Workforce Update Charlotte Lawson Workforce Transformation Programme Manager Karen Ceesay Human Resources Collaborative Project Manager

Vision In order to deliver our ambitious service transformation Plans, we need to ensure we have a secure supply of people with the right skills and behaviours to deliver new service models and ways of working.

Scoping Workforce Challenges Difficult to attract and retain key staff groups General Practitioners & Practice Nursing Senior medical staff in acute medicine & emergency department Hospital pharmacists Residential care nurses Children’s social workers Home care staff Unsustainable use of agency staff Competition between providers for staff Potential loss of staff through early retirement High levels of stress and burnout Expectation of reduction in workforce cost to system

General Practice Workforce Deep Dive Date from multiple sources: NHS Digital Office For National Statistic (ONS) National Patient Survey Local Workforce survey Health Education England data GP practice clinical systems

Initial findings – General practice landscape 41 GP practices that service the four localities 27 in Mansfield & Ashfield (pop, 191,572) 14 in Newark & Sherwood (pop, 133,084) Higher that national average patients per GP ratio in M&A when benchmarked to East Midlands & National picture N&S – 60 FTE GPs (17 % aged 55-59) 2% >60 M&A – 77 FTE GPs(12 % 55-59) 6% >60 EM range Lincoln East 23% 55-59 – Hardwick 2%

Initial findings – Population M&A Ranked 53/209 indices of multiple deprivation N&S 127 (the most deprived CCG is given a rank of 1, and the least 209) Disease burden (patient proportion aged 65 and over) M&A 19%, N&S 22% (Nationally 18%) Nottinghamshire is expecting a 3.3% increase in population over the next 5 years, Nationally 3.7% (M&A, 2.6, N&S 3.3)

Initial Findings – Practice workforce 28/41 practices completed the survey 10/28 Practices reporting current GP Vacancies 22 Vacancies in total/ mix of partner, salaried, trainee and retainers Most Vacancies Salaried GP (10) On average each vacancy advertised 3x 10/28 Practices reporting PN Vacancies 18 vacancies in total 17 staff members expecting/considering reducing their hours 20 staff expecting/considering retiring in the next 5 years (7 of which GP Partners) 15 practices report they use locums 10 Practice reported locum spend average 49k range 2-115K

Initial Findings - Capacity Practice list size range 2,800 – 18,800 (6 fold) Larger practices deliver more appointments per capita Average number of appointments per person strongly correlated with age Small variation in appointment duration by patient age, with majority between 10 and 11.5 minutes Patients cancel around 7% of appointments, and DNA around 4% - a further 2% are cancelled by practices

Summary High patient GP ratios Multiple vacancies/ vacancies to staff ratios high 18% of the GP workforce aged 55 and over Population aging, older population use more appointments Population growing Variation in sessions delivered Larger practices more efficient Appointments wasted via DNA

Opportunity GP Example

Retention Return to practice scheme – for GPs who have had a career break GP Retainer scheme – offering salaried roles for GPs who no longer want to be full time partners More to do on…… Wellbeing of the workforce Portfolio careers Working more closely together to share workload (Federating)

Recruitment New Roles in Primary Care - GP Forward View Bursaries for GP Training Scheme - attract Drs to Mid-Notts Fellowships - Encouraging newly qualified GPs to stay in the area International Recruitment – Offering opportunities for EU GPs New Roles in Primary Care - GP Forward View Physician Associates Pharmacists Mental Health Therapists More to do on……promoting careers in health

Opportunity Flexible Workforce

Making Better Use of the Existing Workforce Allows organisations to share staff resources in a safe and cost effective manner Matches demand to the pool of regional supply across the system – reduces the agency spend and reduces reliance on agency staff

Benefits for Staff (and the patient) Improved choice and flexibility for NHS staff and opportunities to gain experience in other health environments Reduction in unsafe working practices (everything is visible within one system) Supports retention and recruitment of staff within our system

Initial Focus Initial focus on Nursing…….. (Healthcare Assistants and Registered Nurses) Possibility of extending the scheme to include other staff groups such as Doctors (including GPs)