb-Mar 19 8 ride-out shifts

Planned Expenditure (please be as specific as possible. Please provide a breakdown of the planned expenditure against
these priorities, with reference to the above activities.

Topic/ theme            Types of education or    Target staff groups      Estimated cost          RAG Rating (priority
                        training e.g. course,                                                     level)
                        toolkit etc.

LTCs and Admissions     Course                   Paramedics               £17,380                 R

Avoidance Training
for Paramedics          On the job training

5. Regional HEE Priorities

Demonstrate how the CEPN will respond to HEE’s regional priorities (it is not expected that CEPNs should
deliver against all of these priorities)

• Development of support workers
• Upskilling current staff through increased non-medical prescribing capacity

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Primary Care - Community Education Providers Network (CEPN) Investment and Activity Plan 2018/2019

• Upskilling registered professionals and others to take on extended and advanced roles in priority service areas –
  Cancer; the child and new-born, primary care, integrating care teams, mental health, learning disabilities, long term
  conditions, urgent and emergency care, and leadership
• Supporting patient safety and person centred care - upskilling to embed person centred care, proactively address
  patient safety risks, awareness and impact of human factors
• Supporting career progression – career advice, guidance and support for transition into employment and onward
  career development – including RTP.
• Apprenticeships
• Promoting prevention and population health and well-being
• Prevention

Camden CEPN has been proactively responding to the regional HEE priorities through all its activities since its
establishment.

All CEPN activities are delivered in a multi-professional approach, with a strong emphasis in including the non-clinicians
to the education and training activities where possible and appropriate. We would like to continue delivering
education and training in neighbourhoods using a multi-professional approach, and would therefore like to deliver
MPLGs for three separate subjects (subjects to be determined through consultation with neighbourhoods).

CEPN has engaged the practice managers in Camden to ensure that their needs are discussed and responded to by the
CEPN. This year we would like to work on developing a practice manager career pathway through apprenticeships.
This will further engage the wider admin staff within practices and support them to develop themselves as practice
managers.

We increased the non-medical prescribing capacity with investment in previous years, and last year organised a
refresher/update training to ensure that upskilled workforce improve their confidence to utilise these skills. However,
we acknowledge that mentoring and supervision that is required for non-medical prescribers to prescribe is difficult to
secure within primary care, which is a challenge for the upskilled workforce to put their new skills into practice. This
year, we would like to support the Rapid Response Team to provide Non-Medical prescribing training to two of the
nurses, with an intention that an additional two will be supported to be trained by the provider. Those trained will
be tied in to a contract for at least a year to ensure benefits are realised.

CEPN has been working with the CCG primary care team to increase the numbers of advanced nurse practitioners, but
also have started engaging the advanced AHPs to ensure that their skills are fully utilised for system wide benefits.

Through our work in apprenticeship and widening participation, we have developed career pathways for HCAs to
become registered nurses, and are currently working with social care colleagues to develop a career pathway for the
workforce based at care homes.

CEPN has been actively encouraging the workforce to take part in MECC training, which we are coordinating with Public
Health and the STP Prevention work stream. We have also started working with the CVD project within the STP
prevention work stream, and will work on engaging wider workforce in order to increase the early identification of AF
through pulse-checks.

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