1. CfWI produces quality intelligence to inform better workforce planning, that improves people’s lives Showcasing the latest in workforce modelling

2. Agenda 1.Introduction Dr Graham Willis, Analysis & Modelling Lead, CfWI 2.Workforce modelling tool Sarah Copley, Head of Workforce Transformation, NHS West Midlands 3.Whole systems modelling Trish Knight, Deputy Director of Workforce Development, East Midlands SHA 4.Issues and challenges for the future Dr Simon Peck, Deputy Director, Workforce Directorate, DH

3. Sarah Copley, NHS West Midlands Workforce Modelling Tool

4. Strategic Context Numerous challenges in the system with significant implications for workforce acknowledging: Organisations have very different capabilities to model the impacts of these changes There is significant need for clinical input to identify the future workforce needed to deliver services There is little consistency of approach in identifying workforce needs across the different sectors making it extremely difficult to develop an aggregate strategic view E.g. many of the changes in dementia services impact the same staff groups, and acknowledges that dementia is everyone’s business There are numerous workforce scenarios possible when delivering services, and the tool will help you consider these across the entire workforce

5. Development History A framework for modelling in which will: Support the building of capacity and capability in planning the workforce and ensuring clinical decision making Link workforce, finance and activity planning Developed with and for Trusts/ PCTs Recognise the needs for scenario development Sticking Points Information Governance IT access to new platform

6. Example Scenarios Pathway changes: what happens if we restructure / change the activities that we undertake along a particular pathway? Service reconfiguration: what happens if we shift demand between existing services or introduce new services? Workforce reconfiguration: what happens if we change skill mix, competencies and make up of our workforce? Introduction of new roles: how will these impact the demand for other staff groups and what competencies should they possess? Ultimately, this is a decision support not a decision making tool

7. Tool Overview – Functional Schematic Adjust demand baseline Model whole of workforce capacity Direct FTE Input Lens Metric Lens Pathway Lens Activity Lens Upload workforce data Input final demand Configure scenario Submit workforce return Gather info to inform modelling Model workforce segment capacity Analyse modelling Community Demand Side Capacity Side

8. Workforce Capacity Modelling The capacity (future available workforce) is modelled as follows: 1.The size of the current workforce, taken from the Electronic Staff Record, is used as a baseline 2.The user is able to scale the future workforce (either by a percentage or FTE) based on their estimates for: Expected recruitment rates Promotions in/out Transfers in/out Retirements Attrition 3.Adjustments can be applied to the whole workforce, or to specific areas of the workforce. eg by area of work, pay band, directorate, ward etc. Current workforce (ESR) Inflows e.g. Recruitment, promotions Outflows e.g. retirements, transfers out Future workforce capacity

9. Direct and Pathway Modelling Lens There are four methods of modelling future workforce demand 1.Direct adjustments a.Direct entry of expected staffing level b.Percentage scaling, using the existing workforce as a baseline c.Increase/decrease staffing by a specified FTE each year 2.High level pathway based modelling Areas of the workforce are assigned to high level care pathways, eg Care Pathways based upon % time spent on each pathway The modeller is able to enter how activity levels are expected to change for each pathway and the workforce is scaled accordingly 80 % Mental Health 20 % Dementia Mental HealthDementia dementia caseload projected to double 100 FTE 120 FTE Example: Psychiatric Nurses who work on Mental Health & Dementia pathways

10. Metric Based Modelling Lens Third party data, eg population projections, estimated number of beds can be entered into the tool Selected areas of the workforce are then scaled to achieve a desired ratio for safe and effective care. Examples of metrics: GP: population ratios The model is also able to calculate derived demand, eg calculating number of blood tests required based on each ward’s projected activity to predict workforce requirements for a new phlebotomy service

11. Activity Based Modelling Lens Uses detailed clinical pathways such as Map of Medicine for modelling the workforce, eg individual activities for history taking, investigations, treatment etc (a) Pathway to Workforce mapping Each stage of the patient journey is associated with specific areas of the workforce, and the amount of time they spent delivering care After entering expected activity levels for future years, the workforce is scaled accordingly Allows modelling of transition of delivery of care from one staff group to another, as well as workforce impacts of productivity gain (b) Competence Based Modelling Skills for Health competences (National Occupational Standards) are linked to activities on a care pathway and then modelled against competences possessed by the workforce Allows modelling of scenarios involving changes to skills mix, use of new roles, impact of changes to clinical activity

12. Homepage

13. Manage Data Uploads

14. Model Homepage

15. Wider Functions Planning wizards Data uploads from ESR or other data sources Organisation wide capacity modelling over time by: –Staff group –Area of work –Agenda for Change band Demand modelling –Pathway –Staff group –Activity –Metric Aggregating workforce demand Community facility

16. Reporting Outcomes

17. So what next? Wider Launch in January 2011 Intellectual Property of NHS Develop method for roll out with SHAs Agree process for training and maintenance Manage non-NHS commercial aspects Licensing agreements

18. Trish Knight, East Midlands SHA Whole Systems Modelling

19. ‘Quality patient care is dependent upon robust service planning underpinned by effective workforce development planning which informs educational and modernisation investment’

20. Next Stage Review: challenge to workforce An approach to informing strategic workforce decisions using systems modelling Becomes Policy levers or changes: Increasing the percentage of people whose last days are in the community rather than in hospital; Avoiding significant numbers of hospital admissions and providing care through integrated and co- ordinated specialist teams in the community; The impact of providing support at the early stages of diagnosis and enhancing self care such that the period before complex care management is needed is extended. Apply Using Engagement Modelling the system The Functional Health Map Grid Workforce shifts – the challenge Informing LONG TERM CONDITIONS

21. Capacity change ‘City’ PCTCounty PCT InitialFutureInitialFutureChange Generic9884261225-14% Enhanced5047133125-6% Specialist13 35 Level Total161144429384 Overall care and support needs reduce as a result of policy impact, more than cancelling out demographic changes, although with the greatest change at lower levels of skill requirements

22. Skill mix - hospital 2008 to 2018 Slightly less reliance on generic skills, with corresponding shift toward enhanced and specialist skills.

23. Skill mix - community 2008 to 2018 Similar shift to that in hospital toward higher skills mix but at a larger scale.

24. Skill mix - shifts Generic skills requirements would reduce in both hospital (by 22%) and in the community (by 14%) due to the greater emphasis on early intervention, but would reduce to a greater extent in a hospital setting due to fewer admissions for either primary or secondary diagnosis of a LTnC; Enhanced skill levels would remain constant in the community as early intervention and the shift from hospital to community appear to balance each other out, although in the hospital there is a reduced need for this level of skills by approximately 16%; Specialist skill levels would increase in the community whilst reducing in a hospital setting by almost exactly the same amount – in a city configuration this would equate to just under 1wte member of staff moving from hospital to community whilst for a County configuration this would rise to almost 2wte.

25. Trish.knight@nhs.net

26. Simon Peck, Workforce Directorate, DH Issues and challenges for the future

27. Issues and challenges for the future Questions on the models Workforce issues and challenges Gaps and omissions Ideas for the future – what do you need? To continue the debate please join the Workforce Analysis & Modelling Community www.cfwi.org.uk/forums

28. Workforce analysis & modelling community of interest www.cfwi.org.uk/forums