1. yh.hee.nhs.uk Introduction Thank you to all the organisations who contributed to this years planning process 100% return and higher quality than ever before.

2. yh.hee.nhs.uk Provider Evidence The information presented today has come from provider plans which were submitted at the end of July and consisted of three parts: Part A – Workforce planning numerical data Part B – Workforce challenges and risks Part C – Narrative describing the future workforce Data was collected from:  14 Acute Trusts (including 1 Children’s Acute)  9 Community organisations  3 Mental Health Trusts  1 Ambulance Trust

3. yh.hee.nhs.uk Historical Trends: Staff in Post 2009-2013

4. yh.hee.nhs.uk Key Findings: Medical & Dental FTE’s Forecasted FTE’s in North Yorkshire and the Humber over the next five years by Specialty. Direction of travel 2013 to 2018 (FTE)

5. yh.hee.nhs.uk Key Findings: Medical & Dental Newly Qualified Trend from 2013-2018 Forecasted Newly Qualified in North Yorkshire and the Humber over the next five years by Specialty.

6. yh.hee.nhs.uk Key Findings – Medical & Dental Risks  Difficulties in recruiting to Consultant posts, especially in A&E and Medicine specialties, resulting in a reliance on locum and / or agency staff  Significant difficulties recruiting to Consultant level posts in the majority of specialties in some areas. Additionally there are concerns regarding the age profile of the Consultant body.  Difficulties in recruiting to posts in A&E, Anaesthetics and some Medicine specialties.  Specialty Doctor posts can be difficult to recruit to in specific areas.  Reduction in training posts and the inability of the Deanery to fill all available posts is a significant issue for Trusts  All grades, but particularly training grades, difficult to recruit to.

7. Key Findings: Non-Medical On average there is a forecasted increase of 0.7% FTE (170 FTE) across all specialisms between 2013 – 2018. The main increases were forecasted in:  Registered Nursing, Midwifery and Health visiting staff +7% (+545.7 FTE)  Apprenticeships +178% (+91 FTE) The forecast for the Yorkshire and the Humber Non-Medical staff is a decrease of 1.9% (-1,868.1 FTE).

8. yh.hee.nhs.uk Key Findings Non-Medical: FTE’s Forecasted FTE’s in North Yorkshire and the Humber over the next five years by specialty. Direction of travel 2013 to 2018 (FTE)

9. yh.hee.nhs.uk Key Findings - Non Medical: Newly Qualified Forecasted Newly Qualified in North Yorkshire and the Humber over the next five years by Specialty. Trend from 2013 to 2018

10. yh.hee.nhs.uk Key Findings – Non-Medical Risks  Increase in advanced Nurse Practitioners  Recruitment of Midwives and Health Visitors and in some area nurses.  Skills Gap - training people in extended roles  Providing physical and mental health care simultaneously  Patient acuity – older, more frail and more dependant

11. yh.hee.nhs.uk Support Staff Plans for all Trusts are forecasting a reduction in support to clinical staff of 244 FTE (3.2%). A sub-category of this is the support to STT & HCS staff which is forecast to fall 1.5%. However, forecast figures for apprenticeships across the Yorkshire and the Humber region are encouraging and backed by the evidence.

12. yh.hee.nhs.uk Advanced Practice  LETB & Service Priority in the following key areas:  Acute Medicine, Emergency Medicine, Paediatrics, Surgery, & Anaesthesia  Workforce Plans contain little evidence of need, this is not unexpected as earlier discussions show that many NHS Trusts are still developing their thinking around Advanced Practitioner deployment  LETB to aid development by providing ‘Start Up Support’ to Trusts, this will include:  Financial support during the implementation phase for those Trusts with well- developed plans  Provide all Trusts with the opportunity to access the Calderdale workforce analysis tool to aid role identification  Establish a Yorkshire & Humber Task & Finish Group to develop the York’s & Humber Advanced Practice Framework

13. Key Findings: Risks and Challenges

14. yh.hee.nhs.uk General Risks (1) Additional risks highlighted by Providers that they believe require LETB support. Technology  Telehealth /medicine - training required to meet complexity and new demands  Personalised care planning  Excellent IT skills and paperless  In communities using mobile technology

15. yh.hee.nhs.uk General Risks (2) Additional risks highlighted by Providers that they believe require LETB support. Skills Reviews  Evidencing the qualifications and competence of staff in light of Francis, Keogh and CQC approach etc.  Effectively training, supporting and supervising a large support worker workforce

16. yh.hee.nhs.uk General Risks (3) Additional risks highlighted by Providers that they believe require LETB support. Pride & Professionalism  Attracting staff to the NHS – morale/ intensity of work/ reputation  Professional standards  Skills at point of registration – mixed views on this

17. yh.hee.nhs.uk Questions Do you have any questions?