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Nursing Workforce Summit What the Medics are thinking and doing

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

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  1. Nursing Workforce SummitWhat the Medics are thinking and doing Simon Plint Dean of Medical Education Commissioning

  2. 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

  3. Reorganisation, Reorganisation

  4. The NHS

  5. The NHS

  6. The NHS

  7. The NHS

  8. The NHS

  9. New Model – Same Function

  10. Expenditure • Highest spending since 1982–83 • Lowest tax burden since 1960–61 • Highest borrowing since WWII £178bn borrowing this year Receipts

  11. 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'

  12. 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’

  13. Workforce Planning - Steering the Super Tanker

  14. Gender Profile of Medical Undergraduates

  15. 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

  16. National Context Overall reduction nationally in junior doctor training numbers From 7500 in 2007 down to 6500 in 2011 Balance between Hospital and GP

  17. 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

  18. 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.

  19. 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

  20. MPET Reduction 14%

  21. Impact of MPET reduction £000

  22. 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

  23. 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

  24. 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

  25. CCT Supply and Demand Scenarios

  26. GP Demand & Supply Scenarios

  27. General Surgery - NationalSupply Forecast Source – 2009 WRT Supply Model

  28. RETIREMENTS ST7 ST6 ST5 ST4 ST3 CT2 CT1

  29. ST7 ST6 ST5 ST4 ST3 CT2 CT1

  30. ST7 ST6 ST5 ST4 ST3 CT2 CT1

  31. O&G - NationalSupply Forecast • Source – 2009 WRT Supply Model

  32. Our Shared Challenge • Ensuring MPET envelope invested for future workforce supply • Avoiding / deliberately destabilising service provision? • What opportunities for service redesign and role substitution?

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