Healthier Futures Black Country and West Birmingham used the Health and Wellbeing Framework as a catalyst for system-wide working to support workforce wellbeing
What we’ve done
Who we are
Healthier Futures Black Country and West Birmingham is an Integrated Care System (ICS) supporting place-based working between the NHS, local government and the voluntary and community sector for a population of 1.5 million people. The ICS includes 7 NHS trusts, 1 ambulance service, 5 councils, NHS England and Improvement and 1 clinical commissioning group with over 200 general practices and other partners.
What we did
- We used NHS England and NHS Improvement’s Health and Wellbeing Framework to help organisations focus on workforce wellbeing at system-level. We took a pragmatic step-by-step approach, starting by using the Framework’s diagnostic tool with acute, community and mental health trusts and the ambulance service. We then gained a snapshot of health and wellbeing in the primary care sector, focusing on specific elements to make it more manageable. We are planning to extend to include councils and other social care providers over time.
- Each organisation completed a shortened version of the diagnostic tool, where they RAG-rated themselves against good practice across seven core elements. We used just the first column of the diagnostic tool to self-assess, which provided quick results without being onerous.
- We compiled the information into a system-wide overview that provided trusts with insight into what everyone else was doing so they could benchmark themselves. We also prepared a list of which organisations had self-assessed themselves well and less well on each element to help trusts buddy up and learn from each other.
- All organisations that completed the self-assessment met to review themes. We identified that many were working on dashboards but had limited capacity to focus on data insights. To aid consistency, the ICS prioritised data insights for system-level work. We are now drawing together data about workforce demographics and health inequalities, which will feed into a system-wide Health and Wellbeing Strategy.
What we’ve achieved so far
- Benchmarking using the diagnostic tool helped identify areas of good practice and areas for development. We cut down the diagnostic tool to make it easy to complete, but some trusts thought it was so valuable that they decided to complete the tool in full. One trust identified a gap in data insights and immediately used the findings to justify a business case for a business analyst post.
- Using the Framework was the first time that all of our NHS trusts had met to review workforce wellbeing. Everyone found it worthwhile, so we made this a monthly meeting to agree system priorities and review progress. We intend to benchmark using the diagnostic tool 2-4 times each year.
- This tool has given trusts a conceptual framework with which to think about health and wellbeing. Most trusts are now refreshing the self-assessment regularly for their own tracking purposes, so the tool is being embedded into routine work.
“Using the Framework brought wellbeing leads together around a common goal. It helped us identify areas where we collectively could be doing more, such as musculoskeletal health, which will inform priorities and funding.” – Trust representative
“The Framework opened our eyes to consider whether we have the right people involved in setting priorities. It worked well to bring operational people together to share ideas, so we want to embed more operational and frontline experience into our strategic planning work.” – ICS representative
What we’ve learnt so far
It is valuable to use the diagnostic tool across an ICS, but there are some things to bear in mind
Some partners saw the tool as being focused on NHS trusts, rather than accounting for the different cultures and structures in primary care, social care and the voluntary sector. It is more difficult to identify appropriate umbrella organisations in these sectors, which are made up of many small enterprises. We worked with the Director of Primary Care to get a quick snapshot of primary care and plan to do the same with Skills for Care and councils.
The key to using the Framework is showing individual providers what’s in it for them
No-one wants to spend time reporting to ‘big brother’ using a large spreadsheet, so systems need to emphasise that the goal is to support providers to improve things locally. We emphasised positive outcomes such as building relationships between health and wellbeing leads and helping to prioritise funding allocations.
It is essential to do something practical as a result of using the Framework
All the wellbeing leads from trusts in our system are now meeting monthly. We are focusing on an element of the Framework each time to hear what everyone is doing at operational level. We want to showcase areas of excellence so we can raise the bar across the whole ICS. We matched up trusts that felt that there were and were not doing well in particular areas. This took time, but it is worth it to build conversations and relationships to help organisations learn from each other.