Workforce Issues Paul Newell Deputy Head Workforce Planning

Workforce Issues Paul Newell - Deputy Head: Workforce Planning & Intelligence

Recent Workforce Trends

Key Staff Groups Supply Forecasts

Adult Nursing Acute, Elderly and General Nursing - South Region (FTE) 60, 000 50, 000 49791. 5 40915. 0 41449. 1 2014 2015 50080. 7 42809. 6 42779. 6 42180. 5 42783. 1 43484. 4 43987. 2 44359. 5 2016 2017 2018 2019 2020 2021 2022 30, 000 20, 000 10, 000 0 Staff in Post (SIP) Supply Forecast Gap between: 2019 Demand Forecast 2019 Supply Forecast FTE Gap Demand Forecast 50080. 7 42783. 1 -7297. 6

Mental Health Nursing (Acute & Community) - South Region (FTE) 10, 000 9355. 4 9, 000 9410. 7 8, 000 7918. 5 7585. 5 7391. 2 7342. 9 7447. 7 7625. 1 7740. 1 7859. 3 7292. 7 2015 2016 2017 2018 2019 2020 2021 2022 6, 000 5, 000 4, 000 3, 000 2, 000 1, 000 0 2014 Staff in Post (SIP) Supply Forecast Gap between: 2019 Demand Forecast 2019 Supply Forecast FTE Gap Demand Forecast 9410. 7 7447. 7 -1963. 0

Childrens Nursing Paediatric Nursing (Acute & Community) - South Region (FTE) 7, 000 6238. 5 6, 000 6253. 5 5, 000 4546. 2 4649. 2 4781. 6 2014 2015 2016 4800. 5 4863. 0 2017 2018 5035. 8 5214. 3 5397. 0 5609. 6 3, 000 2, 000 1, 000 0 Staff in Post (SIP) Supply Forecast Gap between: 2019 Demand Forecast 2019 Supply Forecast FTE Gap 2019 2020 Demand Forecast 6253. 5 5035. 8 -1217. 7 2021 2022

Midwifery Gap between: 2019 Demand Forecast 2019 Supply Forecast FTE Gap 5244. 6 5383. 2 138. 5

Diagnostic Radiography Gap between: 2019 Demand Forecast 3517. 9 2019 Supply Forecast 3273. 3 FTE Gap -244. 6

Future Supply Issues Student Intakes

Programme 2016 -17 Starters 2017 -18 Starters 2018 -19 Starters Adult Nursing 3423 2448 2136 Mental Health Nursing 659 569 555 Childrens Nursing 445 431 472 Midwifery 593 578 493 Diagnostic Radiography 276 271 193 * 2018 -19 Starters as end of Q. 2

Future Supply Issues New Roles

Nursing Associates • The introduction of Nursing Associates across England aims to create a significant shift within the nursing and care workforce. • A new support role that will sit alongside existing healthcare support workers and fully-qualified registered nurses to deliver hands-on care for patients. • The NMC opens registration for newly-qualified Nursing Associates on 28 January

Nursing Associates • Wave 1 – 61 NAs have completed their training and can register • Wave 2 – Approx. 290 will qualify from March 2019 • Wave 3 - Just under 1, 100 TNAs over 33 cohorts started in 2018. To qualify over the course of 2020 • Wave 4 - The South’s target in 2019 will be between 1, 500 and 1, 750. To qualify over the course of 2021

Nursing Associates • Wave 4 will see different models of training which will likely include; • the Apprenticeship route, • individuals who may choose to self-fund and • employers may choose to sponsor their employees. • HEE will be setting out the support arrangements in place as they different models emerge. . • One example of a new models is being piloted in Wessex for overseas nurses who will undertake a shortened programme in order for them to achieve Nursing Associate status within 12 to 18 months

Physicians Associates • Physician associates are medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. • They act in an enabling role, helping to reduce the healthcare team’s workload • Physician associate support also provides cover so that trainee doctors can attend training, clinic or theatre.

Physicians Associates • Faculty of Physician Associates 2018 Census estimates that there are currently 600 PAs and up to 1, 600 students training to be PAs. Number of HEIs delivering the PA course. Wessex Thames Valley South West Kent, Surrey & Sussex By Autumn 2019; • Bournemouth University • University of Portsmouth • • • University of Reading • University of the West of England Plymouth University • • University of Surrey Canterbury Christ University Brighton & Sussex Medical School

Future Supply Issues International Recruitment

74. 2% 72. 8% 80% 71. 9% Registered Nursing, Midwifery and Health Visiting (% FTE) 70% 60% 50% 40% 8. 9% 10. 4% 11. 5% 8. 4% 7. 7% 7. 4% 10% 8. 4% 9. 2% 20% 9. 2% 30% 0% UK EU/EEA May 2016 May 2017 ROW May 2018 Not Stated

Vacancies

• Workforce plans are an opportunity to outline workforce shortages. • Last year’s process included a 2 year demand forecast for HEE • Required Staff in Post and Establishment data. • Provides an indication of current and likely future vacancies.

Registered Nursing, Midwifery and Health Visiting (FTE) 80, 000 70, 493. 30 70, 000 62, 727. 06 60, 000 50, 000 40, 000 30, 000 20, 000 7, 766. 24 10, 000 0 Actual SIP (FTE) 30/09/17 Actual Estab (FTE) 30/09/17 Actual Vacancy (FTE) 30/09/17

Assessment Process

• Data Quality – Are Trust occupation codes in ESR up to date using the latest guidance – Does the workforce plan align with ESR WTE numbers? • Triangulates with other Trust plans – Does the workforce plan align with finance, quality and activity plans to ensure that workforce levels are affordable and adequate to deliver safe care? • Aligns with overarching system-wide plans – How are staffing resources modelled to meet planned requirement including key areas such as mental health, cancer?

paul. newell@hee. nhs. uk Ashley. joyce@hee. nhs. uk