We need to talk about BOB

The Buckinghamshire, Oxfordshire and Berkshire West STP

 Patricia Marquis 4 Oct 2017 South East

BOB – sounds friendly enough, but this is a huge STP covering Buckinghamshire, Oxfordshire and Berkshire West.

BOB was one of the “hidden” STPs, leaked by Reading Borough Council in November last year, such were their concerns.

At the time, we spoke to the press and said: “The densely packed 112 page document says nothing to explain how they intend to achieve the plans aspirations they outline – it is this lack of clarity and transparency that concerns the RCN. One of the most concerning areas of the plan is regarding the workforce. The draft plans sketch out how the skills mix of staff will be adapted to create a more flexible workforce by 'use of generic support workers (across health and social care), reduction of nursing grade input, increased use of healthcare assistants'."

Generic support workers?? We all know the arguments for a skilled registered nursing workforce as was highlighted in our Safe Staffing report.

Since then we have been seeking assurances from BOB leaders as to how they will progress and in doing so are reassured that the clumsy description of the workforce changes described above were not quite as drastic as we first believed. However, we keep an eye on them!

The main problem with BOB is the sheer physical size of the area they want to cover. The three counties are very different and within each are hundreds of healthcare providers.

I recently went to a workshop organised by BOB LWAB (Learning Workforce Action Board). The purpose of the workshop was to start to build on work to develop a coherent STP workforce strategy. After presentations from the three localities, the facilitators sought to introduce the modelling framework to enable a strategy to be pulled together.  Whilst there are clear consistent themes: poor supply, retention and shift to out of hospital, each locality is in a very different place but all lacked expertise around workforce planning.  Further webinars are planned to support development of local plans using a consistent framework tool. 

The workshop really highlighted the challenge faced by this STP who are clearly struggling to come together and articulate a coherent workforce plan for the STP. It has been increasingly clear to everyone that the STP is actually really three STPs and this is now made even more clear as two of the localities, Buckinghamshire and Berkshire West, are seeking to become some of the first Accountable care systems (ACSs) in England. Exactly what this means is yet to be seen, but essentially it’s about them having a budget that they manage to deliver health and social care services in their geographical patch.  We are seeking further detail on how they believe this will work.

It has taken a year to get this far. It has very recently been agreed that the way the STP Local workforce action board (LWAB) needs to function should be localised so they will be setting up Locality workforce implementation boards within each locality and there is an agreement that staff side involvement will be crucial in how these develop. This is good news for us as it means we have a guaranteed place at the table in order to make our position clear.

Patricia Marquis

Patricia Marquis

RCN England Director

Patricia is a registered nurse and lifelong campaigner. She has worked at the RCN for over 20 years.

Page last updated - 05/09/2018