Pan-London Summary of 2014 Workforce and Education Planning for 2015/16 Commissions

Pan-London Summary of 2014 Workforce and Education Planning for 2015/16 Commissions

1.1 Adult Nursing

Commissioning trend

• To begin boosting the supply of registered nurses equipped to work in neonatal units a pilot cohort of 15 adult nurses programmes will be commissioned with a neonatal focus.

• Trusts are attempting to reduce turnover by 3% over five years; LETBs are exploring options to support Trusts to reduce staff turnover and use CPD more effectively.

Summary Pan-London education commissions for Adult Nursing were increased by 7% when compared to the previous year. This is in line with government priorities for safer staffing following Francis, Keogh and NICE 2014 . Trusts also forecast increased demand due to increasing acuity and complex cases, the proposed transition to 7 day working and the achievement of the targeted clinical standards ,and the increased need for specialist and community nurses to support future service transformation.

Summary of Stakeholder Engagement• Across London, a number of trusts are using international recruitment to

address the immediate shortage of nurses. • There is an overall aim to reduce the vacancy rate over the 5 year planning

period. Trusts are aiming for a 5% vacancy rate, although most are currently closer to 8-10%.

• The general issues of high costs of living in London and consequent migration of staff out of London remain.

LETB 14/15 (Placed)

15/16 (Planned) Change

Pan-London 1824 1962 +7.6%

NCEL 722 750 +3.9%

NWL 470 517 +10%

SL 632 695 +10%

* 14/15 starters for Jan cohorts assumed to be equal to planned number

LETB Vacancies Attrition Uptake Amendments following stakeholder engagement

Pan-London

11.3%> 7.6% 21.9% 78.9% [see below]

NCEL 10% 20% 85%- Vacancy from 11.3% to 10%- Attrition from 23% to 20%- Uptake from 75% to 85%- Initial establishment increased by 1,010

NWL 7.8% 23% 75%

SL 15.4%>5% 23% 75% - Vacancy reducing over 5 years from 15.4% to 5%

- Turnover reduced by 3% over 5 years

Commissioning decisions and course split

Demand & Supply Assumptions

Pan-London Workforce Data: Demand & Supply

BSc151284%

PGDip25914%

MSc201%

Course split is based on 2014/15 pan-London starters (Jan 2015 cohort starters assumed to be equal to planned number).

14/15 15/16 16/17 17/18 18/19 19/2027500

30000

32500

35000

37500

40000

Demand

Supply

FTEs

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

500

1000

1500

2000

2500

643 632 665

380 470 536

650 722 750

594 632

439 479

623 680

1673 1651 1673 16561824 1791

1951

NCEL Starters NWL Starters SL StartersPan-London Starters

Other recommendations

2.1 Child Nursing

Commissions

Other recommendations• Placement capacity to be addressed to allow for future growth. The location of placements

is also to be explored to ensure a good spread across London and reduce dependency on core units like Great Ormond Street Hospital.

Commissioning trend

Summary of Stakeholder Engagement• Pan London workforce data shows a clear need to grow the Child Nursing

workforce by increasing supply through education and improving staff retention. • Trusts are aiming to lower their vacancy rates to 5%; this remains difficult to

achieve• There is recognition that London trains children’s nurses for the whole country. • The general issues of high costs of living in London and consequent migration of

staff out of London remain. • There is concern that growth of the adult nurse workforce is impacting on the

number of child nurses being trained• Placement capacity needs to be expanded, including growth in primary care and

community placements • Some Trusts face recruitment difficulties due to competition from popular Trusts

like GOSH that provide placements.

LETB 14/15 (Placed) 15/16 (Planned) Change

Pan-London 684 709 +3.7%

NCEL 245 270 +10.2%

NWL 181 181 0%

SL 258 258 0%



Pan-London 10.3% 24% 83% [see below]

NCEL 10% 24% 83%- Vacancy from 16% to 10%- 2015/16 joiners (excl. newly qualified) increased from 326 to 400

NWL 7% 24% 83%

SL 13% 24% 83% - Vacancy from 16% to 13%

Commissioning decisions and course split Demand & Supply Assumptions



BSc57486%

PGDip77

12%

2nd reg183%

14/15 15/16 16/17 17/18 18/19 19/205000

5250

5500

5750

6000

6250

6500

Demand

SupplyFTEs

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0100200300400500600700800

168258 258

80

181 181

437245 270

165 203

83134

387332

737674 685

635684 669 709

NCEL Starters NWL Starters SL Starters Pan-London Starters

Summary Pan-London education commissions for Child Nursing were increased by 3.7% when compared to the previous year. This increased commissioning was based in North Central and East London. London Trusts forecast the demand for Child Nursing to increase by 12.3% over the next five years. Pan London workforce supply and demand data shows a clear need to grow the Child Nursing workforce through increasing education commissions and improving staff retention. This year placement constraints have limited increases in commissions; an issue highlighted to be addressed.

