1. QAH HospitalPortsmouth Hospitals NHS Trust Workforce Planning for Non-Nursing Roles Presentation to Council of Governors Barry Hodgson – Head of Education, Training and Development for Health Care Scientists and AHPs Abi Williams – Head of Workforce Planning and Intelligence

2. QAH HospitalPortsmouth Hospitals NHS Trust Introduction  Each year the Trust undertake a Business Planning process which integrates Activity Planning, Financial Planning, the Quality Agenda and Workforce Planning working with each CSC and Corporate Function.  As part of this process the long term view of workforce requirements is considered.  Nursing staff have a comprehensive process which explores the number of beds, acuity of patients and case mix and determines a required nurse to bed ratio.  Most other staff groups don’t have the same defined staffing levels, however reviewing the workforce requirement is equally as important. Page 211/21/2016

3. QAH HospitalPortsmouth Hospitals NHS TrustPage 311/21/2016Page 3 Six Step Workforce Planning Process Methodology widely used has been developed by Skills for Health and our planning process incorporates these steps Clinical Strategy Business Plan Workforce Plan Workforce plan should be integral part of Clinical Strategy and Business Plan

4. QAH HospitalPortsmouth Hospitals NHS TrustPage 411/21/2016Page 4 Determining problem areas 1)In 2013/14 we surveyed all managers to identify shortage areas and any areas where recruitment was problematic 2)Business planning process Interview with each clinical service to determine future supply and demand, and any associated actions required 3)Benchmarking template Imaging and pathology as pilot Roll out to other staff groups 4)Existing work streams/intelligence

5. QAH HospitalPortsmouth Hospitals NHS TrustPage 511/21/2016Page 5 Therapeutic Radiographers Regional Supply of FTEs has increased at a stable rate since 2009 If current workforce and commission trends continue, supply will meet demand in late 2016 to early 2017 Supply will exceed demand in years thereafter Local Increasing numbers is dependent upon placement capacity, though PHT have reviewed this and taken action. Retention issue in this staff group as more favourable conditions in other sectors, staff engagement key in allied health professionals.

6. QAH HospitalPortsmouth Hospitals NHS TrustPage 611/21/2016Page 6 Diagnostic Radiographers Regional A current gap between supply and demand exists If recruitment trends continue, supply will increase and match demand by 2018 Supply will exceed demand in years thereafter, and has potential for oversupply Local Recruitment difficulties exist in the scanning specialisms, at Band 6 and above. Work on qualification requirements for this level to take place in conjunction with University of Portsmouth or other suitable HEI.

7. QAH HospitalPortsmouth Hospitals NHS TrustPage 711/21/2016Page 7 Sonographers Regional Lack of workforce capacity to provide placement supervision Ongoing investment in sonography training regionally since 2010/11 to increase the trained supply pool through salary support Local 2x salary support posts per year to train our own sonographers 2 have completed, and a further 4 in the pipeline Proposal to expand the Radiography Department Assistant role. Expanding Sonographer role to free up radiologist time (hard to attract and retain) and attraction /improved framework for sonographers Risk of reduced salary support from HEE which will impact on programme and local actions being considered.

8. QAH HospitalPortsmouth Hospitals NHS TrustPage 811/21/2016Page 8 Pharmacists Regional Sustained and substantial increase in supply, especially in 2013-14 Recruitment trends indicate increased demand year on year for the past 4 years Oversupply nationally of Pharmacists which will be ongoing Local Higher level of turnover in this group as lose staff to retail/industry. Larger number of M Pharm graduates locally, so potential to explore supply to other roles, eg Physicians Associates. Course changing to include more placements. Salary support for pre reg pharmacists, and acceptance of high turnover. At PHT Pharmacy have put an additional post into the Emergency Department to explore potential to develop the role into Advanced Clinical Practitioner.

9. QAH HospitalPortsmouth Hospitals NHS Trust Pharmacy Technicians Regional Salary support for 4x per year Pharmacy Assistants retention issue, due to more favourable T&C’s in retail sector. Local Pharmacy Assistant apprenticeships introduced, though BTEC delivered by our own centre. Improved knowledge and understanding Paid as apprentice, and though turnover exists, they are likely to return later as trainee pharmacy technicians. Potential to earn some income from neighbouring trusts. Page 911/21/2016

10. QAH HospitalPortsmouth Hospitals NHS TrustPage 1011/21/2016Page 10 Healthcare Scientists Regional Health Education Wessex supported 2 Higher Specialist Scientific Training posts in 2014 Demand is historically stable Increasing future demand, especially in physics and engineering (17%+ 2014- 2019) and physiological sciences (10%+ 2014-2019) Education commissioning team working with two education providers to support placement capacity Local 20 Trainee Scientists across range of disciplines, the first cohort of which has just finished and all have been employed by PHT. Developing the higher specialist scientific trainees – consultant scientists Histopathology and advanced practitioners in dissection Investigating interface with Medical/ Scientist to explore advanced roles.

