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

2. 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.

3. 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

4. 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

5. 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% – Hardwick 2%

6. 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)

7. 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

8. 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

9. 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

10. Opportunity GP Example

11. 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)

12. 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

13. Opportunity Flexible Workforce

14. 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

15. 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

16. 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)