Winter Pressures: Why it’s not just a problem for the NHS

By Cllr. Ketan Sheth

The term ‘winter pressures,’ is a phrase we hear regularly at this time of year as hospitals struggle to meet demand. But what does it mean in practice? That’s what my scrutiny committee wanted to find out when we discussed this issue earlier in the year.

It has, for many years, been commonly perceived that winter pressures are the NHS’s problem. But is this really fair given we serve the same communities and the pressure on health and social care are significant?

In response, Brent Council, Brent Clinical Commissioning Group and London North West University Healthcare NHS Trust have teamed up to address the problem in recent years.

It is no small challenge as parts of Brent are among the most deprived places in London, and Northwick Park Hospital is one of the busiest A&E departments in the capital. Early planning and a co-ordinated cross organisational approach have helped us shape a robust winter plan that maintains patient experience, safety and clinical effectiveness during the most demanding period of the year.

This planning began with lessons learnt during the winter of 2017/18, which were subsequently built into our current plan. It boils down to keeping people out of hospital; ensuring patients who are admitted are treated and discharged quickly (and safely); and provision of adequate home support in the community.

Brent CCG responded by giving patients access to GP appointments from 8am-8pm seven days a week via a network of GP hubs. The hubs play a crucial role in curbing the number of people going to A&E with minor ailments. Their use rose by 42% between Oct-Dec 2017 and the same period a year later. The CCG also provided an enhanced service in care homes, a targeted approach to flu vaccinations and developed a closer working relationship between acute and primary care providers.

The Department of Health provided the council with a one-off payment of £1.3M to support hospital discharges. It ‘purchased’ an additional 15 beds, provided reward payments to care homes that could quickly assess and accommodate patients as well as provide an additional handyman service for home adaptations. It also invested in additional social worker, OT and co-ordinator capacity to boost its Home First initiative to get patients home with the minimum of delay.

Ambulance handover times between crews and A&E staff at Northwick Park Hospital has improved and benefited from an additional paramedic/nurse to assist with triage and advanced assessment triage area.

These plans have helped but under pinning it all is the dedication and hard work of staff on the front line.

The reality is that we face a growing population that is living longer and increasingly troubled by a host of long-term conditions. The only way we can manage this, aside from promoting greater personal responsibility for health, is for the public sector and its partners to develop a healthy working relationship, which recognises this is everyone’s problem.

ketanKetan Sheth is Councillor for Tokyngton Wembley and Chair of Brent Council’s Community and Wellbeing Scrutiny Committee

 

 

 

All views in this blog are those of the author and not INLOGOV or the University of Birmingham.

Why one size does not fit all: addressing the requirements of the public service leader

Stephen Jeffares

One of the key roles for Apprenticeship Week is to raise awareness of what is a relatively new form of qualification: the higher degree apprenticeship. For many years aspiring public service leaders have returned to university to study for a master’s degree. For many years this was generously funded by their organisation. However over the last decade successive austerity budgets have dramatically impacted on employer funded higher degrees. Here at INLOGOV we’ve seen the balance shift from employer to employee funded degrees. Public managers seeking that next challenge have resorted to self-funding. It has required managers to study in their spare time and take annual leave to attend campus sessions.

The arrival of master’s level degree apprenticeships offers a whole new model, a whole new opportunity. Public managers can now study for a postgraduate degree funded by their organisation’s “use it or lose it” apprenticeship levy pot. There’s a growing number of degree apprenticeships and university providers to choose from.

Of interest to aspiring senior leaders is the “Senior Leader” apprenticeship. Developed by public and private industry the standard describes the knowledge, skills and behaviours required of a senior leader. If you take a moment to read some of these 15 capabilities none will be out of place in the person specification for a chief executive of a large public organisation.

With more and more providers starting to offer degrees mapped to the new Senior Leader Apprenticeship it is important to recognise they are not all the same. Some are offered by large business schools, or traditional broad-spectrum research-intensive universities, or providers with a track record of working with mature students or innovative teaching methods.