11. QAH HospitalPortsmouth Hospitals NHS Trust Pathology - Scientific/Technical workforce  The largest non medical, non nursing workforce – workforce/skill mix changes in 2010, currently being further reviewed and adjusted.  Approximately 300 staff  Clinical Scientists – from band 7 up to Consultant Scientist (Scientist Training Programme, Consultant Training Programme)  Biomedical Scientists (undergraduate placements, trainees) –Increasing number of band 5 and reducing number of band 6/7  Associate Practitioners (AP) – 25, increasing number (Foundation Degree – developed locally)  Senior Medical Laboratory Assistants – supervise sample processing and other support functions (Team leading NVQ)  Medical Laboratory Assistants (MLA) – (Apprentices and NVQ/QCF through our own centre  Progression route from Apprentice – MLA – Associate Practitioner.  Current gap is progression from AP – BMS Page 1111/21/2016

12. QAH HospitalPortsmouth Hospitals NHS Trust Midwives Regional 2009 onwards has seen supply fluctuate with large spikes and increases, especially a 5.5% growth between 2012-2013 Demand exceeded supply in 2014, and supply will exceed demand in 2015, increasing further year on year Demand is solely dependent on Wessex’s birth rate Potential for oversupply, sooner rather than later Local Fluctuations in staffing levels based on university outputs, however birth rate increases and co-morbidities of local population (higher than average high risk births) mean increased requirement for midwives. Page 1211/21/2016

13. QAH HospitalPortsmouth Hospitals NHS Trust Physicians Assistants/Associates Page 1311/21/2016 National Role of Physicians Associate developed across country (200) involves assessment and diagnostic processes. Acting at Registrar level. Role of Clinicians Assistant is less developed nationally, and variable in nature. Local Developing the Education and Career Framework from Apprentice to Practitioner level. Utilising Ex-Military Combat Medical Technicians, with highly developed clinical skills. Recruiting apprentice medical technicians to undertake range of duties, but concentrating primarily on phlebotomy. Recruiting Trainee Medical Technicians with NVQ Level 3 experience to be trained as Medical Technician and undertake Foundation Degree at Solent University, supported by Health Education England funding.

14. QAH HospitalPortsmouth Hospitals NHS Trust Assistant/Associate Practitioners Page 1411/21/2016 These are staff at band 4 level who support clinical staff in a semi-autonomous way, to delivery clinical care. In Portsmouth we are developing the role in a variety of areas. Regional Wessex LETB developed specific modules at academic levels 4 and 5 to map against the assistant/associate practitioner skill and function framework Education commissioning approach designed around needs of trust, to support development – promotes growth of this new role and the continuous development of band 4 staff Local Introduced into theatres and pathology, respiratory, cardiology, Clinician’s Assistants Investigating foundation degrees for non-hearing aid dispensers – audiology technicians A small number in the therapy/ Nursing workforce

15. QAH HospitalPortsmouth Hospitals NHS Trust Apprenticeships Page 1511/21/2016 Regional HEE Mandate to double the number of apprenticeships Clinical and non-clinical apprenticeships available in a number of areas e.g. pathology, HCSW’s, Pharmacy and Admin etc. Health Education Wessex promotes Young Apprenticeships, and demand is forecasted to increase in 2014/15 (2013: 68 16-18 year olds enrolled) Higher apprenticeships are available and specific pathways such as End of Life Care and Child Health can be undertaken Local Locally the appenticeship programme has been very successful, and we have reached out annual target of 90 within the first half of the year, with low levels of attrition and almost 100% employment following apprenticeship period. Currently have 192 staff on apprenticeships in the following areas: Pharmacy, Pathology, Phlebotomy, Medical Tech, Audiology, Business Administration, Estates, HCSW Evidence of continued career progression from apprenticeships to higher qualifications over the last 2-3 years. E.g. progression to band 4 role in Pathology

16. QAH HospitalPortsmouth Hospitals NHS TrustPage 1611/21/2016Page 16 Medical staffing Regional Reductions in supply in recent years in speciality posts to align training posts with future demand Significant gap between numbers of junior doctors to meet workforce future demands and the number of junior doctors upon whom delivery is necessary during their training Certain specialities are experiencing supply and recruitment problems, especially general practice, psychiatry and emergency medicine Local Development of alternative roles e.g. physicians assistant Advanced Clinical Practitioner in A&E Recruitment from overseas to fill vacancies

17. QAH HospitalPortsmouth Hospitals NHS Trust Conclusion Page 1711/21/2016 With the introduction of the more detailed workforce review process, we will be building on these initiatives and focus our attention on areas needing work to ensure they are able to maintain high quality and cost effective service provision. QUESTIONS?