1. Reshaping the Medical Workforce in Scotland Update to NDPIG – July 2010 Alastair Cook Senior Medical Officer SGHD Senior Medical Officer SGHD

2. OUTLINE CONTEXT – MEDICAL WORKFORCE CHANGE IN LAST DECADE CONTEXT – MEDICAL WORKFORCE CHANGE IN LAST DECADE PROJECTED MEDICAL SUPPLY AND DEMAND PROJECTED MEDICAL SUPPLY AND DEMAND RESHAPING WORKFORCE IN SCOTLAND RESHAPING WORKFORCE IN SCOTLAND ISSUES FOR PAEDIATRICS ISSUES FOR PAEDIATRICS

4. UK MEDICAL SCHOOL INTAKES

5. Estimated annual retirements from NHS in Scotland and England 2011-2036 0 1000 2000 3000 4000 5000 6000 201120162021202620312036

6. PARTICIPATION RATES BY CONSULTANTS 1998-2008 SHOWN BY GENDER 0.7 0.8 0.9 1 199820002002200420062008 Participation rate totalmalefemale

8. SUPPLY Vs DEMAND (AS DETERMINED BY PAYBILL)

9. RESHAPING MEDICAL WORKFORCE IMPROVE PATIENT CARE BY INCREASING PROPORTION DELIVERED BY TRAINED DOCTORS IMPROVE PATIENT CARE BY INCREASING PROPORTION DELIVERED BY TRAINED DOCTORS REDUCE RELIANCE ON DOCTORS IN TRAINING FOR SERVICE DELIVERY REDUCE RELIANCE ON DOCTORS IN TRAINING FOR SERVICE DELIVERY DELIVER APPROPRIATE SKILL MIX ACROSS CLINICAL TEAMS DELIVER APPROPRIATE SKILL MIX ACROSS CLINICAL TEAMS CAPITALISE ON THE “BULGE” OF TRAINEES POST MMC CAPITALISE ON THE “BULGE” OF TRAINEES POST MMC

10. SPECIALTY ESTIMATED RETIREMENTS EXPECTED CCTs PROJECTED OVERSUPPLY EMERGENCY MEDICINE 10138128 ANAESTHESIA70311241 DIAGNOSTIC SPECIALTIES 79198119 MEDICAL SPECIALTIES 184546362 SURGICAL SPECIALTIES 142406264 MENTAL HEALTH SPECIALTIES 95250155 OBS & GYNAE 27163136 PAEDIATRICS33153120 GENERAL PRACTICE 5501460910 PUBLIC HEALTH & OCC. MEDICINE 416322 TOTAL123136882457 THE BULGE 2010-2014

11. RESHAPING OBJECTIVES WORK WITH BOARDS AND REGIONS ON MEDICAL WORKFORCE PROJECTIONS WORK WITH BOARDS AND REGIONS ON MEDICAL WORKFORCE PROJECTIONS CONSULT ON AND SET TRAINING INTAKE NUMBERS 2011-2015 CONSULT ON AND SET TRAINING INTAKE NUMBERS 2011-2015 CO-ORDINATE BOARD AND REGIONAL PLANNING OF TRANSITION TO RESHAPED WORKFORCE CO-ORDINATE BOARD AND REGIONAL PLANNING OF TRANSITION TO RESHAPED WORKFORCE

12. PAEDIATRIC ISSUES BULGE ? BULGE ? NES FIGURES 142 CCTS TO FEB 2015 NES FIGURES 142 CCTS TO FEB 2015 TPD SURVEY WEST AND NORTH SHOWS ONLY 46 OF PREDICTED 59 (N & W) BY 2013 TPD SURVEY WEST AND NORTH SHOWS ONLY 46 OF PREDICTED 59 (N & W) BY 2013 COMMUNITY CHILD HEALTH COMMUNITY CHILD HEALTH 178 (138WTE) SGAS DOCTORS AT 2009 178 (138WTE) SGAS DOCTORS AT 2009 ATTRITION – LOSSES AFTER ST1/2 TO GP OR OTHER SPECIALTIES ATTRITION – LOSSES AFTER ST1/2 TO GP OR OTHER SPECIALTIES

13. PAEDIATRIC ISSUES (LONGER TERM) ATTRACTIVENESS OF SPECIALTY ATTRACTIVENESS OF SPECIALTY RELATIONSHIP BETWEEN VERY SPECIALIST SERVICE, DGH SERVICES AND COMMUNITY RELATIONSHIP BETWEEN VERY SPECIALIST SERVICE, DGH SERVICES AND COMMUNITY SUSTAINABLE WORKFORCE SOLUTIONS THAT ALLOW TRAINING QUALITY SUSTAINABLE WORKFORCE SOLUTIONS THAT ALLOW TRAINING QUALITY

14. SOLUTIONS ? NEW PATTERNS OF WORKING FOR CCT TRAINED DOCTORS NEW PATTERNS OF WORKING FOR CCT TRAINED DOCTORS DECOUPLING TO ALLOW REPLACEMENT OF SGAS DOCS DECOUPLING TO ALLOW REPLACEMENT OF SGAS DOCS TRAINING OF ACUTE PAEDIATRICIANS TRAINING OF ACUTE PAEDIATRICIANS TRAINING OF OTHER SPECIALTIES – GP, ACUTE PHYSICIANS, EM DOCTORS IN MANAGING PAEDS EMERGENCIES TRAINING OF OTHER SPECIALTIES – GP, ACUTE PHYSICIANS, EM DOCTORS IN MANAGING PAEDS EMERGENCIES MULTIDISCIPLINARY SOLUTIONS MULTIDISCIPLINARY SOLUTIONS