3.1 Mental Health Nursing

Commissioning trend

Other recommendations• Short-term undersupply to be mitigated by Trusts working to improve recruitment and

retention (possibly including RTP), and reducing demand. • Trusts to aim to reduce vacancy rates.• Further work is being planned to improve the quality of mental health nursing graduates;

research to be undertaken to understand the complete mental health nursing workforce.

Summary of Stakeholder Engagement• The forecast reduction in demand was queried, as Trust forecasts be may have

been led by financial constraints rather than workforce need, planned service reconfiguration may not be reflecting true need, and a considerable proportion of the workforce (i.e. those outside of secondary care) were not included in the forecast.

• Short term interventions to increase nurse numbers include implementing HR interventions for return to practice and overseas recruitment as commissioning changes will not impact for 3 years.

• Suggestions were made to improve education and service delivery in MH nursing, including dual training (with social care) and the introduction of supernumerary posts.

• Trusts indicated an appetite for addressing quality issues through focusing on mentorship, and are aiming to increase failures in the short term in order to improve uptake rate in the long term.


Pan-London 575 627 +9.0%

NCEL 209 230 +10%

NWL 147 178 +21.1%

SL 219 219 0%



Pan-London 12.7% 19% 70.1% [see below]

NCEL 10% 19% 80%- Vacancy from 8% to 10%- Uptake from 64% to 80%- 2015/16 joiners (excl. newly qualified) increased from 72 to 250

NWL 21% 19% 64%

SL 8.7% 19% 64% - Vacancy from 21.2% to 8.7%




14/15 15/16 16/17 17/18 18/19 19/205000

5500

6000

6500

7000Demand

Supply

FTEs

BSc38066%

PG Dip19834%

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

100

200

300

400

500

600

700

181 219 219

113147 178

261209

230

179 219

116126

273 213

591 555 555 568 575 558627

NCEL Starters

NWL Starters

SL Starters

Pan-London Starters

Summary Pan-London education commissions for Mental Health Nursing were increased by 9% when compared to the previous year. Current workforce data forecasts a workforce shortage within 2 to 3 years. Whilst workforce demand is projected to decline, the validity of this is unclear as it could be driven by financial constraints and it may exclude those working outside of secondary care. Therefore education commissions were increased. London has led a retendering process for education providers in order to improve the quality of Mental Health Nursing education and further work is also being planned to improve the quality of education.

4.1 Midwifery

Commissions

Other recommendations• For Trusts to achieve growth over the next 12 months, recruitment of 50-60 additional

midwives above current recruitment levels will be required.• There is a need to expand the role of Maternity Support Worker as well as developing an

advanced practitioner role to assist with obstetric emergencies.• A reduction in staff attrition by 5% over five years should be targeted• Work will commence with HEIs to ensure placements are available to support future growth

and ensure that placements are available equally across the geography.

Summary of Stakeholder Engagement• The currently projected oversupply was questioned because Trusts

are still falling below the required 1:30 midwife to births target • Staff turnover varies significantly from Trust to Trust. In some areas a

5% reduction in attrition should be targeted.• Placement capacity and management issues, particularly with regard

to community placements and the availability of mentors would need to be addressed prior to plans for growth in the future.