Applicants we speak to are mostly concerned with the location of the university, the structure of the programme, and the reputation of the institution. However, another factor is the preference of the employer. Some are happy to work with a range of providers, while others want to keep it simple and work with one provider or to develop partnerships with their local universities.

As a provider of public management degrees for over 30 years, we at INLOGOV saw the development of a degree based on the Senior Leader standard as a natural transition. The Senior Leader standard set us the following challenge – how to create a programme that would equip our next generation of public service senior leaders. Whilst we recognise managerial reform has led to some blurring of public and private sector management, there are unique challenges facing public leaders that necessitates a tailored approach. Our research clearly demonstrates that effective leadership in the political environment of the public sector requires more than a generic set of management capabilities.

This challenge has led us to design and build a programme that connects the senior Leader standard with cutting edge public management research and real-world cases.

Our programme is based on three key design elements.

First is a set of six modules addressing critical public management issues, whilst also considering the required capabilities of the Senior Leader standard. Our programme addresses a broad range of important topics including public management, governance, leadership, evidence, digital, commercialisation, finance, strategy and performance (you can read more about our programme here).

Second is building the flexibility of blended learning to deliver much of the core content through a Virtual Learning Environment, thereby reducing the time spent passively learning in lecture theatres and allowing learners to fit their learning around their schedule.

Third is to retain a campus experience. Senior leaders need networks that extend beyond their own organisations or localities.

All this means participants can graduate with a dual award – both an MSc in Public Management and Leadership and a Senior Leader apprenticeship.

jeffares-stephenStephen Jeffares is Senior Lecturer in Public Policy at INLOGOV and co-Director of the Public Management and Leadership Degree Apprenticeship alongside Louise Reardon, Lecturer in Governance and Public Policy at INLOGOV.

If you are interested in joining a growing number of public agencies investing their levy in senior leadership please contact our Degree Apprenticeships Facilitator Kulvinder Buray (K.Buray@bham.ac.uk). We are currently recruiting for our September 2019 start.

Using learning technologies to support our degree apprentices

Paul Dyson

An important feature of our Public Management and Leadership Degree Apprenticeship is its blended format – with learning facilitated through a combination of online and face-to-face delivery. This format provides much needed flexibility for both the apprentice and their employer.

The University of Birmingham is well placed to offer a blended learning experience. The University’s high quality teaching was awarded Gold in the Teaching Excellence Framework, and INLOGOV has recently pioneered a 100% online Distance Learning Masters of Public Administration. We are therefore able to combine these two areas of expertise into a first class blended learning experience.

Both online and class-based learning is managed through ‘Canvas’; the University of Birmingham’s Virtual Learning Environment (VLE). Each module has its own dedicated Canvas page. Each page includes all of the learning materials for each week of the module, and links to related reading materials. Throughout the programme, module convenors will interact with and support their students through Canvas as a complement to on-campus activities. Moreover, throughout the module a student forum is available for students to ask questions.

Our online content is designed to ensure it is engaging and inspiring in order to enhance the learning experience. For example, discussion boards are a key element of our online teaching and learning. On these boards, module convenors pose questions and topics, and apprentices are asked to respond and react to each other’s views and ideas, drawing on their own work experiences and learning. We also use interactive scenarios, exercises, quizzes, interactive diagrams, videos and case studies to help develop student learning.

We also use a software called Big Blue Button to host live online interactive lectures within modules and to hold academic skills sessions. The playback functionality on these platforms means that live lectures and seminars can be recorded so that those who were not able to join in live do not miss out, and enabling learners to have a programme-long resource.

It is not just in the taught component of the apprenticeship that we use technology to support our learners. All degree apprenticeships are predicated on the need to develop a portfolio that provides evidence of the apprentice’s development journey. This portfolio contains a record of the candidate’s evidence claims against national standards.  During the course of the apprenticeship programme the apprentice is required to keep a record of their evidence claims as they accumulate over time.

