1. WORKFORCE PLANNING June 2011 Amr Fouad Training & Research Sector Ministry of Health & Population

2. Presentation Outlines Introduction Overview on Workforce Planning Model Model Applications: Examples for Model Results Conclusions and next steps 2

3. 3 Human Resource in Egypt

4. Why Egypt? 4

5. Human Resource Challenges in Egypt Egypts Health reforms in hospitals and the Family Health Model require changes in staff skills and mix. Workforce distribution poorly allocated: Between urban and rural areas Between primary, secondary, and tertiary care Among different specialties New management skills due to increasing complexity of health systems. The need for linking training programs to actual staffing needs. 5

6. Development and Application of Workforce Planning Model in Egypt

7. Objectives of our Work Identify a good methodology to plan the number and type of staff needed Build MOHP capacity in workforce planning Develop Egyptian standards for Health Workforce Develop a strategy report on long-term MOHP workforce plan 7

8. What is the Workload Indicators of Staffing Need (WISN) Model? The Health Systems 20/20 adapted the World Health Organizations Workload Indicators of Staffing Need (WISN) methodology to the Egyptian context. The method uses expert-generated activity standards and the observed volume of services at a hospital to estimate numbers of workers needed. 8

9. Why the WISN Model? 9

10. Traditional Methods vs. WISN Model 10

11. 11 WISN Results in two Fifty-bed Hospitals Source: S. Ozcan et al. 1998. Determining hospital workforce requirements: a case study. Human Resources for Health Development Journal (HRDJ) Vol. 3 No. 3

12. Workforce Planning Model Determines staff requirements based on actual Workload or Service Volume 12

13. 13 Expert Opinion Panel Local Labor/HR Laws Facility Records 1. Clinical & nonclinical activities of heath workers (e.g., Outpatient exam., admin., training) 1. Clinical & nonclinical activities of heath workers (e.g., Outpatient exam., admin., training) 2. Activity standards (Time per activity) 2. Activity standards (Time per activity) 3. Total available working hours 3. Total available working hours 5. Actual workload or annual service volume (e.g., no. of patients, surgeries, admission,..) 5. Actual workload or annual service volume (e.g., no. of patients, surgeries, admission,..) 4. Standard workload 6. Staffing Needs or Number of Workers Required (R) 6. Staffing Needs or Number of Workers Required (R) 8. Workforce Ratio 7. Workforce Gap Workforce Planning Model in Egypt

14. Activity Standards What are Activity Standards? Time it takes a trained and well-motivated staff member to perform the action to acceptable professional standards in the circumstances of the country. 14

15. 15 Activity Standards: Example

16. Establish Standard Workloads What are Standard workloads? Amount of work (within one activity) that one person could do in a year, e.g.; Full time Specialist in General Surgery performs: 16

17. Example of Standard Workloads 17

18. Determine Required Staff Actual Workload for activity R = Standard workload for activity 18

19. What Does the Model Measure? 19

20. 20 What is WP Model can Do? Can Do - Estimate the Required Staff based on workload - Workforce Gap - Workforce Ratio

21. 21 User-friendly Access-based software was developed to estimate the gap between available and required staff, and quantify shortages and surpluses of workers.

22. Build MOHP Capacity in WP (Taskforce & Governorate Teams) 22

23. Build MOHP Capacity (Hospital Teams) 23

24. Build MOHP Capacity (Data Entry Training) 24

25. Build MOHP Capacity (Data Verification OJT) 25

26. Set Activity Standards 26

27. Challenges with ROUTINE DATA MOHP lacks personnel database Patient registration and records are incomplete Lack of activity standards for health services Inconsistencies between reported and actual workload Data on severity and case mix are absent or inaccurate Necessary to do: Data collection Special studies Estimates 27

28. Challenges with POLICIES & ORGANIZATION Top-down assignment of staff Current policies E.g. minimum staff required even if workload is zero! To maximize benefit of workforce planning need: HR strategy Institutional home Steering committee to engage policy makers 28

29. Results of Workforce Assessment in one of the Pilot Governorates 29 Example of Egypt Workforce Analysis Results

30. Current Staff Profile Staff Composition 30

31. Current Staff Profile Hospital Staff Flow (Percent Gain and Loss) 31

32. Current Staff Profile Registered vs. Actually Working Staff 32

33. Current Staff Profile Retirement: Staff Distribution by Age 33

34. Current Staff Profile Years of Experience of Hospital Staff 34 Least Experience

35. Workforce Gap Analysis Results

36. Gharbia hospitals have surplus in all staff types. Gap between Current and Required Staff 36

37. Physicians Gap Analysis 37

38. 38 Physicians Gap Analysis across Hospitals in Gharbia Governorate

39. Nurses Requirements by Specialty

40. Other Staff Requirements Staff TypeCurrentRequiredGAPRatio Dentists9245472.0 Pharmacists2871171702.5 Admin Staff170711285791.5 Medical Technicians Dentistry7310637.3 Lab.10749582.2 Radiology2211620513.8 40

41. 41 Next Steps Application in primary health care facilities (PHCs), other type of hospitals and other sectors. Designing training programs in response to actual staffing needs. Using results of workforce assessment as a basis for developing workforce plans. The workforce standards should be officially adopted by the MOHP.

42. 42 Conclusions An effective, valid workforce planning model was developed for the Egyptian context. The model quantified the magnitude of staff imbalances by governorate, specialty, and staff category. Implications Policies are needed to close the gaps observed between the need for and supply of health workers for all levels of service provision.

43. Thank you