• The failure rate of numeracy tests of students doing the 18-months programme is high


Pan-London 624 624 0%

NCEL 235 235 0%

NWL 174 174 0%

SL 215 215 0%



Pan-London 10.6%

20%>

18.3%81% [see below]

NCEL 10% 20% 81%- Vacancy from -7% to 10%- 2015/16 joiners (excl. newly qualified) increased from 149 to 200

NWL 14% 20% 81%

SL 9.12%20%

>15%

81%- Vacancy from 2.77% to 9.12%- Attrition to reduce from 20% to 15% over five years





12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0100200300400500600700

215 215 215

102 174 174

299 235 235

213 201

102 168

319 241

595 595 616 634 624 610 624 NCEL StartersNWL StartersSL StartersPan-London Starters

BSc55891%

PGDip529% 14/15 15/16 16/17 17/18 18/19 19/20

4000

4250

4500

4750

5000

5250

Demand Supply

FTEs

Summary Pan-London education commissions for Midwifery were unchanged from the previous year. Implementation of the London Quality Standards is contributing to an increase in demand for midwives. Education commissions for midwifery have consistently been increased over the past three years, as a result, projected workforce supply is forecast to meet increased demand. Therefore this year education commissions were unchanged. This is in line with stipulations within the HEE mandate. Placement capacity and the management of placements via HEIs are issues that remain to be addressed.

Commissioning trends


5.1 Learning Disabilities Nursing

Commissioning trend

Other recommendations• Research to be undertaken to understand real workforce demand and the training routes

for non-NHS employed LD nurses. • Future engagement with social care and the third sector will be important.• The LETBs will link in to the national project addressing the hidden demand for this

workforce.

Summary of Stakeholder Engagement• A considerable proportion of the LD nursing workforce is outside of the

NHS so is difficult to identify the real workforce supply and demand picture. It is widely recognised that more work is required in this area.

• 10% of learning disability nurses deliver services in prisons.• LD nurses are often employed by the local authority; although

sometimes LD nurses in this setting are provided by hospitals• Currently placements are a problem so an increase in commissions

would be difficult to implement.


Pan-London 76 81 +6.6%

NCEL 25 30 +20%

NWL 22 22 0%

SL 29 29 0%




NCEL 18% 11% 47%

NWL 19 % 11% 47%





Course split based on 2014/15 pan-London starters (Jan 2015 cohort starters assumed to be equal to planned number).

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0102030405060708090

1729 29

20

22 2225

25 30

17 26

2123

2525

67 66 62 63

76 7481

NCEL StartersNWL StartersSL Starters

14/15 15/16 16/17 17/18 18/19 19/20200

205

210

215

220

225

230

235

240

245

250

Demand

Supply

FTEs

BSc74

100%

Summary Pan-London education commissions for Learning Disabilities Nursing were increased by 6.6% when compared to the previous year. Workforce data requires improvement as it does not include the independent sector which make up a large proportion of the workforce. Workforce Demand projections are also inconsistent across London . Therefore conservative education commissioning decisions have been made this year. Work is being planned to improve data quality. The DH is currently undertaking a review of LD nursing. There are indications these services will increasingly be provided by local enterprises which is likely to result in different service models.

6.1 District Nursing

Commissioning trend

Other recommendations• Broad agreement to re-define the programme as postgraduate training for expert nurse

leaders in community care in the home.• To survey HEIs to establish placement capacity.

Summary of Stakeholder Engagement• Decisions recognise the shift for delivery of care from the acute

sector to community settings and the need for an increase number in community based staff.

• Recruitment and retention still a challenge particularly because the cost attached to training a DN is £40k. Incentivising strategies need to be considered to reduce staff leaving the profession .

• The DN programme is still considered valid as commissioners are expressing more interest in developing this role. In previous years potential candidates have been attracted into HV roles.

• DNs need more acute skills, different from the current roles in community to reduce readmissions.


Pan-London 112 113 +0.9%

NCEL 38 39 +2.6%

NWL 31 31 0%

SL 43 43 0%




NCEL 10% 6% 66%

NWL 15% 6% 66%




Pan-London workforce Data: Demand & Supply


14/15 15/16 16/17 17/18 18/19 19/200

50

100

150

200

250

300

350

400

450

Demand

Supply

FTEs

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

20

40

60

80

100

120

68

2336 43 43

2631 31

3838 39

13 1917

245

4068

23

100

35

112

83

113

NCEL StartersNWL StartersSL StartersPan-London Starters

BSc67

81%

PGDip15

18%

MSc1

1%

Summary Pan-London education commissions for District Nursing were marginally increased by 1% when compared to the previous year. Current workforce data suggests that workforce supply will exceed demand imminently. Whilst this forecast may not adequately reflect the increased demand that will result as care moves out of hospital and into the community, previously education commissions for District Nursing have been difficult to fill. This is reflected in the current commissioning decisions.

