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Nursing Workforce Summit What the Medics are thinking and doing. Simon Plint Dean of Medical Education Commissioning. 1. Images of the NHS. 2. Economic Context. 3. National Training Context. 4. MPET Reduction. 5. Principles for South Central. 6. Illustration of Mismatch.

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nursing workforce summit what the medics are thinking and doing

Nursing Workforce SummitWhat the Medics are thinking and doing

Simon Plint

Dean of Medical Education Commissioning

slide2

1. Images of the NHS

2. Economic Context

3. National Training Context

4. MPET Reduction

5. Principles for South Central

6. Illustration of Mismatch

6. Our Shared Challenge

slide10

Expenditure

  • Highest spending since 1982–83
  • Lowest tax burden since 1960–61
  • Highest borrowing since WWII

£178bn borrowing this year

Receipts

slide11

Do we have a 'General McChrystal moment' on the way?

  • Nicholson said the government plans raised big issues that were being 'hotly discussed and disputed'
slide12

NHS chief executive Sir David Nicholson has launched a scathing attack on health secretary Andrew Lansley's proposals for handing over commissioning responsibility to GPs

  • Sir David also turned his fire on the ability of GP commissioners, saying that if PBC groups were rated on the quality of their commissioning on a scale of one to 10, even the best were ‘only about a three’
slide15

South Central Facts and Figures

  • 3400 Trainees
  • 2800 MADEL Salary Support
  • 600 Trust Funded
  • £122m MADEL Budget
  • Nearly 90% Salary Support
  • Only 2.7% Management Costs
slide16
National Context

Overall reduction nationally in junior doctor training numbers

From 7500 in 2007 down to 6500 in 2011

Balance between Hospital and GP

slide17
National Context

Future numbers of commissions should be based on projected future service need

Services should be planned around delivery by trained practitioners and move away from dependence on junior doctors

slide18
Temple Report

Time for Training

High quality training can be delivered within the reduced number of hours available but fails if trainees:

• have the major role in providing out of hours service;

• are poorly supervised; or

• have limited access to learning.

slide19
Temple Report

Time for Training

Hospitals remain too reliant on junior doctors to provide out-of-hours services

Service needs to be redesigned so consultants work more flexibly and more "directly responsible" for patient care around the clock

slide22

MADEL Reduction 14%

  • Management cost reduction of 30% across deaneries would only save 1%
  • 14% reduction in MADEL investment equivalent to £17m
  • 14% reduction in MADEL training activity equivalent to 390 doctors
slide23

Principles for South Central MPET Review

  • MPET should be invested on the principle of supplying the local workforce
  • Investment should be proportionate to future service need, with a duty of care to the tax payer and students to commission neither an oversupply nor undersupply of health professionals
  • The long term outcome of the MPET reduction should be a sustainable steady state investment plan which will supply the future service need of South Central
slide24

Principles for South Central MPET Review

  • Can we be smarter than simply reproducing the existing workforce, and anticipating and shaping the future workforce?
  • At time of disinvestment, consideration should be given to prioritising retraining of the existing workforce rather than training new workforce
  • Role substitution
slide27

General Surgery - NationalSupply Forecast

Source – 2009 WRT Supply Model

slide28

RETIREMENTS

ST7

ST6

ST5

ST4

ST3

CT2

CT1

slide29

ST7

ST6

ST5

ST4

ST3

CT2

CT1

slide30

ST7

ST6

ST5

ST4

ST3

CT2

CT1

slide32
O&G - NationalSupply Forecast
  • Source – 2009 WRT Supply Model
slide33
Our Shared Challenge
  • Ensuring MPET envelope invested for future workforce supply
  • Avoiding / deliberately destabilising service provision?
  • What opportunities for service redesign and role substitution?