Wiltshire HWB and Health Education South West Health Education South West Thursday 16 July 2015 Derek Sprague – LETB Director 1
HEE Overview ������������ The driving principle for reform of the education and training system is to improve care and outcomes for patients and HEE exists for one reason alone – to help ensure delivery of the highest quality healthcare to England’s population, through the people we recruit, educate, train and develop. Through: � A Single Statutory HEE Board � 13 LETBs which are sub-committees of HEE, made up of representatives from local providers of NHS services and cover the whole of England. � LETBs are responsible for the training and education of healthcare staff, both clinical and non-clinical, within their area.
NHS Organisations NHS provider organisations in the South West: 12 acute trusts 3 healthcare trusts 5 partnership trusts 1 ambulance trust 1 specialist trust 1 specialist trust 1 community services trust (potential) Other NHS organisations/ networks: 11 CCGs 1 Local Area Team 2 Academic Health Science networks 1 Clinical senate 2 Public health centres 1 West Local Delivery Partnership 1 PenCLAHRC – Peninsula Collaboration for Leadership in Applied Health Research and Care 3
Non-NHS Providers Non-NHS Providers in the South West: 6 social enterprises 5 independent treatment centres 16 voluntary sector providers 628 GP practices 865 Dental practices 865 Dental practices 302 Optician employers 1559 Care Homes 520 Care Homes with Nursing In addition there are increasing numbers of private providers across a range of services, currently including: � Virgin Care – Children’s services � South West Pathology services 4
Education Providers Further Education Providers: Higher Education Institutes: � Bridgwater College � Plymouth University � Cirencester College � Bournemouth University � City College Plymouth � University of the West of England � City of Bath College � Oxford Brookes University � City of Bristol College � University of Bristol � Cornwall College � � Exeter College University of Bath � Gloucestershire College � University of Exeter � University of � New College Swindon � New College Swindon � � University College of St Marks & St John University College of St Marks & St John Bath Bath � Norton Radstock College � Petroc � Plymouth College of Art � Richard Huish College � Somerset College � South Devon College � South Gloucestershire and Stroud College � Strode College � Swindon College � Truro and Penwith College � Weston College � Weymouth College � Wiltshire College � Yeovil College 5
Local Authorities � 13 Health & Wellbeing Boards 6
Operating model 7
� HEE Budget – (2015/16) � £4.9Bn � HESW Budget – (2015/16) � £332M of which: � £332M of which: � Undergraduate medical/dental - £65M � Postgraduate medical/dental - £132M � Non-medical undergraduate - £108M � Workforce development (CPD, Bands 1-4 etc) - £16M 8
Medical Trainees Geriatric 17 Others Trauma & Under Medicine Plastic Orthopaedic Surgery 139 41 Surgery Endocrinology Graduates Core 81 Cardiothoracic & Diabetes Paediatric Medical 16 179 Surgery 2,818 Surgery 8 Training 26 11 6 ENT Core Surgery Foundation Medicine Respiratory Haematology Medicine 33 21 F1/F2 123 Surgery 565 39 Urology 985 377 Renal Dental 24 16 OMFS Medicine 117 8 Cardiology Neurosurgery 27 General 94 14 28 Gastroenterology 33 Public Surgery Health Health Acute Medicine Acute Medicine 34 Child & 13 inc ACCS Adolescent 6,700+ Medical Trainees Forensic Ophthalmology ACCS Psychiatry 5 Psychiatry 41 Anaesthetics Psychiatry General 72 188 33 Adult Anaesthetics 16 Psychiatry Medical 279 Microbiology 4 & Virology Psychotherapy Old Age 14 207 Paediatrics & Clinical Psychiatry 9 Child Health Radiology 30 Psychiatry of 190 99 110 Learning Disability Anaesthesia Histopathology GP Core Psychiatry 794 Obstetrics & Emergency Gynaecology Medicine Source: Severn Deanery & 117 Total trainees 93 Peninsula Deanery stock take 9 1 st October 2012 Split of trainees
Non-medical Child Health Adult Nurses Nurses 101 755 Physiotherapy 116 Midwives Mental Health 119 Nursing Nurses 206 Clinical 1092 Psychology 36 Occupational PTPs Therapy LD Nurses 45 45 112 112 30 30 2000+ Non-medical Students School Healthcare Nurse Scientists 20 Speech & Specialist Language Community Dental 32 Podiatry Care STPs Public Health 30 Pract.s Pharmacy 24 236 30 Health Therapeutic Radiography ODPs Visitors Occ. Technicians 35 211 64 29 Health Dietetics 5 30 Diagnostic Pharmacy Radiography 35 Total students 103 Source: Planned Education Commissions 2011/12 – 10 Split of students excludes Dorset commissions