7.1 School Nursing

Commissioning trend

Summary of Stakeholder Engagement• Local authorities are key decision makers for both strategy and

implementation relating to school nursing roles. • The correct recording by local councils as to whether school nursing demand

is being met was questioned.• Some Trusts have had difficulty in recruiting School Nurses • The possibility of changing the existing training model was questioned, but

any change would need to follow a pan-London requirement and approach on how this would take .

• It has historically not been possible to fill all commissions placed.



NCEL 19 24 +26.3%

NWL 17 17 0%

SL 18 18 0%




NCEL 12% 11% 70% - Uptake from 60% to 70%

NWL 19% 11% 60%


Commissioning decisions and course splitDemand & Supply Assumptions



14/15 15/16 16/17 17/18 18/19 19/20150

170

190

210

230

250

270

Demand

Supply

FTEs

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters

*

15/16 Planned Comms

0

10

20

30

40

50

60

70

5038

18 18 18

14 17 17

19 19 24

21 19

9 15

20 11

50

38

51 5054

45

59

NCEL Starters

NWL Starters

SL Starters

Pan-London Starters

BSc36

80%

PGDip9

20%

Summary Pan-London education commissions for School Nursing were increased by 9.3% when compared to the previous year. School nursing is an HEE mandated priority area. Despite workforce forecasts predicting a an oversupply, it is likely that recent increases in birth rates followed by an increase in demand for health visitors will translate into an increased demand for school nurses which is not reflected in workforce demand forecasts. Therefore commissions were marginally increased in London. Local authorities will implement new strategies in the future which are likely to impact school nursing roles.

8.1 Health Visiting

Commissioning trend

Other recommendations• There is a significant difference between the trust staff in post demand forecast and the staff in

post forecast from the Health Visiting planning initiative . The LETBs will scrutinise the data sources and reconcile the data. Planning for this workforce needs to become part of the routine workforce planning rather than a specific project.

Summary of Stakeholder Engagement• Sustainability of the health visiting workforce is a key issue, with

attrition, retirement and turnover all concerns.• Local authorities and Public Health will eventually take on

commissioning training responsibility; there may be not employment opportunities in the future

• Post-election, the future of Health Visiting may well change in 2015/16.


Pan-London 260 211 -18.8%

NCEL 60 60 0%

NWL 66 70 +6.1%

SL 134 81 -39.6%




Pan-London Workforce data: Demand & Supply




NCEL 13.4% 11% 92%

NWL 12.6% 11% 69%


14/15 15/16 16/17 17/18 18/19 19/20750

1000

1250

1500

1750

DemandSupplyFT

Es

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

050

100150200250300350400450500

374

264

134 13481

99 6670

240

6060

16074

105

48

159

89

374

264

473424

260211 211

NCEL StartersNWL StartersSL StartersPan-London Starters

BSc14267%

PGDip69

33%

Summary Pan-London education commissions for Health Visiting were reduced by 18.8% when compared to the previous year. Following significant growth in commissions over the past 3 years in line with government policy, this year education commissions in London have been reduced. Although workforce data still forecasts a future workforce shortage, other factors such as addressing staff turnover , difficulty in course uptake and new policy have impacted on this years commissioning decision. Health visiting has recently changed from a national programme to local planning by Trusts and as a result the availability of localised planning data is limited. A national working group has been set up to ensure workforce sustainability.

9.1 Therapeutic Radiography

Commissioning trend Summary of Stakeholder Engagement• The Society and College of Radiography, SCoR, is producing guidance

to allow for 7-day access to services, which may impact on workforce demand and skill mix requirements

• There is debate over the potential requirement for placements to require students to participate in 7 day working or evening shifts

• Raising the profession’s profile is a challenge, as the government and media’s choice of words used discourages school leavers;

• There is no shortage of newly qualified AfC band 5 applicants, however there is a recruitment issue at more senior levels. The development of the existing workforce to overcome the shortages of good quality senior staff is seen as a priority.



