1. Tankersley Manor 11th May Solutions and Opportunities
GP Workforce Event
Tankersley Manor 11th May
Solutions and Opportunities
Mark
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!

2. 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

3. 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.

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

5. 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

6. 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
Thank anyone who fills in the data tool
Leadership and reconnecting system with itself
Infrastructure
@NHS_HealthEdEng

7. ATP spoke development
Infrastructure

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

9. 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

10. Distribution of HCA Apprenticeships
Apprentices 2.7% of general practice workforce

11. Distribution of Advanced Clinical Practitioners

12. 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

13. 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

14. 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