Horizon Scanning for the UK Department of Health Peter Sharp BSc PGCE DipEd CertEdPsych MA CPsychol CSci AFBPsS Head of Wellbeing, Cordis Bright
Four main themes: 1. Context: ‘VUCA’ world 2. Case Study: Horizon Scanning (HS) for the Department of Health 3. Making use of HS 4. Evidence based decision making in workforce planning 2
“…the next big economic driver will be biology and the global well-being economy. The last big economic driver was engineering and the first stage of the digital age.”
http://www.amazon.co.uk/Leaders-Make-Future-BK-Business/dp/1605090026
Dr. Bob Johansen, Distinguished Fellow, Past President and CEO, The Institute for the Future
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‘VUCA’ world: Volatile, Uncertain, Complex, and Ambiguous • In a Volatile time, vision gets rewarded highly.
“The kind of strategy that works is to be very clear about where you’re going, but very flexible in how you get there.”
• Uncertainty yields to understanding, a deeper cultural understanding of the context within which all this uncertainty evolves. • Complexity yields to clarity. But one of the ugly things about the VUCA world is, clarity gets rewarded, even if it’s wrong, • Ambiguity yields to agility.
“It’s variable speed and flexible speed that will win in the VUCA world.”
Bob Johansen, a Distinguished Fellow at the Institute for the Future, http://www.forum.com/downloads/transcripts/VUCA-Interview-2010-Final.pdf
“The best leaders are characterised by vision, understanding, clarity, and agility.”
“Leadership is like fast, staccato steps through sharp rocks.”
Health and Care System in England Fit for purpose – probably not? Fragmented, too many Quangos, Competing and Vested Interests?
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Key drivers Drivers for change: demand, ageing population & workforce, technology, disease, expectation, value for money and affordability. Led to call for action e.g. more nurses in the community setting
Greater use of wi-fi, telemedicine, shared consultation, portable kits, biometrics etc.
A major shift to working in the community
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Key drivers – shift to home and community > 25% of patients in hospital beds don’t need to be there and could be looked after by NHS/care staff at home (Department of Health. The Year: NHS Chief Executive’s annual report 2008/09. May 2009.)
2000 – 2010 Hospital admissions up by 38% and for over 75s by 66% Compare this with Sweden 1.6% & 0.6% respectively Prof Nick Bosanquet Imperial College, FT Feb 2012
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Key drivers Workforce implications – improving integrated care 1
… support people as close to their own homes as possible, particularly those with long-term conditions
Health promotion
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… develop health promotion and health improvement strategies with individuals, carers, families and communities
Supporting self-care
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… enable and develop individuals’, families’ and communities’ self-care skills
Supporting carers
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… support unpaid and paid carers e.g. care plans, information, hands-on .
Safeguarding
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… identify and protect adults, young people and children from harm
Community based
After: Visible, Accessible and Integrated Care. Report of the Review of Nursing in the Community in Scotland 2006
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Horizon scanning (HS) Systematic exploration • potential future developments • driving forces – factors outside the organisation’s control • potential ideas – potential future situations that would impact on demand and supply of the workforce. STAGES: • Information gathering: 1:1 interviews are held with experts. Ask for their insights into the driving forces that may impact the key question. • Idea and uncertainty analysis: The driving forces and ideas identified through the information gathering stage and supplementary research are collated and a report is created.
http://www.horizonscanning.org.uk/ 9
Business Intelligence (BI) High quality BI informed by systematic horizon scanning
1. Knowledge with experience Wisdom
2. Information + models Knowledge Experience, context & values
Strategic foresight supports better decisionmaking
3. Data + Analytics Information Data analysed to distil meaning
4. Facts Data Values of qualitative and/or quantitative variables
[email protected] 10
Environmental analysis Potential futures Data, Information, Analytics
Probable futures
Horizon scanning leading to scenario planning
Patterns of interaction
Scenario Planning
Known variables Trend analysis
Plans and objectives to deliver vision
The heart of strategic thinking
Past, present, future Resources, staff and outcomes
[email protected] 11
Useful references for Horizon Scanning – especially
George Wright
Pero Micic 12
Hindsight, Insight, Foresight, Action (HIFA)
Data + Analysis
Better decisions
HINDSIGHT - The past
What happened? Historical perspective Lessons learned
How and why did it happen? Analysis, Catalysis Implications
INSIGHT - The present
FORESIGHT - The future
What is happening now? Monitoring, dashboards, evaluations, plans External reviews
What is the plan for the future? Synthesis, Scenario planning Possible futures
What will happen? Prorating and extrapolating Forecasting
What’s the best or worst scenario? Prediction and simulation Probable futures
ACTION
Vision Strategy Plans Objectives Outcomes
* Decision-making using HIFA likely to be more robust and successful than short-termism or pragmatism
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Strategic planning means looking ahead 10 – 20 years… and building scenarios
http://www.horizonscanning.org.uk/ http://www.horizonscanning.org.uk/publications/horizon-2035-international-responses-to-big-picture-challenges/ 16
The modelling used for health and care could equally be used for energy, oil, etc. The approach is composed of four steps: 1. model scoping 2. model construction 3. model documentation and 4. model testing. Each stage is described in detail in this report and supported by best practice guidance.
