Tankersley Manor 11th May Solutions and Opportunities GP Workforce Event Tankersley Manor 11th May Solutions and Opportunities Mark Purvis @purmj Introduce self Work for Health Education England the arms length body in charge of the workforce taps Different to NHS England, the arms length body in charge of the plugs And we wonder why the workforce bath is not full!

Bottom Line Nationally substantive GP FTEs have fallen three and a half thousand since 2009………. …………whilst numbers of registered patients has increased three and a half million and this caseload is more morbid, consulting more frequently, for longer, with greater complexity Decision density of the GP day is unsustainable Opportunity for Candour! (In case we still need to grieve the position we are in) the bottom line is that primary care is under pressure Labour costs esp locum costs are high More stress and ill health with more statutory leave to cover Most practices have or expect vacancies Some are “vacating” stopping doing stuff or outsourcing HEE’s strap lines is: developing the right people with the right skills in the right place…to meet the needs of people Sadly there is evidence that we have developed the wrong people (doctors rather than the wider workforce), in the wrong place (hospitals and centres rather than community and periphery), with the wrong skills (specialist rather than adaptable flexible generalists with a focus on prevention and reablement) @NHS_HealthEdEng

Reminder what we are trying to achieve Triple aim Not going to achieve this without: Co-operative rather than competitive approaches, characterised by patient, political and workforce engagement. An important milestone/marker is raised staff morale – happier workforce A shift of focus from disease intervention to more prevention and re-ablement Strong primary care Strong social care.

The inverted toblerone, actually a Dalek The numerical challenge is NOT GPs it is the unregistered workforce

Maximising supply of GPs and Practice Nurses   Maximising supply of GPs and Practice Nurses Giving New Skills to Existing Staff Bringing NHS Healthcare Roles into General Practice    Developing new roles  Making it happen – the three enabling works Intelligent Decisions, Leadership Space, Training Infrastructure The five boxes – can talk to each, blurring the boundaries – between roles and between organisations. Maximising supply involves RECRUIT/RETAIN/RETURN strategies but we are fishing in an overfished pool for both GPs and practice nurses, so cannot be our ONLY workforce strategy PAs probably fit best in “developing new roles” but also band 1-4 health care support workers (beyond traditional HCA?) ACP can sit with giving existing staff extended capability to do the work better – but also is a way of getting transferable skills into primary care from other healthcare contexts

Enabling Work GP Data Tool as a way of identifying workforce gaps/risks, measuring change/improvement and engaging stakeholders Primary Care engagement – workforce groups mapped to STPs Training infrastructure/capacity: training practices, ATP networks, placement capacity for a broader workforce: nurse educator (sign off mentor) as the sentinel marker, multi-professional school @DeepEndGP_YH   Thank anyone who fills in the data tool Leadership and reconnecting system with itself Infrastructure @NHS_HealthEdEng

ATP spoke development Infrastructure

ATP undergraduate nurse placements in GP Latest data this week 478 UG nurse placement

Broadening the workforce Skill mix, new ways of working GPN Ready scheme Year two HCA apprenticeship scheme PAs in 1ry care ACP including physiotherapy Support for New Care Models What else do we need to do Expert patients Wellness advisors Health Coaches Care navigators Medical Assistants Medicines Optimisation Technicians @NHS_HealthEdEng

Distribution of HCA Apprenticeships Apprentices 2.7% of general practice workforce

Distribution of Advanced Clinical Practitioners

Early Career Stage Work Promoting GP/Primary Care Careers Widening participation GP conference for undergraduates Foundation tasters Use of social media #WhyGP #GPTrainYH Upstream work @NHS_HealthEdEng

Later Career Stage Work Promoting GP/Primary Care Careers Promoting GP leadership, academic, teaching and special interest roles, learning beyond registration, nurse/AHP educator roles Action Learning Set for Practice Manager Change Agents: activation of community assets and partnership with patients Downstream Patient/community activation @NHS_HealthEdEng

You’ve been great and I want to share a video of what is possible with activation of community assets I choose an organisation that I work with called IMAS inclusion mixed ability sports Anthony has consented to this video being shared When I first met Anthony at mixed ability sports taster day he had some movement in his left hand. Anthony has been a regular attender at the “unorthobox” coaching sessions, where he undertakes the same training routines as the other boxers. This video was taken two weeks ago this Thursday I wanted to share the improvement in function NO HEALTH SERVICE INTERVENTION TO THIS REABLEMENT We have lots of “Anthonys” – they are “reablement champions by experience” We have lots of community health assets that are under used