The use of system dynamics in a strategic review of the English dental workforce32nd International Conference of the System Dynamics Society

The CfWI produces quality intelligence to inform better workforce planning that improves people’s lives

Dr Graham Willis – CfWI Head of Research and DevelopmentDr Siôn Cave - Decision Analysis Services LtdHannah Darvill – CfWI Head of health (medical)Daniele Gioe’ – CfWI Principal Data ModellerParu Patel – CfWI Senior Analyst

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

Introductions

• The national authority on workforce planning, providing advice and information to the NHS and social care system.

• Independent business unit within Mouchel, wholly funded by the Department of Health

• Workforce planning is ensuring “The right people, with the right skills, in the right places, at the right time”

• Decision Analysis Services Ltd (DAS) is a strategy consultancy based in Basingstoke and Bristol, UK

• We are experts in the application of systems modelling and simulation methods in the analysis of policy and strategy

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

The scale of the health and social care workforce

Planned expenditure for 2013/14 is £110bn55% to 75% is spent on the workforce

The English National Health Service employs:1.4 million people140,000 Doctors, 370,000 Nurses

Similar numbers for social care sector:

1.6 million people employed22,000 employers6.4 million unpaid carers

Robust workforce planning (RWP)

Focal question

Understand the system Stories about the future Qualitative and

quantitative System mapping

Explore the future Stakeholder workshops Checked for consistency Expert elicitation of

uncertain quantities Probability distributions

Simulate the possibilities Supply complicated Demand complex Sensitivity and uncertainty analysis

Make robust decisions Test policies against scenarios Decision-makers don’t

like uncertainty!

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

Project purpose

CfWI were commissioned to undertake a review to inform the 2014 dental student intake.

The objectives of the dental student intake review was to:

• support the provision of training for the right blend of dental workforce to meet the needs of the population

• inform investment decisions on dental student intake

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

The dental workforce

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Hea

dco

un

t

Workforce, Headcount

NHS Dentists Total GDC registered dentists

0

50

100

150

200

250

300

350

400

450

500

20 25 30 35 40 45 50 55 60 65 70 75 80

Workforce age profile

Men Women

Hea

dco

un

t

Training to become a dentist

850

860

870

880

890

900

910

920

930

940

2007 2008 2009 2010 2011

Un

der

gra

du

ates

ad

mit

ted

Year

Student intake

0

500

1,000

1,500

2,000

2,500

3,000

Un

der

gra

du

ate

stu

den

ts F

TE

Number of undergraduates

Women Men

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

SD Modelling in relationship to the RWP

Horizon scanning

Scenario generation

Workforce modelling

Policy analysis

Our rigorous approach to SD modelling

Workforce Modelling

Horizon Scanning Scenario Generation Policy Analysis

Model scoping

Model construction

Model documentation

Model testing

Our rigorous approach to SD modelling

Workforce Modelling

Horizon Scanning Scenario Generation Policy Analysis

Model scoping

Model construction

Model documentation

Model testing

Model Requirement• Calculate supply and demand for the

dental workforces to 2040• Segment the workforce by age and

gender• Represent the training pipeline from

entering university through to delivering service as fully qualified dentists

• Represent the complex career paths for doctors and dentist following qualification

• Execute rapidly and produce outputs that can be readily analysed

• Be fully tested and documented, with an audit trail for all assumptions

Data Availability

Scenario / Policy Questions

Specification

Model scoping

Stakeholders• Health Education England• Department of Health• Schools of clinical dentistry• UCAS• NHS• British Dental Association• Dental project reference group• National road shows….

Model construction

Dental schoolDental

foundation training 1

Staff grade

Dental core training 1

(includes OMFS)

Specialty training - specialist

General dental practitioners,

salaried dentists and DwSI

Additional training

Consultant practice

Specialist practice

Clinical academic training

Dental core training 2

2011 stock =4,5582010 intake =1,013

2012 = 893 2009 = 555

2012 = 22,920

2011 = 142 2012 = 523 2010 = 43

2012 = 36 2012 = 2706* 2012 = 787

2010 = 20

Model construction

segmented by age and gender can include country of

origin/qualification, skill and competences

includes attrition, delays, exits and returns, migration

Include full/part-time working

Testing included: 1. Independent CfWI testing 2. Comparison with other models3. Review of the results with relevant stakeholders 4. Sensitivity analysis

Testing

Contents

1. Introduction2. Robust workforce planning3. Purpose of the strategic review of the English dental workforce4. The English dental workforce5. The System Dynamics model6. Impact of the study

Impact

The projections produced with the Dental Workforce Model indicated that there was a significant risk of a future oversupply of dentists for England

Ministers have agreed to a recommendation from the Chief Dental Officer to change dental school intake. This change will be implemented in the 2014 intake.

CfWI has been commissioned to undertake a stocktake of Dental Care Professionals (DCP).

More information….

www.cfwi.org.uk/publications/a-strategic-review-of-the-future-pharmacist-workforce

www.cfwi.org.uk/publications/a-strategic-review-of-the-future-dentistry-workforce-informing-dental-student-intakes

www.cfwi.org.uk/publications/gp-in-depth-review-preliminary-findings

www.cfwi.org.uk/publications/a-strategic-review-of-the-future-healthcare-workforce-informing-medical-and-dental-student-intakes-1

Workforce studies

www.cfwi.org.uk/publications/developing-robust-system-dynamics-based-workforce-models-a-best-practice-guide

www.cfwi.org.uk/publications/robust-workforce-planning-medical-model-technical-description

www.cfwi.org.uk/publications/horizon-scanning-analysis-of-forces-and-factors

www.cfwi.org.uk/publications/robust-workforce-planning-an-introduction

Method based

The use of system dynamics in a strategic review of the English dental workforce32nd International Conference of the System Dynamics Society

The CfWI produces quality intelligence to inform better workforce planning that improves people’s lives

Dr Graham Willis – CfWI Head of Research and DevelopmentDr Siôn Cave - Decision Analysis Services LtdHannah Darvill – CfWI Head of health (medical)Daniele Gioe’ – CfWI Principal Data ModellerParu Patel – CfWI Senior Analyst