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NHS GRAMPIAN. SERVICE REDESIGN STRATEGY WORKFORCE IMPLICATIONS & PLANS. FORCES AND DRIVERS. Ageing population - demand & supply Health of local population eg 52% overweight Working time regulations - medical workforce Desired patterns of work Skills shortages in some specialities.

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Nhs grampian l.jpg

NHS GRAMPIAN

SERVICE REDESIGN STRATEGY

WORKFORCE IMPLICATIONS & PLANS


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FORCES AND DRIVERS

  • Ageing population - demand & supply

  • Health of local population eg 52% overweight

  • Working time regulations - medical workforce

  • Desired patterns of work

  • Skills shortages in some specialities.


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SUGGESTED SOLUTIONS

  • Reduce demand - improve health / selfcare.

  • Improve flow of work (increase day case, extract intermediate care, Community based work-up and DTCs.

  • Manage demand - MCNs / referral protocols.

  • Telemedicine / automation.

  • Improve recruitment & retention - flexible working patterns.

  • The multi-professional team - flexible roles / less ‘hand off’.

  • Growth of the generalist.


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SOME FACTS & FIGURES

  • NHS Scotland - 6% of workforce grown by 9% over 10 years.

  • Grampian unemployment under 2%, local employers predicting 35% increase in workforce.

  • Grampian Consultant Nos increased c4% per annum - long training time (c14 years). & now increasing for GPs.

  • c50% of social care workforce in Grampian employed by private sector.

  • In NHS Grampian low turnover and high stability - particularly locally trained staff - value of ‘growing your own’.


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NHS GRAMPIAN - STRATEGIC FRAMEWORKFOR WORKFORCE PLANNING (2003)

  • Integrated workforce and Service Plans.

  • Workforce Plans for Multi-Professional Teams.

  • Workforce Plans supporting whole system patient journey approach.

  • Linking with education providers.

  • Underpinned by information and intelligence.

  • Meeting needs of local population with appropriate Regional and National links.


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WORKFORCE PLANNING IN KEY SERVICE REDESIGN PROGRESS

  • Unscheduled Care

  • Planned Care

  • Integrated Care


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Where are we now

GMS OOH - multi-professional framework.

The start of joint training & protocols.

The commitment of clinicians.

What next

Development of primary and secondary care competency/training framework.

Local triage/MCN.

Reward Strategy.

SERVICE REDESIGN - UNSCHEDULED CARE

Aim - integrate primary & secondary care services


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Where are we now

Facing medical workforce redesign.

Facing skills shortages eg radiology/radiography.

Developing network of GPs with specialist interests.

AfC facilitating development of non medical clinics.

What next

Need to link with Hospital @ Night project.

Actively develop cross professional/cross domain solutions to medical workforce redesign.

Actively develop redesign/recruitment strategies for radiology/ radiography & labs.

PLANNED CARE

Aim - extended working day/development of specific inter mediate care services/expand diagnostic facilities/ non medical led clinics.


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Where are we now

Baseline workforce plan Aberdeen City and Old Age Psychiatry.

Commitment to redesign among clinicians.

Commitment to develop assistant practitioner roles

Recruitment difficulties.

What next

Further develop & agree priorities within workforce plans.

Develop assistant practitioner career pathway.

Redeploy skills of hospital based staff.

Importance of team building/joint training & education.

INTEGRATED CARE

Aim - reduce beds & develop community based alternatives. Close alignment of specialist teams with community teams/step down facilities/rapid response.


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WORKFORCE PLANNING PRIORITIES

  • Design of multi-professional teams in unscheduled care.

  • Medical workforce redesign - impact on service/Hospital @ Night/multi-professional team/intermediate care/regional dimension/change in culture.

  • Intermediate care - specialist interest GP/ non medical led clinics/recruitment & redesign specialist diagnostic staff.

  • Integrated care - build on baseline plans.assistant practitioner role.

  • Workforce planning infrastructure

    - links with service redesign/ education/region/national.

    - availability of workforce intelligence/planning tool.

    - formulating communication & involvement strategies.

    Do you agree?

    But - capacity and commitment?


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