NCEL 31 32 +3.2%

NWL 22 23 +4.5%

SL 29 31 +6.9%



Pan-London 10% 30% 60%

- Vacancy from 15% to 10%- Attrition from 37% to 30%- Uptake from 44% to 60%





12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

20

40

60

80

100

120

101 102 96 91

29 29 31

22 22 23

31 31 32

101 102

8296

8291 86

NCEL Starters

NWL Starters

SL Starters

Pan-London Starters

BSc80

88%

PGDip11

12% 14/15 15/16 16/17 17/18 18/19 19/20200

300

400

500

DemandSupply

FTEs

Summary Pan-London education commissions for Therapeutic Radiography were increased by 4.9% when compared to the previous year. This is in preparation for a predicted increase in demand due to the provision of seven day services and additional cancer services including GSTT’s new Cancer Centre and the UCLH Proton Centre. Trust demand data is corroborated by independent sector data. These developments will draw from the pool of more senior / specialist staff across London and probably further afield.TR has historically had extremely high attrition and poor uptake rates. Action plans put in place over the last two years appear to be impacting and will result in an enhanced supply. Therefore only modest increase is recommended to ensure security of future supply.

10.1 Physiotherapy

Commissioning trend

Summary of Stakeholder Engagement• The planning assumption for in-course attrition seems high – some

suggest that it may be closer to 10% – and that it would be very difficult to reduce the level of unnecessary attrition by a further third to meet HEE’s policy requirements.

• It is more difficult to recruit to higher band posts than entry level positions, but there is a large variance between Trusts and between specialties, eg easier to recruit to more popular specialties such as neurology, trauma and musculoskeletal (MSK).

• The impact of 7-day working and increasing complexity of patients means that there is a requirement for more advanced clinical skills.

• There is a need for rotations across traditional acute/community/specialist boundaries and between health, education and social care.

• There is a loss of core skills, a need for more generic skills and less specialisation, but specialisation is seen as the main route to career progression; the BSc programme may be more suitable for a producing workforce less keen to specialise immediately.

• The majority of trusts showed agreement towards maintaining current commissions and a slight oversupply.



NCEL 86 86 0%

NWL 60 60 0%

SL 82 82 0%






14/15 15/16 16/17 17/18 18/19 19/202,700

2,800

2,900

3,000

3,100

DemandSupplyFT

Es


Pan-London 13% 18% 56% - No amendments

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

50

100

150

200

250

228 230 229 234

82 82 82

60 60 60

86 86 86

228 230 228 229 228 234 228NCEL Starters

NWL Starters

SL Starters

Pan-London Starters

BSc

162

69%

MSc7231%

Summary Pan-London education commissions for Physiotherapy were unchanged from the previous year. Supply of Physiotherapists is predicted to continue to increase at a desirable level higher than demand, therefore commissioning volumes will be maintained at 2014/15 levels. In addition to this, an additional 16 places as part of a pilot programme to train community based physiotherapists.

11.1 Occupational Therapy

Commissioning trend

Summary of Stakeholder Engagement• All attendees reported issues with recruitment. Historically there has been

an issue in recruiting band 7s; this has now extended to 6s and 8As.• Attendees were in support of OT being on the shortage profession

immigration list again; many OTs are recruited from abroad and tend to stay in post for longer.

• Many OTs working in Social Services are recruited via private agencies. People who don’t get band 5 roles tend to get lost in the system. Qualified OTs also go into assistant roles, support worker and recovery worker roles. Many OTs go into the 3rd sector and don’t retain their registration or the OT job title.

• Placements are managed by the Placement Management Partnership which has solved a lot of management problems and allows students to be placed in different areas.

• The lack of paediatrics placements is an issue which then affects OTs getting paediatrics jobs later on in their careers, as they haven’t had the relevant experience.

• There were several suggestions for increasing the supply of OTs, including increased use of return to practice, and assistance in staff wanting to change careers to OT.



NCEL 85 85 0%

NWL 60 60 0%

SL 81 81 0%






14/15 15/16 16/17 17/18 18/19 19/202,100

2,150

2,200

2,250

2,300

2,350

2,400

DemandSupplyFT

Es

BSc (3 yr)

14760%

BSc (4 yr)177%

PGDip52

21%

MSc31

13%


Pan-London 13% 21% 61% - Vacancy from 14% to 13%

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters

*

15/16 Planned Comms

0

50

100

150

200

250

300

239 245224

247

81 81 81

60 60 60

85 85 85

239 245226 224 226

247226 NCEL

Starters

NWL Starters

SL Starters

Pan-London Starters

Summary Pan-London education commissions for Occupational Therapy were unchanged from the previous year. A significant workforce oversupply is predicted. Commissions are being maintained at 2014/15 levels and not being reduced as significant demand exists outside of the NHS which is not being factored into the data used and due to feedback from stakeholders suggesting shortages of OT staff.

