Joint briefing paper: Health, Social Care & Sport Committee 23rd January 2019

Health Education and Improvement Wales (HEIW) and Social Care Wales (SCW) welcome the opportunity to meet with the committee and provide members with an overview of our work, particularly our joint work in relation to workforce development.

1. About us

Heath Education and Improvement Wales (HEIW)was established as a Special Health Authority on 1 October 2018, bringing together the Wales Deanery, the Wales Centre for Professional Pharmacy Education and the NHS Workforce and Education Development Service.  The background to the establishment of the new organisation is well documented through two independent reviews both supporting the need to establish a single body to develop an integrated and comprehensive approach to the planning and development of the health workforce, and to drive sustainable improvement.  Our vision is “Transforming the workforce for a healthier Wales”. Our functions are:




Workforce Intelligence

HEIW will be the central, recognised source for information and intelligence about the Welsh health workforce.  It will provide analytical insight and intelligence to support the development of the current and future shape of the workforce.  It will act as a central body to identify and analyse sources of intelligence from Wales, UK and abroad.

Workforce Planning

HEIW will provide strategic leadership for workforce planning, working with health boards/trusts and the Welsh Government to produce a forward strategy to transform the workforce to deliver new health and social models of service delivery.  In addition, through this process, HEIW will identify any new workforce models required within the NHS.

Education Commissioning

HEIW will utilise its funding to ensure value for money and the provision of a workforce which reflects future healthcare needs.  This will include commissioning and contracting as well as design and delivery of education and training.

Quality Management

HEIW will quality manage education and training provision ensuring it meets required standards, and improvements are made where required.  This will include supporting teachers, trainers, trainees and working closely with regulators.

Supporting Regulation

HEIW will play a key role representing Wales in liaison with regulators, working within the policy framework established by the Welsh Government. HEIW will also undertake, independently of the Welsh Government, specific regulatory support roles.

Leadership Development and Succession Planning

HEIW will establish the strategic direction for the development and delivery of leadership development and succession planning for NHS Wales.

Careers & widening access

HEIW will provide the strategic direction for health careers and the widening access agenda, delivering an ongoing agenda to promote health careers.

Workforce Improvement

HEIW will provide strategic and practical support for workforce transformation and improvement, including skills development, role design, CPD, and career pathway development.


Some key facts about the new organisation:


·         We have an annual budget of over £200m, the majority of which is spent on education;

·         We have over 400 core members of staff;

·         We also work with over 1,800 medical and dental trainers and mentors, based in primary and secondary care;

·         At any one time we are working with NHS colleagues to support 3,000 training-grade doctors and dentists across Wales;

·         At any one time we support over 9500 students/trainees via health professional education and training budget;

·         We offer over 50 different specialist medical training programmes;

·         We operate 12 district GP training schemes in Wales;

·         We promote over 350 different careers in NHS Wales;



Social Care Wales (SCW) is a Welsh Government Sponsored Body established under the Regulation and Inspection of Social Care (Wales) Act 2016 to protect, promote and maintain the safety and well-being of the public in Wales. Launched in April 2017, Social Care Wales replaced the Care Council for Wales and incorporated the Social Services Improvement Agency.


Our vision is for every person who needs support to live the life that matters to them. Our aims are to:


·         Provide public confidence in the social care workforce;

·         Lead and support improvement in social care; and

·         Develop the early years and social care workforce.

Our purpose is to build confidence in the workforce, and lead and support improvement in social care. We:

·         Set standards for the care and support workforce, making them accountable for their work;

·         Develop the workforce so they have the knowledge and skills to protect, empower and support those who need help;

·         Work with others to improve services for areas agreed as a national priority;

·         Set priorities for research to collect evidence of what works well;

·         Share good practice with the workforce so they can provide the best response; and

·         Provide information on care and support for the public, the workforce and other organisations.



2. Developing a strategy for the development of a sustainable health and care workforce for the future

‘A Healthier Wales’ set out the commission for HEIW and SCW to develop a workforce strategy for the health and social care system by the end of 2019. The strategy is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             essential to ensure the ambitions to transform service models set out in ‘A Healthier Wales’ can be delivered successfully.

The workforce strategy will deliver the ambition of ‘A Healthier Wales’ for a seamless social care and health system. It will build on a number of the principles that are embedded in ‘Prosperity for All’ and ‘A Healthier Wales’ including:

·         The workforce of the future will be defined by new models of integrated health and social care, which are based upon evidence of good practice and sustainability, to deliver better health and well-being; 

·         To be effective in planning the future workforce, a clear understanding of the current workforce is required including challenges of maintaining and sustaining current service supply with an understanding of the required changes in skills mix to support new models of delivery;

·         Needs will be met based upon who is best placed to provide the care not solely directly employed or contracted staff.  This will include workers who are employed outside of statutory health and social care organisations e.g. housing associations, independent and voluntary sector;

·         The role of unpaid carers will be better supported, to ensure they have the knowledge and skills to continue caring and that their own well-being needs are considered;

