Part 1: Integrated Planning

In our role relating to ICS People Function Outcome area 9 ‘Leading coordinated workforce planning using analysis and intelligence’ (also see, Appendix 1); we will:

• support understanding of workforce planning and its elements within service planning architecture;
• help consider how developing ICS governance and planning infrastructure best enables integrated population health, service and workforce planning;
• support workforce planning as part of statutory or mandated service planning (eg annual, multi year); and enable ICS and wider stakeholder engagement in longer term strategic workforce planning (including HEE’s Strategic Framework development) and support maximising interventions which demonstrate benefit over different timeframes

Integrated planning seeks to set out how workforce planning can best be integrated with population health,service and financial planning.  Currently, planning takes place at different spatial levels (eg provider, place, ICS, region, national); over different timeframes (eg in year, annual, multi-year) and through different lenses of eg place, programme, pathway, profession. The ‘levers’ in/for these planning units are held by different and disparate parties involved in strategy, planning, delivery, improvement and oversight. Triangulating workforce demand and supply in and across these units; ‘all levers, all levels’ to make decisions about what interventions will be carried out to meet supply requirements is necessary to ensure as comprehensive a set of solutions as possible.

Statutory ICSs in collaboration with regional and national teams (primarily of NHSE&I and HEE) have a unique opportunity to align and coordinate planning and delivery of service activity and development, workforce and finance to meet population need across these levers. The Health and Care Bill includes (proposed) statutory duties on Integrated Care Boards (ICBs) to undertake annually updated five-year health service planning (s14Z50); and on Integrated Care Partnerships to develop a health and care strategy to meet local population need (s20(4))

Our integrated planning framing is designed to enable:

• A consistent description and scope of workforce planning in health and care;
• Integration of workforce planning with planning for population health finance and service;
• Transparency of each of the different elements of workforce planning and relationships between those elements, including the intervention ‘levers’ held by disparate parties;
• Coordination and governance in/of the different elements to enable development, implementation and monitoring of an ‘all levers, all levels’ action plan with feedback loops back into the planning system; and
• Framing the areas of activity we and other parties will carry out in partnership with ICSs

The integrated planning framing diagram in the ‘Integrated Care Systems: Guidance on HEE and ICS Relationship‘ document comprises a series of connected activities.  It is broadly based in ‘six step’ integrated planning methodology (as developed by Skills for Health) with the addition of the functions of coordination and governance of both service planning and workforce planning in relation to the activities in the rest of the framing.  It also uses the 10 People Function outcome areas contained in NHSE&I’s ICS People function guidance as the taxonomy for the different levers and functions to help ICSs more easily link workforce and education related activity into this framing as part of their overall governance, planning and operations.

Firstly, across the top of the diagram is a box entitled ‘system goals’, showing the ultimate purpose of using integrated planning in its unit of application is to achieve the goals of that ‘unit’. We have used ‘system’ because of the focus of our Operating Model on ICSs where we see the greatest potential for coordination of different levers for greatest impact on local populations. 

Secondly, underneath ‘system goals’ are three columns of activity, In the centre column is a series of boxes numbered 0-4 which comprise the following elements which are shown sequentially, albeit in practice you can enter the cycle of activity at any point:

1. Establishing service plans based on system goals (this step may also include longer term population health need identification and associated plans; in addition to short term service planning)
2. Establishing the required workforce to deliver the service plans
3. Assessing supply against the demand requirement using supply and demand modelling
4. Creating an ‘all levers’ action plan; coordinating workforce related interventions
5. Implementing the action plan; monitoring and refreshing; including feedback loops into the other elements of integrated planning

Box 3, ‘create an ‘all levers’ action plan’ then links to a box to its right containing a more detailed description of ‘all levers’, using ICS People function outcome areas 1-8. This box has feedback loop arrows into boxes 0-2, as the result of activity under any of those ‘levers’ may impact on service planning, workforce requirement and supply.

Thirdly, in the left-hand column under ‘system goals’ are two boxes ‘A’ and ‘B’. Box A is ‘governance of service planning – across time/ level/ lens (place, pathway, profession)’. Box B is ‘governance of workforce planning’ – the planning process and oversight regime across time, level, lens. These boxes are included to ensure consideration of who is responsible for coordination of service and workforce planning and decision making in and between both as critical elements of integrated planning. Box B is linked to boxes 1-4 above, which are the elements of workforce planning. Boxes A and B are linked to each other as interdependent. Box A links back up into the ‘system goals’ box as the outcomes of service planning may impact system goals.

Finally, across the bottom of the diagram are the ICS People function outcome areas 9 and 10: Leading coordinated workforce planning using analysis and intelligence; and Supporting system design and development. This recognises that both these functions (potentially) have a role in and across all elements of integrated planning as it is designed into and operates within an ICS setting, and reflects the way these functions are described as such in the NHSE&I ICS People Function guidance.  This expands on how a function of workforce planning may be seen as provision of analysis and intelligence to establish workforce demand and supply (Boxes 1 and 2); and how system design and development may be more related to organisation development change initiatives within elements of the system as one of the Box 3 levers.