nursing workforce summit what the medics are thinking and doing simon plint dean of medical...
Post on 19-Dec-2015
213 views
TRANSCRIPT
Nursing Workforce SummitWhat the Medics are thinking and doing
Simon PlintDean of Medical Education Commissioning
1. Images of the NHS
2. Economic Context
5. Principles for South Central
4. MPET Reduction
3. National Training Context
6. Illustration of Mismatch
6. Our Shared Challenge
The NHS
The NHS
The NHS
The NHS
The NHS
200
300
400
500
600
700
£bn
Expenditure
Receipts
£178bn borrowing this year
• Highest spending since 1982–83• Lowest tax burden since 1960–61• Highest borrowing since WWII
• Do we have a 'General McChrystal moment' on the way?
• Nicholson said the government plans raised big issues that were being 'hotly discussed and disputed'
• NHS chief executive Sir David Nicholson has launched a scathing attack on health secretary Andrew Lansley's proposals for handing over commissioning responsibility to GPs
• Sir David also turned his fire on the ability of GP commissioners, saying that if PBC groups were rated on the quality of their commissioning on a scale of one to 10, even the best were ‘only about a three’
Workforce Planning - Steering the Super Tanker
Gender Profile of Medical Undergraduates
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
Female
Male
South Central Facts and Figures
• 3400 Trainees• 2800 MADEL Salary Support• 600 Trust Funded• £122m MADEL Budget• Nearly 90% Salary Support• Only 2.7% Management Costs
National Context
• Overall reduction nationally in junior doctor training numbers
• From 7500 in 2007 down to 6500 in 2011• Balance between Hospital and GP
National Context
• Future numbers of commissions should be based on projected future service need
• Services should be planned around delivery by trained practitioners and move away from dependence on junior doctors
Temple ReportTime for Training
• High quality training can be delivered within the reduced number of hours available but fails if trainees: • have the major role in providing out of hours
service;
• are poorly supervised; or
• have limited access to learning.
Temple ReportTime for Training
• Hospitals remain too reliant on junior doctors to provide out-of-hours services
• Service needs to be redesigned so consultants work more flexibly and more "directly responsible" for patient care around the clock
MPET Reduction 14%
2009-10 2010-11 2011-12 2012-13 2013-140
50,000
100,000
150,000
200,000
250,000
300,000
350,000
MADELMADEL MADEL MADEL MADEL
NMETNMET NMET NMET NMET
LBRLBR LBR LBR LBRSGUSGU SGU SGU SGU
SIFTSIFT SIFT SIFT SIFT
ADMINADMIN ADMIN ADMIN ADMIN
Impact of MPET reduction
£000
MADEL Reduction 14%
• Management cost reduction of 30% across deaneries would only save 1%
• 14% reduction in MADEL investment equivalent to £17m
• 14% reduction in MADEL training activity equivalent to 390 doctors
Principles for South Central MPET Review
• MPET should be invested on the principle of supplying the local workforce
• Investment should be proportionate to future service need, with a duty of care to the tax payer and students to commission neither an oversupply nor undersupply of health professionals
• The long term outcome of the MPET reduction should be a sustainable steady state investment plan which will supply the future service need of South Central
Principles for South Central MPET Review
• Can we be smarter than simply reproducing the existing workforce, and anticipating and shaping the future workforce?
• At time of disinvestment, consideration should be given to prioritising retraining of the existing workforce rather than training new workforce
• Role substitution
Wessex Deanery
CCT Supply and Demand Scenarios
Wessex Deanery
GP Demand & Supply Scenarios
General Surgery - National Supply ForecastSource – 2009 WRT Supply Model
Number of trained specialists
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Projected headcount
Headcount - estimatedrequirement
Projected FTE
FTE - estimatedrequirement
CT1
CT2
ST7
ST3
ST4
ST5
ST6
RETIREMENTS
CT1
CT2
ST7
ST3
ST4
ST5
ST6
CT1
CT2
ST7
ST3
ST4
ST5
ST6
Surgery Training Structure in NHS SC
O&G - National Supply Forecast• Source – 2009 WRT Supply Model
Number of Trained Specialists
0
500
1000
1500
2000
2500
3000
3500
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025
Forecast Headcount
Estimated Requirement (H/C)
Forecast FTE
Estimated Requirement (FTE)
Current Employment Level
Our Shared Challenge
• Ensuring MPET envelope invested for future workforce supply
• Avoiding / deliberately destabilising service provision?
• What opportunities for service redesign and role substitution?