Workforce Planning: Reduction of Training Numbers Vicky Osgood Postgraduate Dean Wessex Deanery

Workforce Planning Tight central control v Market forces

NHS Plan 2000 By 2004 1000 more specialist registrars – key feeder grade for consultants 450 more GP trainees By 2005 40% rise in medical student numbers from 1997

CCT Supply and Demand Scenarios

GP Demand & Supply Scenarios

Change in Training Numbers EWTR Service pressures ‘Cost’ of GP increase

Expenditure Highest spending since 1982–83 Lowest tax burden since 1960–61 Highest borrowing since WWII £178bn borrowing this year Receipts

SPENDING REVIEW: NHS protected but must save £20bn No credible plan for £20bn NHS savings, warn MPs

“Over-supply of consultants” If NHS employed all new secondary care CCT holders over next 10 years, consultant numbers would increase from 35,000 to 61,000 CfWI 2010

Hospital service is dependent on the trainee pipeline Proportions of Medical Workforce NHS Census 2009 51,000 trainees 35000 Consultants 36000 GPs Trainee Pipeline GP and Consultant Workforce Hospital service is dependent on the trainee pipeline

Training numbers are not aligned with replacement consultant numbers

The “dual dilemma “– there are insufficient trainees to cover existing rotas, and there are too many trainees to fill existing consultant positions

Unless we increase the numbers of trained doctors delivering service We can’t reduce numbers of trainees without disrupting hospital service Unless we increase the numbers of trained doctors delivering service Or........ we reconfigure the way we deliver services

Rebalancing the Medical Workforce Trainee Pipeline We could remap the funding to expand the consultant workforce with the excess CCT holders

Rebalancing the Medical Workforce Available trust funding for trained doctor expansion The 15% reduction in trainee numbers to align with future workforce demand The 15% proportion of trust funded trainee posts

What shape of service? Trained doctor delivered service Generalists trained to higher level Majority of specialists still have generalist skills Blurring community / hospital distinction Multi-professional teams

Plan Reduction in overall ST1/CT1 entry points Rebalance specialty and GP Rebalance geographically Look at higher specialty training posts Too many surgical Still gaps in other specialties Demand and need may vary with different service models and financial situation

C O G P E D 9th National Multi-specialty Conference for Heads of Schools, Programme Directors, Directors of Medical Education 25 & 26th January 2011