Workforce planning in healthcare: Ireland Jasmina Behan Skills and Labour Market Research Unit, Training and Employment Authority (FÁS) and Expert Group on Future Skills Needs April 2010

Outline Institutional context Scope Methodology An example Recommendation

Institutional context Expert Group on Future Skills Needs EGFSN Skills and Labour Market Research Unit, FÁS National Skills Database Ministry for Health and Children Health Service Executive A quantitative tool for workforce planning in healthcare: example simulations (2009)

Task To develop quantitative tool To assess balance between demand and supply under various scenarios

Scope General practitioner Medical consultant Medicine Pathology Surgery Obstetrics/gynecology Paediatrics Emergency medicine Anaesthesia Psychiatry Radiology Public health medicine Nurse Therapists Speech and language therapist Radiation therapist Physiotherapist Health care assistant Home help Clinical psychologist Social care worker Medical physicist

Output Outline of the situation in 2008 (demand and supply) Illustration 1: what happens if population grows, sourcing is limited to domestic supply and healthcare model remains unchanged Illustration 2: what happens if selected parameters underpinning the model change

Forecasting method Expansion demand ( ) –Baseline: headcount/population ratio constant (CSO pop projections) –Scenarios: Existing policy targets Target population (e.g. children, 65+ etc.) Segment of service (e.g. public only) Replacement demand (control for age, gender, nationality, part time work) Supply –Medical practitioners: cohort analysis –Graduate output (control for attrition, first destination, gender and part time work) –Alternative pools (maternity leave, Irish students abroad, non-Irish)

An example: General practitioners VariableValue Employment2,500 Current density (per 100,000 pop)58 Share of females37% Annual increase in female share (points) 0.02 Share of non-Irish5% Share of part-timers in male stock4% Share of part-timers in female stock20% Head count to WTE ratio0.5 Estimated annual retirement55-85 Estimated annual early retirement11-13 Employment 65+ (annual estimate) Share of female retirees12% Attrition due to illness, emigration etc. 0.5% (15)

Assumptions VariableValue Share of females on maternity3% (40) Share returning from maternity90% Share of returnees working part time75% Graduate intake120 Cumulative attrition rate (training)3% Share female graduates78% FD: employment in Ireland96% FD: employment part-time5% Actual from training109 Annual immigration0

Baseline projections

Baseline vs. scenario

Recommendations Address data gap Adopt an integrated approach in setting level and type of service provision Approach workforce planning as an ongoing process