12.1 Diagnostic Radiography

Commissioning trend

Other recommendations• Pan-London: As the bulk of the forecast increase in demand is predicted to occur in the next 12

– 18 months, it will require development and implementation of short-term HR strategies in Trusts rather than educational interventions.

• An appetite exists to commission a postgraduate sonography programme in London. A national approach is being explored with HEE as this is a common issue.

Summary of Stakeholder Engagement• There is a reported issue with career progression from Agenda for Change

(AfC) Band 6 to band 8. Consequently there is a shortage of good candidates within this career range.

• a 24/7 service is highly under estimated and complex to sustain. 24/7 working includes providing care throughout the day; the majority of the workforce consists of junior roles and therefore there is a need to increase this workforce.

• The quality of students has improved along with a reduction in attrition from the undergraduate programme as a result of increasing the entry requirements.

• There is a rise in partnerships of independent providers prepared to tender for new work. Trusts are placing other services out to tender through these partnerships and utilising the independent sector to underpin the capacity gap. There is some movement away from external contracts due to quality issues and CCGs may want radiographers to return to trusts; this may impact on demand for hospital based radiographers.

• Salary support across the three London LETBs for Sonography training would be helpful as currently this is only provided by HENCEL.


Pan-London 187 200 +7%

NCEL 70 75 +7.1%

NWL 50 54 +8%

SL 67 71 +6%





14/15 15/16 16/17 17/18 18/19 19/201,900

2,000

2,100

2,200

2,300

2,400

2,500

DemandSupplyFT

Es



- 2015/16 joiners (excl. newly qualified) increased from 300 to 350- Uptake from 58% to 85%

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

50

100

150

200

250

193 189 195 193

67 67 71

50 50 54

70 70 75

193 189 187 195 187 193 200 NCEL StartersNWL StartersSL StartersPan-London Starters

BSc193

100%

Summary Pan-London education commissions for Diagnostic Radiography were increased by 7% when compared to the previous year. This is to ensure that the supply of Diagnostic Radiographers keeps pace with increased service demands due to a combination of activity increases, extended hours, 24/7 service delivery, increases in complex work and cancer imaging. Data from the independent sector has also been accessed which shows a modest decline in demand over the next three years. The lack of specific ESR NHS occupation codes for sonographers masks a known shortage– a trend leading to overseas recruitment.

13.1 Speech & Language Therapy

Commissioning trend

Other recommendations• Further work is required to understand both the local authority workforce and future demand.

Summary of Stakeholder Engagement• 30% of activity is in adults and 70% in children.• Commissioners have limited sight of demand within the profession;

therapists are more in demand than perceived. There is a lack of funding from commissioners to deliver the right level of patient care.

• People with speech and language disorders are dealing with long term complex conditions. SLTs are required to hand over to carers; there is a high risk involved in passing skills on to those who are not qualified.

• CCG commissioners are not utilising the Public Health tool, which is an important aspect as it demonstrates the need for SLTs. There is a lack of partnership in commissioning.

• Placement capacity is an increasing issue. The workforce is small and supervising students at critical times may pose a risk to service delivery. The group therefore offer support to each other in order to fill placement capacity issues.

• There is a trend for speech and language therapists to seek jobs outside of London.



NCEL 65 65 0%

NWL 46 46 0%

SL 62 62 0%


Commissioning decisions and course splitDemand & Supply Assumptions



14/15 15/16 16/17 17/18 18/19 19/201,200

1,300

1,400

1,500

1,600

DemandSupplyFT

Es


Pan-London 10% 16% 70% - Vacancy from 17% to 10%

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters*

15/16 Planned Comms

0

40

80

120

160

200

172 177 176 176

62 62 62

46 46 46

65 65 65

172 177 173 176 173 176 173

NCEL StartersNWL StartersSL Starters

BSc39

22%

PGDip81

46%

MSc56

32%

Summary Pan-London education commissions for Speech & Language Therapy were unchanged from the previous year. Although forecasts from Trusts indicate a modest growth of 2% across London compared to 2013, supply is more than sufficient to address this need, therefore pan-London commissions will be maintained at 2014/15 levels. Data from independent hospitals indicates a largely unchanged workforce demand; however demand from local authorities is unclear. Public Health data indicates an increased birth rate over the last few years and the Royal College have shown an increase in children with speech and language conditions. Referrals to SLTs have increased by 30% which reflects growth in birth rates. The ageing population will also impact on service need. Demand is therefore likely to be greater than estimated.