http://www.horizonscanning.org.uk/publications/developing-robust-system-dynamics-based-workforce-models-a-best-practice-approach/ 17
Big Picture Challenges Four Domains WHY DO HORIZON SCANNING? • influence workforce policy to anticipate possible future developments • ensure security of workforce supply • increase value in the health and social care system • improve quality of care by planning for a sustainable workforce that meets the health and social care demands of the population • improve the efficiency and productivity of the workforce.ty of care by planning for a sustainable workforce that meets the health and social care demands of the population • improve the efficiency and productivity of the workforce. 18
Horizon Scanning for the Department of Health
Health systems – international rankings
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Aspirations “People will see health and social care fully joined-up by 2018” NHS England and LGA https://www.gov.uk/government/news/people-will-see-health-and-social-care-fully-joined-up-by-2018
http://www.institute.nhs.uk/qipp/joined_up_care/joined_up_care_homepage.html http://www.institute.nhs.uk/images//documents/Joined_Up_Care/Joined-up%20measurement.pdf
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Aspirations “An ambition to make joined-up and coordinated health and care the norm by 2018 – with projects in every part of the country by 2015”
Care and Support Minister Norman Lamb said:
“People don’t want health care or social care, they just want the best care.” https://www.gov.uk/government/news/people-will-see-health-and-social-care-fully-joined-up-by-2018
20 May 2013
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£3.8bn NHS Better Care Fund policy delayed after damning Whitehall review Review concluded that claims for policy to bring together health and social care services 'don't stack up' 7th May 2014
A government policy intended to stop the NHS from becoming overwhelmed has been delayed after a confidential Whitehall review concluded it would not work as hoped. Neither would it help to balance the NHS budget or bring about an intended revolution in patient care.
http://www.theguardian.com/society/2014/may/06/nhs-better-care-fund-policy-halted-whitehall-review?CMP=twt_gu
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Better Care Fund policy delayed after damning Whitehall review • A Whitehall source said the Cabinet Office believed that the claims for the Better Care Fund did not stack up and wanted "a lot more work done on the policy". • Cabinet Office review found that plans to save money from local hospital budgets by moving care elsewhere lacked financial credibility, with little or no detail about how savings would be delivered.
• Now a team of officials from both departments responsible for the new policy have been told to produce extra evidence to make it more "credible" and overcome deep Cabinet Office scepticism. • The Cabinet Office also voiced concern that hospitals have been consulted far too little about the plans, while local councils and the GP-led NHS clinical commissioning groups have drawn up local plans.
http://www.theguardian.com/society/2014/may/06/nhs-better-care-fund-policy-halted-whitehall-review?CMP=twt_gu
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Making use of Horizon Scanning
Workforce Planning: Right people, right place, right time, doing the right things for the right reasons
http://www.horizonscanning.org.uk/our-research/horizon-2035/ 28
Keep the system simple and accessible
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Evidence-based decision making in Workforce Planning
[email protected]
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Workforce planning framework Again, devised for health and care but equally applicable for Technology, Energy, Transport etc. This can work for planning any workforce…
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Workforce planning for all health and social care workforce Practical applications: • Informing recruitment, retention • Organisational development • New ways of working • New job descriptions • Managing need differently CASE STUDIES - Shortages of health and care workforce: • Nurses • General Practitioners • Emergency Medicine (Accident & Emergency) • Psychiatrists 33
TECHNOLOGY Hopes for the future - global • At the cutting edge: How telehealth works at Airedale NHS Foundation Trust in West Yorkshire and the implications for the health and social care workforce • Genomics heralds far reaching changes in health • Web health e.g. Online CBT: A game changer for psychological therapy? • Challenges in innovation for the health workforce of the future http://www.horizonscanning.org.uk/publications/future-workforce-matters-issue-3/ 34
FREE Horizon Scanning App – iPad or Android
https://itunes.apple.com/gb/app/cfwi-hs-hub/id705113986?mt=8 35
Thank you for your participation. Video links – Horizon Scanning
https://www.youtube.com/watch?v=l-DVQ5BICjk
https://www.youtube.com/watch?v=Y 4CM9g_FmwQ
https://www.youtube.com/watch?v=p2fvId6kf9o https://www.youtube.com/watch?v=efT4S814jMM
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http://petersharp.webs.com/
[email protected] Mob +447818 567 202 37
