NHS Board Workforce Projections 2017 NHS LANARKSHIRE Table of Contents 1. Overall 1.1 Comments / Data Quality Issues / Direction of Travel 1.2 Brief Information on Workforce Cost Savings (non-staff) i.e. Bank/Agency usage, overtime and excess etc. 1.3 Please note how workforce changes are being driven by the implications of an older or ageing workforce 2. Medical and Dental 2.1 Comments / Data Quality Issues / Direction of Travel / Service and Speciality Issues 3. Medical and Dental Support 3.1 Comments / Data Quality issues 3.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 4. Nursing and Midwifery (Excluding Interns) 4.1 Comments / Data Quality issues / Workload and Workforce Planning Tools 4.2 Assumptions Include direction of travel, changes resulting from legislative or policy developments, service redesign and configuration for Nursing and Midwifery workforce, Advanced Practice and Support Workers 5. Allied Health Profession 5.1 Comments / Data Quality Issues 5.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 6. Other Therapeutic Services 6.1 Comments / Data Quality Issues 6.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 7. Healthcare Science 7.1 Comments / Data Quality issues 7.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 8. Personal and Social Care 8.1 Comments / Data Quality issues 8.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 9. Ambulance Services 9.1 Comments / Data Quality issues 9.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 10. Support Services 10.1 Comments / Data Quality issues 10.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 11. Administrative Services and Management 11.1 Comments / Data Quality issues 11.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration
11.3 Health and Social Care Transfers
1. Overall 1.1 Comments / Data Quality Issues / Direction of Travel 1.2 Brief Information on Workforce Cost Savings (non-staff) i.e. Bank/Agency usage, overtime and excess etc. NHSL are projecting an increase in workforce of 27.7 WTE This is required to support services changes mainly in: Health Visiting Ophthalmology Acute Services Out if Hours With this it should be noted, NHSL assumes all additional workforce requirements generated from emerging National polices will be fully considered and funded centrally. Consequently, any such change will be additional to this projection. Medical Locum costs over the last year amounted to 12.04m. The average total nursing resource utilised per months during 2016/17 was 5,745.41 WTE - this includes in-post, bank, Agency, overtime and excess hours. There is ongoing local work to reduce the Locum and Agency spend in 2017/18. This will be achieved by greater reliance on more cost effective staffing models e.g. filling vacancies, staff bank, fixed term contracts, overtime and excess hours. 1.3 Please note how workforce changes are being driven by the implications of an older or ageing workforce Changes to the local population and labour market require NHSL to plan the future workforce now. The population of Lanarkshire are living longer and expected birth rate is falling, therefore there is a continuing shift towards a more elderly population. Over the next 20 years there will be nearly 37,300 more people aged 75 and over, an increase of 76% which will have an impact on population health and social care needs. Over the same period, the working age population is predicted to decline with a reduction of 5.9% in North Lanarkshire and similarly a reduction of 5.5% in South Lanarkshire by 2037. The estimates take into account the future changes in the state pension age. Consequently, the age profile of the NHSL workforce will change. 2. Medical and Dental 2.1 Comments / Data Quality Issues / Direction of Travel / Service and Speciality Issues The figure 1011.10 WTE is inclusive of medical locums (variance relating to ISD Coding) Medical staffing continues to present a challenge for recruitment. The Board has been successful in recruiting to Consultant vacancies in Paediatrics, Orthopaedics, Anaesthetics, Ophthalmology, Care of the Elderly, Acute Medicine, General Surgery, Breast Surgery, Urology and Rheumatology. Neonatology, Histopathology and Dermatology have regrettably been unsuccessful.
There continues to be a mixed response to recruitment for Specialty Doctors with success in Emergency Medicine, Care of the Elderly, Breast Surgery, Sexual Health and Orthopaedics but with on-going challenges in Mental Health and General Surgery. In addition to the traditional recruitment routes, which include advertising and sourcing Agencies, there have been further initiatives undertaken within the Board which include: International Medical Recruitment; International Medical Training Fellowship; Joint Academic and Service Consultant. It is hoped that these initiatives will help address some of the recruitment challenges. 3. Medical and Dental Support 3.1 Comments / Data Quality issues 3.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 4. Nursing and Midwifery (Excluding Interns) 4.1 Comments / Data Quality issues / Workload and Workforce Planning Tools NHSL continues to review all NMAHP workforce areas to identify and rate existing NMAHP workforce risks with a view to develop risk management strategies and prioritise areas for future NMAHP workforce / workload analysis. The Nursing & Midwifery Workload and Workforce Planning tools (NMWWP) are utilised throughout this process and the exercise has highlighted 5 key areas for review over 2017/18; namely o Mental Health - Community o Addictions o Theatres o Prisoner Healthcare o GP Hospitals - South Routine completion of the following Nursing Workload tools will continue in order to maintain trend data and comply with mandatory national runs; Adult Inpatient tool Neonatal Maternity (Inpatient & Community) SCAMPS (Paediatric Inpatients) CCSN (Community Childrens Nursing) 4.2 Assumptions Include direction of travel, changes resulting from legislative or policy developments, service redesign and configuration for Nursing and Midwifery workforce, Advanced Practice and Support Workers The figure 5,242.6 WTE has a variance of 17 WTE to the ISD Data (variance due to ISD Coding) NHSL has recently reviewed its position regarding the national funding allocation for Health Visiting and has reported: The national funding allocation does not fully support the necessary increase of 37.7wte health visitors
Attrition from retiral and turnover equates to circa 15wte and therefore the Board requires funding to support the training of student health visitors on a recurring basis Expanding the funded establishment is not possible currently as we have been unable to recruit adequate numbers and therefore the funding available is being utilised to support students in training Practice support from the current workforce can be provided for a maximum of 30 students per year The allocation did not take account of Boards existing vacancy factor and the requirement to support health visitors in training to reduce vacancy numbers 5. Allied Health Profession 5.1 Comments / Data Quality Issues 5.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 6. Other Therapeutic Services 6.1 Comments / Data Quality Issues 6.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 7. Healthcare Science 7.1 Comments / Data Quality issues 7.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 8. Personal and Social Care 8.1 Comments / Data Quality issues 8.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 9. Ambulance Services 9.1 Comments / Data Quality issues 9.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration 10. Support Services
10.1 Comments / Data Quality issues 10.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration It is anticipated that portering services will reduce by 2 WTE in 2017/18 due to natural turnover. 11. Administrative Services and Management 11.1 Comments / Data Quality issues 11.2 Assumptions - Include direction of travel, changes resulting from service redesign and reconfiguration It is anticipated that admin services will increase by 1 WTE Band 4 to support ophthalmology service redesign. It is also anticipated that admin services will decrease with 0.5 WTE Band 2 through natural turnover. Therefore the in year change is projected to be an increase of 0.5 WTE. 11.3 Health and Social Care Transfers