·         There will be parity of esteem between all health and care professionals, who have similar levels of responsibility and accountability;  

·         The health and well-being of staff will be designed into workforce and service models, including support to better manage demand through service re-design;

·         Education, training and development must evolve and diversify to support a multi professional approach, an increased focus on prevention, early intervention and the delivery of care across settings from home, primary and community through to hospital and specialist provision; 

·         Changing expectations of work and careers must drive increased flexibility in work patterns, education, training, career pathways and workforce models to improve recruitment and retention.  This will maximise opportunities arising from part time learning and working, digital technology and accelerating digital change, and new ways of delivering treatment, care and support; 

·         Increased flexibility will require an understanding of how the workforce is currently deployed and measures that can be taken to strengthen deployment approaches which maximises the mobility and flexibility of the workforce in meeting shifting service demands;

·         Prudent principles will be used to ensure that staff are supported to work at the top of their competence and to drive the expansion of generalist skills; and

·         A whole system collaborative approach will be taken to aligning workforce planning, recruitment and career pathways across health and social care to avoid competition and de-stabilisation.

The strategy will include planning for new workforce models, strengthening prevention, well-being, generalist and Welsh language skills, developing strategic education and training partnerships, supporting career long development and diversification across the wider workforce. It will reach across to other activity such as national recruitment campaigns including for social care “ the national attraction, retention and recruitment campaign which will promote a positive view of social care as a valued and rewarding place to work”, referenced in the Welsh Government’s ‘Prosperity for All: Employability Plan 2018’ (see Appendix B for further information).

The development of the strategy will take a six-stage approach, encompassing:

·         Mobilisation and preliminary analysis of the workforce;

·         Key challenges and horizon scanning;

·         Engagement with a wide range of agencies and representative bodies;

·         The publication of a completed analysis report;

·         The development of a draft strategy;

·         Formal consultation with a broad range of stakeholders; and

·         Publication of a final strategy, before the end of 2019.


The published strategy will provide a clear ten-year strategic intent and act as a framework and primary reference point for workforce plans and actions for Regional Partnership Boards, professional groups, services, care settings, the whole paid and unpaid workforce and Unions. The strategy will be complemented by a set of implementation plans to deliver the actions.

One of the key challenges for the development of the strategy is the pace and extent of change anticipated over the next 5–10 years. For example, the increasing role of digital and other technologies, the impact of Brexit, the changing needs of the population and the changing expectations of our current and future staff. Therefore, it is essential the strategy builds in as much flexibility as possible to ensure health and social care is better able to adapt and respond to these changes, rather than try to develop detailed plans for what is not fully predictable.

Given this, and the potential breadth of the strategy, the intention is to develop a clear direction and framework to drive, inform and underpin all subsequent workforce plans and models.  This recognises that in the complex system of health and social care plans about the workforce may need to take various forms. For example, focusing on specific professional or occupational groups, individual health or social care services, settings of care or geographical areas. 

The intention is also to ensure in future years the workforce strategy drives and aligns other key activities including:

·         Workforce intelligence and information;

·         Education planning and commissioning;

·         Leadership development;

·         Continuous professional development;

·         Workforce development and modernisation; and

·         Recruitment, widening access and careers management.

This will help ensure we have a sustainable approach to the future development of the health and care workforce.

In respect of process, a small steering group has been established which is jointly chaired by the two organisations to oversee the development of the strategy. However, the shaping of the content and priorities within the strategy will be undertaken through an engagement phase during the spring involving a wide range of stakeholders and partners. There will also be a formal consultation exercise during the summer and further engagement across Wales during 2019 to ensure local and regional needs inform the national priorities.

3. HEIW and SCW’s strategic priorities

See appendices 1 and 2.


4. How HEIW and SCW will work together (and with other relevant partners) to ensure a holistic approach to workforce planning and development

As previously mentioned, a collaborative approach has already been developed between the two organisations through the jointly chaired Workforce Strategy steering group. This approach will also be used to develop the leadership strategy for health and social care, which is another joint commission from ‘A  Healthier Wales’.  Other collaborative projects are already underway including the Joint Health and Social Care Induction Framework which is being piloted in the Hywel Dda University Health Board area.  Joint Executive Team and Joint Board meetings have been planned for the near future to build on these early foundations and explore other opportunities for joint work.

Both organisations need to work with a complex range of stakeholders and partners to deliver on its ambitions – including other NHS organisations, local government, professional bodies, regulators, education providers, the independent and third sectors, Welsh Government, and our counterparts across the UK. 

As noted earlier, the successful implementation of the future workforce strategy will depend upon integration and alignment of all aspects of workforce planning and development and so extensive and continuous engagement is vital. As relatively small organisations, we also recognise the need to secure and utilise the expertise and knowledge that exists across the whole system. 