14.1 Dietetics

Commissioning trend Summary of Stakeholder Engagement• Trusts have more posts than they have done recently. Trusts don’t have

enough Band 5 posts – but where they do they are easy to recruit to.• Specialist areas are growing particularly diabetes and obesity.• Some Trusts don’t have any Band 5 posts – Band 6 are seen as the most cost

effective in terms of service delivery resulting in a reduction in band 5 posts. It is hard to recruit to Band 6, this is likely to be a direct result of the lack of band 5 positions.

• Some Trusts are struggling to accommodate students and have had to reduce the number of placements they offer as a result of the pressures on service.

• Dieticians are employed in a wide range of organisations outside of the NHS: industry, charities like Diabetes UK, BHF, Macmillan.

• Many newly qualified staff apply for Diabetic Support Worker posts or volunteer to get experience. Also, graduate Nutritionists are quite often taking up DSW posts to move into dietetics



NCEL 29 29 0%

NWL 19 19 0%

SL 27 28 +3.7%






12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters

*

15/16 Planned Comms

0

10

20

30

40

50

60

70

80

90

100

7684 86

79

27 27 28

20 19 19

29 29 29

7684

76

86

7579 76

NCEL Starters

NWL Starters

SL Starters

Pan-London Starters


Pan-London 5% 18% 29% - Vacancy from 6.37% to 5%

14/15 15/16 16/17 17/18 18/19 19/20650

700

750

800

850

900

950

DemandSupplyFT

Es

BSc5266%

PGDip18

23%

MSc9

11%

Summary Pan-London education commissions for Dietetics were increased by 1.3% when compared to the previous year. In 2013 an oversupply was forecast for this profession, leading to a predicted 15.4% oversupply in 2018/19. In 2014/15 an oversupply is still forecast, therefore commissions were increased marginally just to ensure safety in supply.

15.1 Podiatry

Commissioning trend

Summary of Stakeholder Engagement• There is no sense of difficulty in recruiting in the independent sector and

although some recruitment difficulty is experienced at junior grades, this is in large part thought to be due to slow recruitment processes.

• Services have been undergoing substantial service reconfiguration and re-grading bands 7-8. This has resulted in the loss of significant numbers of staff; management, clinical and senior level. The reduction in the capacity to deliver service is, in many cases, resulting in case loads being withdrawn.

• There is a piece of work that could be undertaken with UEL to scope the potential for increasing student placement within the independent sector; There are some placements in this sector, however UEL highlighted that these are few in number

• UEL currently work with between 40 - 50 placement providers and are reluctant on a significant increase in numbers. In private practices the students are likely to find themselves reduced to observational roles and patients may refuse to be seen by them. It may be more profitable for student time in private practice spent in learning about the business and marketing aspects of the service.

LETB 14/15 (Placed)

15/16 (Planned) Change

Pan-London 37 37 0%

NCEL 14 14 0%

NWL 10 10 0%

SL 13 13 0%







- 2015/16 joiners (excl. newly qualified) increased from 16 to 44- Attrition from 30% to 25%- Uptake from 44% to 80%

14/15 15/16 16/17 17/18 18/19 19/20320

340

360

380

400

420

DemandSupplyFT

Es

12/13 Comms

12/13 Starters

13/14 Comms

13/14 Starters

14/15 Comms

14/15 Starters

*

15/16 Planne

d Comms

0

10

20

30

40

50

60

5041 37

30

13 13 13

10 10 10

14 14 14

50

4137 37 37

30

37

NCEL Starters NWL StartersSL Starters Pan-London Starters

BSc30

100%

Summary Pan-London education commissions for Podiatry were unchanged from the previous year. Current data shows adequate workforce supply and demand forecast to fall over the next five years, therefore, commissioning volumes from last year will be maintained. NHS services have been undergoing substantial service reconfiguration and the extent to which the profession operates outside the NHS is unclear. The Society of Chiropodists and Podiatrists estimates that 75% of podiatrists are employed outside the NHS.

Documents

Pan-London Summary of 2014 Workforce and Education Planning for 2015/16 Commissions