Workforce Plan for England - a summary

What is it?

Health Education England (HEE) is responsible for commissioning the education and training of the health service workforce in England.  This has facilitated the creation of a budget ring-fenced for the training of the undergraduate and post-graduate English healthcare workforce, covering 110 different roles across 129 structured programmes of education. In December 2013, HEE published the first national NHS workforce plan for England.

How has HEE done this?

The new programme is designed, in HEE’s own words, to ‘meet the care needs of future patients’ by ensuring a balanced workforce. It has set about the process by taking a ‘bottom up’ approach; first estimating commissioning needs by gathering information from NHS care providers and stakeholder groups that, in turn, has been fed into the LETBs. This data has been triangulated with other bodies, including those representing of the medical workforce such as the Royal Colleges, to ensure consensus across the board.

The LETBs have formulated a local plan that follows national guidance through a process of ‘review and challenge’, culminating in aggregation of the data at national level by HEE. In doing so, they have taken into account number of other factors that may affect the workforce, for example, natural attrition during training or those returning to work after a career break.  

What does it mean for the medical workforce?

HEE predicts continued growth of the consultant workforce over 4% per annum which is built into the system up to 2020 due to the inherent lag time largely resulting from the length of training. The GP workforce is planned to continue growth at 2.7% per annum, which again, is in line with growth over the previous years.

In specific areas that historically have difficulty in recruiting or retaining staff such as Emergency Medicine, efforts have been made to improve the situation through a number of methods including tapping into the overseas market and increasing in the number of training places. There are also plans to improve retention at a junior level by coupling basic training to higher specialist training by rolling out run-through posts. Other areas have seen a reduction in the number of training posts such as core surgery where traditionally there has been an ‘over-production’.

Limitations

HEE recognises that it has inherited not only a training system in the process of change but also a health service that is undergoing significant reform. As a result, significant gaps in the data mean that predictions may not always be accurate and this is combined with a lack of understanding and clarity around the needs of population which it aims to serve. The organisation is working closely with other groups, such as the Department of Health on the Workforce Information Architecture Project, in an attempt to fill these gaps.

The workforce plan has developed from local intelligence and data from Trusts and LETBs and as such their local predictions of workforce demands may be conservative and reflect what they can afford and not what is needed by the local population.

What does the future hold?

Although not perfect, the national workforce plan has made attempts at predicting the workforce  based on the needs of patients i.e. ‘demand driven’,  rather than the previous methods that looked at planning through, as HEE puts it, a ‘professional lens’.

From a medical point of view it wants the workforce to become more flexible, moving away from a hospital based, consultant lead model and into the community. The plan also recognises other factors that may affect future commissioning around the medical workforce, in particular, the Shape of Training review that sets out new pathways for medical training.

In addition to increasing the numbers of posts, HEE will also have the power to decommission in areas that have numbers in excess of the predicted requirements. Future changes may also reflect gaps in the medical workforce by meeting patient needs through alternative means such as expansion of physician assistants or nurse practitioners.

To find out what it means for you and look at the workforce plan in detail, you can visit the HEE website. You can also look out for the HEE Strategy Framework which is due to be published in May 2014 and will outline the next steps in workforce planning.