The Calderdale Framework: A Facilitation Tool for the Development of a Flexible and Competent Workforce

What is the Calderdale Framework?

The Calderdale Framework (CF) provides a clear and systematic method of reviewing skill mix and roles within a service. This process should be carried out in conjunction with the Skills for Health (SfH) Competences3 (www.skillsforhealth.org.uk). It is wholly transferable to any setting and can enable delegation to support staff or blurred boundary working to be implemented. CF was developed within the Clinical Therapy and Rehabilitation Directorate of Calderdale and Huddersfield Foundation Trust. The framework is a further development of early uni-professional work in delegation carried out by Liz Saunders4,5. The process of applying CF leads to the development of a detailed competency document, based on tasks which are needed to deliver patient focused services. This provides the basis for the training of staff, giving them a clear record of competence , ensuring they are fit for purpose in their role.

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Current Context

The UK is facing a skills shortage in the next 20 years as a result of the increasingly ageing population, technological change and migration1. There is a correlation between skills, productivity and employment which leaves the UK at risk of being unable to compete globally if its skills base is not improved. The Leitch report (2006)1 identified the need for employers to provide accessible vocational training opportunities for their local workforce, in order to ensure a skilled and flexible workforce. The NHS is a major employer and requires staff with a range of skills, some requiring higher education, but many of which can be trained 'on the job' and acting as a stepping stone to further career development. The shortage of staff with appropriate skills will necessitate redesigning services and roles to meet public demand plus the expectation of the UK health system. Hence training needs to provide transferable skills for the current workforce (not just younger people). The Darzi2 review sets out the vision for the NHS over the next decade. The drive is to embrace and lead change in order to deliver fair, personalised, effective and safe NHS services. A competent and engaged workforce, which is locally accountable is at heart of this.

References throughout CF to SfH Competences will be written in bold.

References to local competences will be in italics.

Please note: implementation of the CF in your service area will enable you to utilise the SfH Competences along with the ability to generate your own service specific local competences. This will underpin the elements of 'interventions' within the SfH Competences.

The local competences identified using CF link to and underpin SfH Competences and provide evidence against KSF outlines.
The use of CF focuses on service review and redesign from the 'bottom up'. This facilitates a culture shift, which is important where service and skill mix is being changed.

Term	Basic Meaning
SfH Competences(source SfH 2006/2007)	They describe what individuals need to know and do regardless of whom is performing the activity. Describe the performance criteria, knowledge and understanding required to carry out a work activity effectively. Some of these are National Occupational Standards, meaning they have been additionally approved for use in qualifications (SfH review 2006/2007)
Local competences (source: adapted from CSP* 2005)6	Abilities to undertake specific tasks that relate to specific ability (competency). 'Provide concrete standards against which you can assess your abilities and skills' (CSP 2005)

Seven Stages to Successful Implementation of CF in Your Organisation

1. Awareness Raising - to engage all involved staff at the outset

2. Service Analysis - this step is critical to establish potential changes that can be made. It is an objective process. Links to SfH are made at this stage

3. Task Analysis - consensus around altered practice is gained using decision making tables. Cost benefit considerations are integral to this stage

4. Competency Identification/ generation of local competences - accepted tasks are searched for on SfH website or written as local competences

5. Supporting Systems - communication networks are developed and understood. This is key to managing delegation risks and assuring quality

6. Training - qualified staff learn to delegate effectively whilst support staff are competency trained

7. Sustainability - becomes part of organisational induction and mandatory training.