Vision Proposal

Other national models I asked colleagues in the other nations how they worked: Northern Ireland – no response as yet Wales – total number of trainees (secondary care) = 2,500 Specialty teams work on a national basis, but also a hybrid functional model HEE (Midlands and East) – total number of trainees = 14,000 Functional model – admin teams split into recruitment, assessments and programmes 1 band 4 x 700 trainees (assessments) 1 band 4 x 1000 trainees (programmes) Useful information but not hugely helpful at this stage!!

Our model – how much programme administrator time do we have in each office? Figures below based on: Count of all band 4 hours, plus half of all team lead (band 5) hours – this would enable team leads to devote half of their time to team lead role and development activities. Band 3 staff and time considered separately – their roles currently vary significantly across regions, we want to ensure that their roles are looked at carefully going forwards and with recognition of what they currently do. Office Programme administrator time (WTE) Dundee 4.5 Aberdeen/Inverness 6 Edinburgh 7.95 Glasgow 9.9 TOTAL 28.35

Our model – what is an equitable number of trainees per 1 WTE administrator? (based on numbers only) 1 WTE administrator x 230 trainees This is based on: Total number of trainees (including dental*) = 6439 Total amount of programme administrator time (WTE) = 28.35 6439 / 28.35 = 227.12 Rounded up to 230 for neatness! *we’ve been asked to include dental numbers, on the basis that TM responsibility for dental trainees will move into our team. Dental is a slight unknown quantity at the moment – extensive handover will be required. It is not known yet whether any staff time/resource will move from dental into medical.

Using this calculation, how much programme administrator time is required for each specialty group? Number of trainees WTE admin time An, EM & ICM 629 2.7 Diagnostics 275 1.2 Foundation 1711 7.4 GP, OM, PH & BBT 1221 5.3 Medicine 884 3.8 Mental Health 311 1.4 O&G and Paediatrics 464 2 Surgery 634 2.8 Dental 310 Total 6439 28

We can’t make allocations based on numbers alone – this table considers programme specifics, differences + ‘extras’: Specialty group Recruitment numbers – VM input Academic Posts (Uni) Portfolio(s) OOPs LTFT Mat Leaves Other An, EM & ICM YES FEW 3 SOME Duals, sub-specialties Diagnostics 3-4 Foundation NO NONE 1 (plus no double-keying) Teaching, POFR, ALS, Induction, Shadowing GP, OM, PH & BBT 4 MANY Teaching, Conferences, intro of BBT Medicine 1 Teaching, Duals, PYAs, intro of IMT, sub-specialties Mental Health O&G and Paediatrics 2 Sub-specialties Surgery Teaching, intro of IST, sub-specialties Dental Educational programmes, national events/conferences, study days [few/some/many = low/medium/high]

Based on specifics, differences and extras, suggest some adjustments to allocations of programme administrator time to specialty groups: Foundation: based on trainee numbers calculation, admin time required is 7.4 WTE – this would be more TM staff than are currently involved. Considering current admin time, band 3 support, Foundation School support, support of board administrators; estimate this could be reduced to 5 WTE. GP, Medicine and O&G/Paeds have the highest numbers of extras (e.g. OOP, LTFT, mat leave etc). Suggest the 2.4 WTE taken from foundation is allocated to these specialty groups: GP (1), Medicine (1), O&G/P (0.4). I have not taken into account numbers of portfolio within specialty groups, on the basis that not all admins would need to be able to use every portfolio, this would however be more of a challenge for Team Leads/TM Managers depending on the specialty split.

So, with these adjustments… how much programme administrator time is required for each specialty group? Specialty group Number of trainees WTE admin time An, EM & ICM 629 2.7 Diagnostics 275 1.2 Foundation 1711 5 GP, OM, PH & BBT 1221 6.3 Medicine 884 4.8 Mental Health 311 1.4 O&G and Paediatrics 464 2.4 Surgery 634 2.8 Dental 310 Total 6439 28

Allocation of specialty groups based on admin time There are many possible options based on the numbers…. The following principles were adopted to inform allocations: From the point of view of logistics for our TM staff in relation to numbers of trainees, it would be preferable for Foundation and GP to be managed from either Edinburgh or Glasgow offices. GP, Medicine and O&G/Paeds have the highest numbers of ‘extras’, e.g. OOP/LTFT; in order to spread the workload, these specialty groups should be looked after by different offices. To ease the transition and workload it would be preferable to minimise the number of specialty groups allocated to each region, i.e. no more than three.

Recommended allocation models: Specialty group Number of trainees WTE admin time Option A Option B Option C An, EM & ICM 629 2.7 GLASGOW ABERDEEN/INVERNESS Diagnostics 275 1.2 Foundation 1711 5 EDINBURGH DUNDEE GP, OM, PH & BBT 1221 6.3 Medicine 884 4.8 Mental Health 311 1.4 O&G and Paediatrics 464 2.4 Surgery 634 2.8 Dental 310

Summary These show three possible options based on the principles agreed. The allocations represent a more equitable distribution of trainee numbers across the admin teams. Please consider these options: do you agree with the assumptions made and principles adopted in making this proposal? (slides 6, 7 and 9) are there any considerations which we have missed or got wrong? are there any factual inaccuracies? However, based on the numbers there are many other options (see next slide) which can be tabled if required. However these are based on numbers only and do not factor in our assumptions/principles.

Other options that meet some/most criteria Specialty group Number of trainees WTE admin time A B C D An, EM & ICM 629 2.7 Glasgow Aber/Inver Dundee Diagnostics 275 1.2 Edinburgh Foundation 1711 5 GP, OM, PH & BBT 1221 6.3 Medicine 884 4.8 Mental Health 311 1.4 O&G and Paediatrics 464 2.4 Surgery 634 2.8 Dental 310