South West Whole Health & Care Workforce 11
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Workforce Planning Cycle March : March : Workforce Workforce Forecast system Forecast system open open June: Forecast June: Forecast December: December: templates templates HEE Workforce HEE Workforce completed/ completed/ Plan for Plan for first aggregate first aggregate England / NAIs England / NAIs available available October: October: July: July: Final Final Workforce Workforce Investment Investment Demand Demand Plan / GB Plan / GB Review Review meeting meeting Workshop Workshop Scheduled August: August: for 27 July 15 September: September: Aggregate Aggregate follow-up follow-up Forecast Forecast workshop/ first workshop/ first Demand to HEE Demand to HEE draft draft / Analysis on / Analysis on Investment Investment Supply & Supply & Plan Plan demand demand 13
5YFV � A system solution bringing together the leads for 6 organisations. � National expectation on 5YFV ‘huge’. � Dissolve artificial barriers. � Focus on co-design and system change activity. � Focus on co-design and system change activity. � Establishment of the Workforce Advisory Board 14
Workforce Advisory Board � Chaired by HEE but includes Simon Stevens. � Four areas of initial focus: � Devise plans to retain existing staff/ attract returners in challenged roles e.g. EM and GP; returners in challenged roles e.g. EM and GP; � Provide support to challenged health economies where shortages impeding improvement; � Identify flexibilities to develop new models of care; � Identify new roles to deliver 5YFV 15
Selected future developments � Shape of Caring Consultation � Shape of Training Consultation � Increase of 5000 GPs, and 5000 extra clinical staff, across England by 2020 � Introduction of new roles – e.g. physician assistant � Introduction of new roles – e.g. physician assistant � Talent for Care and Widening Participation Strategies � Apprenticeships (1704 in 2014/15) (1562 in 2015/16) � Increased adult nursing output from 2016 (but not enough) despite 91 RTP and 26 Widening Access places last year. 16
Registered Adult Nursing – HESW forecasts Increased staff in post of 1,000 between March 2013 and Feb 2015 � A significant part of which is international recruitment – increase of 366fte between March 2013 and Dec 2014 � Reduced available labour force for Nursing Homes and other services NB: our increased commissions do not impact on supply until June 2016.
Workforce development delivery - CPD Budget 2014/15 Budget 2015/16 Activity £’000s £’000s Learning4Health (final year 2015/16) 3,000 3,000 CATP Internships for PhD applications - National scheme n/a n/a Non-medical prescribing 400 400 Health Care Scientist and Diagnostic staff CPD 50 100 Mental Health and LD development CPD n/a 150 Theatre staff CPD Workforce Planning skills development 150 100 Simulation, human factors & technology based development 300 200 (Plus 1,200) Support for SAS doctors 665 665 Advanced practice – Primary Care / Community care: 825 900 Advanced Practice – Urgent / hospital care 875 900 Total funding 6,295 6,415 � Areas for CPD development in 2015/16 – Mental Health; Learning Disability; Theatre staff skills; HCS and diagnostics skills – sonography etc. � Areas for CPD development in 2016/17 – for discussion / inclusion in planning round which commences in September.
Wider Workforce Development – (1) Activity Budget 2014/15 Budget 2015/16 £’000s £’000s Public Health Workforce Development 300 400 Values Based Recruitment 50 n/a Frail Elderly and those with dementia/ 200 EoLC/Complex needs (+200k from 13/14) Integration: 300 1,700 1,700 Pioneer and Vanguard sites and the Integrated Pioneer and Vanguard sites and the Integrated Personal Commissioning Demonstrator site work Joint & Partnership working eg AHSNs (Patient 500 Safety) Quality Improvement methodology n/a Innovation: 1,400 1,000 (1m allocated) (maintain level of Innovation projects / pilots funded investment) National Dementia project 847 n/a Ambulance workforce 550 800 Clinical Leadership 500 500 tbc Total 4,400
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