As an example, HEIW has established a robust platform for this through its stakeholder engagement work over the last 12 months, including a variety of workshops and introductory meetings, which continue to be a priority for the Board. Equally it is also important to note that some stakeholders operate at a UK rather than a Wales level, so extending our influence and voice is a key focus, supported by the early development of strong links with colleagues in NHS Education Scotland, Scottish Social Services Council, Health Education England, Northern Ireland Social Care Council, Skills for Care and Social Work England for example.



Health Education & Improvement Wales and Social Care Wales

January 2019


Appendix A

Health Education and Improvement Wales (HEIW)

Strategic Priorities - short to medium term

HEIW has inherited plans for 2018/19 from its predecessor organisations (Wales Deanery, Wales Centre for Professional Pharmacy Education and the Workforce and Education Development Service) and has also been given a remit letter from Welsh Government which has highlighted some additional priorities in year. 

Looking ahead, HEIW has established 7 Strategic Objectives to guide priorities and areas of focus during the first three years (2018-21) of its existence through various stakeholder events held over the last 12 months and by reviewing the work of similar organisations across the UK. These Strategic Objectives have been endorsed in our remit letter and are outlined below:

For 2019/20 HEIW has been asked by Welsh Government to develop an annual plan by the end of January, and are currently progressing this within the above framework and through discussion with other NHS bodies who are also in the process of developing their plans.

Clearly in the first full year of operating we need to balance the continued attention that is required to develop a new and fully integrated organisation, with our ambitions to deliver on the many opportunities that exist for us to support the workforce agenda in health and social care.   However, subject to agreement and resources, some of the key areas of focus for us in 2019/20 could include:

·         Delivering tangible support for NHS Wales service challenges – including urgent and emergency care, cancer and diagnostics, eye care, and development of the multi professional team in primary care. 

·         Working with Social Care Wales, developing the workforce strategy and aligned to that a clear leadership strategy for health and social care. 

·         Re procurement of health professional under graduate education in time for 2020/21 which will give us the opportunity to shape and influence the delivery of education and align it with A Healthier Wales.

·         Development of Specialist and Associate (SAS) grade doctors to provide more support and opportunities to this essential part of the workforce.

·         Coordinating international recruitment efforts particularly in the light of Brexit.

·         Pursuing options to increase GP training places in Wales.


Health Education and Improvement Wales

Appendix B – Social Care Wales

Context and related areas of work

SCW’s Strategic Plan 2017-22 states that developing the workforce is a priority for the organisation. The purpose of SCW is to build confidence in the workforce and to lead and support improvement in social care. We want Wales to have a sufficient, high-quality and skilled social care and early years workforce. Our focus is on attracting more of the right people into the social care, early years and childcare sectors by using evidence of good practice to set standards for the workforce.

SCW is working with HEIW, the Welsh Government and other key partners to develop a motivated, sustainable, robust and highly skilled workforce that is able to respond to the challenges of today and tomorrow, and complements work underway at local authority and regional levels. A key part of the national transformation programme is to build, support and sustain the health and social care workforce by improving well-being, capability, engagement, and leadership, and investing in the future skills we need within the workforce.

Looking ahead, strategic priorities for SCW include:

·         Ensuring the availability of high-quality training to equip and support the workforce so they have the right knowledge, skills, understanding and approach to provide good quality care and support in the social care and early years sectors.

·         Making sure the workforce is supported and provides social care in line with the law and their practice reflects the principles of the Social Services and Well-being (Wales) Act 2014: voice and control; prevention and early intervention; well-being; and co-production.

·         Taking a leadership role, alongside the Welsh Government, in supporting the development and implementation of the long-term workforce plan for childcare, play and early years is another key priority for us.

·         Supporting the progress of registering the domiciliary care workforce, the voluntary registration of care home workers from 2020, before it becomes mandatory in 2022 and rolling out the joint induction framework to all new workers in health and social care.

·         Following a review, ensuring the Social Care Wales Workforce Development Programme grant funding has a stronger focus on local and regional priorities as well as national priorities, and more outcome-focussed reporting.

·         Launching a major campaign in March 2019 aimed at attracting more people to work in social care and early years and childcare roles and build capacity and capability across the sector. This long-term national attraction, retention and recruitment campaign will aim to complement and enhance existing and planned regional recruitment campaigns.

·         In partnership with the Welsh Government and Qualifications Wales, we are introducing a new suite of childcare qualifications across levels 2-5 by September 2019. These new qualifications will play a key role in supporting the sector to train and upskill, providing clearer career pathways and transferability of skills and knowledge between the health, childcare and education sectors.

·         Working in partnership, including with Health and Care Research Wales to implement our Social care research and development strategy for Wales 2018-23. As the document states, central to the success of this strategy will be the development of a skilled research workforce, with expertise in all relevant academic disciplines. This focus area has seven objectives including the need to develop a skilled research workforce of national and international standing that can undertake high quality research.

·         Continuing to work with key partners and monitor closely developments of relevance to the social care sector in Wales arising from Brexit.


Social Care Wales