Here at the University of Birmingham we use PebblePad to capture evidence claims that can be mapped to the appropriate standards. This versatile software allows the learner to not only record their evidence claims but also reflect upon how these were achieved. Each portfolio has also been designed to encapsulate all the necessary record-keeping that is associated with the apprenticeship programme. This includes maintaining a digital record of progress reviews, commonly referred to as tripartite meetings, as well as providing an authentic time-stamped record of how an agreed allocation of training hours are met.

The PebblePad portfolio is an essential digital companion that supports the apprentice through to their end point assessment. Its contents ultimately showcase work achieved over the duration of the programme together with digital artefacts that demonstrate skills gained and professional behaviours exhibited. These artefacts can include video evidence, audio accounts, presentations and blogs.

Apprentices can also enjoy the benefits of the PebblePad mobile app. This app allows for the spontaneous collection of naturally occurring evidence which can in turn be sync’d back to the desktop application.

Technology plays, and will continue to play, an important role in both the undergraduate and postgraduate apprenticeship experience.

Paul DysonPaul Dyson is an Instructional Designer for the College of Social Sciences, University of Birmingham. He works closely with INLOGOV to design and develop online content and PebblePad functionality for the Public Management and Leadership programme.

Want to learn more about our Programme? Contact Kulvinder Buray our Degree Apprenticeships Facilitator: K.Buray@bham.ac.uk 

An Apprentice’s View…

Robert Ellam

I’ve been doing the Public Management and Leadership apprenticeship course for around six months now, and it’s going well so far (I think).  It’s not easy, but perhaps that’s a good sign!

I’ve been a manager for a little over four years, and a leader for far longer than that (yep, it’s not just managers who are leaders).  I’ve found that moving in and out of a leadership role has suited my natural style well – I’m quite prepared to lead when I see that it’s needed, but equally I’m happy to let people get on with it where leadership isn’t needed, or when there is good enough leadership in place, and I rarely solve people’s problems for them either as a leader or a manager.

When I first joined Suffolk County Council, I was fairly sure that I would have to become a manager at some point – having seen various managers and leaders who I thought did it poorly, I was determined to try to get it right.  While I’m not sure I’ve always managed to get it right (boom boom), I’ve tried to learn from those failures.

Because of this, I started taking careful notice of good and inspirational leaders and managers whose approach I saw something good in, and who I thought I could learn something from. I was probably doing it before joining the council, but that was the first time I’d started doing it consciously.

The opportunity to do the apprenticeship came at an opportune time when I was thinking about the next step in my career, and I was really keen to have the dedicated space it provides to understand why I and others lead as we do, see other ways of leading, and think about what I can improve on in my practice.

Robert EllamRobert Ellam is a Business Intelligence Manager at Suffolk County Council and an apprentice on our Public Management and Leadership Programme.

Want to learn more? Tomorrow, Thursday 7 March at 12 noon, we are hosting a live webinar to outline the programme in more detail. Click here to sign up.

How the off the job requirement of our apprenticeship adds value

Louise Reardon and Stephen Jeffares

One of the key requirements of all degree apprenticeship programmes is that apprentices spend 20 percent of their time ‘off the job’ on activities that contribute to their learning, but which are not part of their routine work. It is understandable that in the context of rising demands and diminished resources, this requirement can be a cause of concern for public sector employers; losing important members of their team, indeed managers of teams, for the equivalent of one day a week over the course of the programme. However, ‘off the job’ does not have to mean not contributing to the job. Indeed, on our Public Management and Leadership Executive Apprenticeship we ensure that all activity is pertinent to practice, so that learning can feed back into the workplace from Day 1 of the programme.

So what does the ‘off the job’ requirement look like in practice? Well, a significant portion of the 20 percent is spent on the formal learning delivered through our blended format of online and face-to-face teaching. The face-to-face teaching on campus amounts to eight days per academic year, while the online elements amount to approximately one day per week per blended module (of which there are four per academic year).

