Reshaping the Reshaping the Medical Medical

Workforce in Workforce in Scotland Scotland Update to NDPIG – July 2010Update to NDPIG – July 2010

Alastair CookAlastair Cook

Senior Medical Officer SGHD Senior Medical Officer SGHD   

OUTLINEOUTLINE CONTEXT – MEDICAL WORKFORCE CONTEXT – MEDICAL WORKFORCE

CHANGE IN LAST DECADECHANGE IN LAST DECADE PROJECTED MEDICAL SUPPLY AND PROJECTED MEDICAL SUPPLY AND

DEMANDDEMAND RESHAPING WORKFORCE IN RESHAPING WORKFORCE IN

SCOTLANDSCOTLAND ISSUES FOR PAEDIATRICSISSUES FOR PAEDIATRICS

Doctors in NHS in England and Scotland 1998-2008

020000

400006000080000

100000120000

140000160000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

UK MEDICAL SCHOOL INTAKES

Estimated annual retirements from NHS in Scotland and England 2011-2036

0

1000

2000

3000

4000

5000

6000

2011 2016 2021 2026 2031 2036

PARTICIPATION RATES BY CONSULTANTS 1998-2008 SHOWN BY GENDER

0.7

0.8

0.9

1

1998 2000 2002 2004 2006 2008

Par

tici

pat

ion

rat

e

total male female

Supply of Doctors at different participation rates 2010-2016

140000

150000

160000

170000

180000

190000

200000

2009 2010 2011 2012 2013 2014 2015 2016

Headcount 0.9 participation 0.8 participation 0.7 participation

145000

150000

155000

160000

165000

170000

175000

180000

185000

190000

2009 2010 2011 2012 2013 2014 2015 2016

Headcount 0.9 participation 0.8 participation 0.7 participation

No increase in paybill 2% increase 3% increase 1% increase

SUPPLY Vs DEMAND (AS DETERMINED BY PAYBILL)

RESHAPING MEDICAL RESHAPING MEDICAL WORKFORCEWORKFORCE

IMPROVE PATIENT CARE BY IMPROVE PATIENT CARE BY INCREASING PROPORTION INCREASING PROPORTION DELIVERED BY TRAINED DOCTORSDELIVERED BY TRAINED DOCTORS

REDUCE RELIANCE ON DOCTORS REDUCE RELIANCE ON DOCTORS IN TRAINING FOR SERVICE IN TRAINING FOR SERVICE DELIVERY DELIVERY

DELIVER APPROPRIATE SKILL MIX DELIVER APPROPRIATE SKILL MIX ACROSS CLINICAL TEAMSACROSS CLINICAL TEAMS

CAPITALISE ON THE “BULGE” OF CAPITALISE ON THE “BULGE” OF TRAINEES POST MMCTRAINEES POST MMC

SPECIALTYSPECIALTY ESTIMATED ESTIMATED RETIREMENTS RETIREMENTS

EXPECTED EXPECTED CCTs CCTs

PROJECTED PROJECTED OVERSUPPLYOVERSUPPLY

EMERGENCY MEDICINEEMERGENCY MEDICINE 1010 138138 128128ANAESTHESIAANAESTHESIA 7070 311311 241241DIAGNOSTIC DIAGNOSTIC SPECIALTIESSPECIALTIES

7979 198198 119119

MEDICAL SPECIALTIESMEDICAL SPECIALTIES 184184 546546 362362SURGICAL SPECIALTIESSURGICAL SPECIALTIES 142142 406406 264264MENTAL HEALTH MENTAL HEALTH SPECIALTIESSPECIALTIES

9595 250250 155155

OBS & GYNAEOBS & GYNAE 2727 163163 136136PAEDIATRICSPAEDIATRICS 3333 153153 120120GENERAL PRACTICEGENERAL PRACTICE 550550 14601460 910910PUBLIC HEALTH & OCC. PUBLIC HEALTH & OCC. MEDICINEMEDICINE

4141 6363 2222

TOTALTOTAL 12311231 36883688 24572457

THE BULGE 2010-2014

RESHAPING RESHAPING OBJECTIVESOBJECTIVES

WORK WITH BOARDS AND WORK WITH BOARDS AND REGIONS ON MEDICAL REGIONS ON MEDICAL WORKFORCE PROJECTIONSWORKFORCE PROJECTIONS

CONSULT ON AND SET TRAINING CONSULT ON AND SET TRAINING INTAKE NUMBERS 2011-2015INTAKE NUMBERS 2011-2015

CO-ORDINATE BOARD AND CO-ORDINATE BOARD AND REGIONAL PLANNING OF REGIONAL PLANNING OF TRANSITION TO RESHAPED TRANSITION TO RESHAPED WORKFORCE WORKFORCE

PAEDIATRIC ISSUESPAEDIATRIC ISSUES

BULGE ?BULGE ? NES FIGURES 142 CCTS TO FEB 2015NES FIGURES 142 CCTS TO FEB 2015 TPD SURVEY WEST AND NORTH TPD SURVEY WEST AND NORTH

SHOWS ONLY 46 OF PREDICTED 59 (N SHOWS ONLY 46 OF PREDICTED 59 (N & W) BY 2013& W) BY 2013

COMMUNITY CHILD HEALTHCOMMUNITY CHILD HEALTH 178 (138WTE) SGAS DOCTORS AT 2009178 (138WTE) SGAS DOCTORS AT 2009

ATTRITION – LOSSES AFTER ST1/2 ATTRITION – LOSSES AFTER ST1/2 TO GP OR OTHER SPECIALTIESTO GP OR OTHER SPECIALTIES

PAEDIATRIC ISSUESPAEDIATRIC ISSUES(LONGER TERM)(LONGER TERM)

ATTRACTIVENESS OF SPECIALTYATTRACTIVENESS OF SPECIALTY

RELATIONSHIP BETWEEN VERY RELATIONSHIP BETWEEN VERY SPECIALIST SERVICE, DGH SPECIALIST SERVICE, DGH SERVICES AND COMMUNITYSERVICES AND COMMUNITY

SUSTAINABLE WORKFORCE SUSTAINABLE WORKFORCE SOLUTIONS THAT ALLOW TRAINING SOLUTIONS THAT ALLOW TRAINING QUALITY QUALITY

SOLUTIONS ?SOLUTIONS ? NEW PATTERNS OF WORKING FOR NEW PATTERNS OF WORKING FOR

CCT TRAINED DOCTORSCCT TRAINED DOCTORS DECOUPLING TO ALLOW DECOUPLING TO ALLOW

REPLACEMENT OF SGAS DOCSREPLACEMENT OF SGAS DOCS TRAINING OF ACUTE PAEDIATRICIANSTRAINING OF ACUTE PAEDIATRICIANS TRAINING OF OTHER SPECIALTIES – TRAINING OF OTHER SPECIALTIES –

GP, ACUTE PHYSICIANS, EM DOCTORS GP, ACUTE PHYSICIANS, EM DOCTORS IN MANAGING PAEDS EMERGENCIESIN MANAGING PAEDS EMERGENCIES

MULTIDISCIPLINARY SOLUTIONSMULTIDISCIPLINARY SOLUTIONS