Off the job learning in this regard therefore constitutes a range of activities. For example, the time spent contributing to discussion boards where apprentices debate with their peers about how key concepts apply to their workplace. Time spent engaging with videos illustrating critical case studies or best practice examples. And time spent reading and gathering evidence for assignments.

All the assignments set throughout the programme are geared towards providing the opportunity for apprentices to reflect on how the theories and approaches they are introduced to, apply to their own organisational context and experiences. For example, an assignment might ask apprentices to critically reflect on how an existing ‘wicked problem’ faced by their service could be overcome through applying different modes of governance, or how applying a diagnostic framework can help identify leadership challenges within their organisation.

The work-based dissertation project, undertaken by apprentices in the second year of the programme, also affords the opportunity for apprentices to define their own research question and address a challenge pertinent to their service or authority. So, in spending time off the job on this project, apprentices are effectively undertaking in-house consultancy for their service, or indeed another service in their authority. Providing recommendations for action grounded in evidence and rigorous research, and developed with the support of internationally recognised INLOGOV researchers.

In short, off the job is still relevant to the job. Not only relevant, but adding value.

Want to learn more? Later this week, on Thursday 7 March at 12 noon, we are hosting a live webinar to outline the programme in more detail. Click here to sign up.

Dr Louise Reardon (l.h.reardon@bham.ac.uk) is a lecturer in Governance and Public Policy at INLOGOV. Stephen Jeffares (s.r.jeffares@bham.ac.uk) is a Senior Lecturer in Public Policy at INLOGOV. Both are co-Directors of the Public Management and Leadership Executive Apprenticeship and MSc.

Introducing our Public Management and Leadership Executive Apprenticeship

Louise Reardon and Stephen Jeffares

As its Apprenticeship week, we thought we would take the opportunity to post throughout the week, on different aspects of INLOGOV’s Degree Apprenticeship programme. Today a brief introduction. Our Executive Apprenticeship in Public Management and Leadership gives public sector employers the opportunity to use their Apprenticeship Levy to grow management and leadership expertise within their organisation. It also gives the employee the chance to learn and apply new skills that will help them to excel in their current role and up the career ladder, while at the same time also gaining a master’s degree.

The programme is underpinned by our sector leading research, with recent projects such as the 21st Century Public Servant, putting us at the forefront of understanding the public sector environment and shaping best practice. Moreover, our Apprenticeship is developed in partnership with the Society of Local Authority Chief Executives (SOLACE), ensuring that the Programme’s content meets the demands of public sector employers.

Given INLOGOV’s long history of delivering training to practitioners, we are acutely aware of the multiple demands that part-time learners face, balancing their learning with their busy job roles and personal lives, and the pressures employers face when staff have to be released for study days. That is why we have structured our Apprenticeship using a ‘blended’ format, with teaching delivered through a combination of online and face-to-face delivery.

Apprentices can study online at the time most convenient to them, with all the resources they need available through their laptop, tablet, or phone. This means that our apprentices do not have to spend significant amounts of time away from home or the workplace (only eight days on campus per academic year). The on-campus days give apprentices the chance to learn through task-based exercises, develop a close peer-network of fellow practitioners from across the UK, share best practice, network with guest speakers and the INLOGOV community, and take advantage of our campus amenities, including gym, swimming pool and libraries.

Want to learn more? Later this week, on Thursday 7 March at 12 noon, we are hosting a live webinar to outline the programme in more detail. Click here to sign up.

Dr Louise Reardon (l.h.reardon@bham.ac.uk) is a lecturer in Governance and Public Policy at INLOGOV. Stephen Jeffares (s.r.jeffares@bham.ac.uk) is a Senior Lecturer in Public Policy at INLOGOV. Both are co-Directors of the Public Management and Leadership Executive Apprenticeship and MSc.