Transcript Who will do the work? A whole system approach to workforce planning Dr Paul Forte The Balance of Care Group.

Who will do the work?
A whole system approach to
workforce planning
Dr Paul Forte
The Balance of Care Group
The Issue
• There are pressures to:
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Maximise health and social care resource efficiency
Innovate with new care pathways and technologies
Work across organisations
Provide high quality care
Offer patient choice and carer support
• This requires analysis of:
– types of patients and their needs
– implications for number and type of care staff
required
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Number of patients
Who are the patients?
Admission reason (n = 479)
140
120
100
80
60
40
20
0
Community
Addenbrookes
Alternatives to acute care on day of
survey
Preferred Alternatives for Selected Patients
(Acute = 107, Community = 67)
100
90
80
No of Patients
70
60
50
Acute
40
Community
30
20
10
0
Home based
care
Mental Health Non-acute Bed
Care
- no rehab
Rehab Bed
Other
Potential Changes in Care Location
Community
Care
48
46
35
Acute Hospital
Community
Hospitals
15
16
Care Homes
Community care workforce
implications – by dependency
Weekly Input per Care Package
Input required to meet demand previously met in hospitals
19
12
10
41
Additional WTE to meet additional demand
Additional WTE introduced since survey date
Dependency Level
High
Medium
Low
Therapy
Nursing Care Assistants
Hours per week Visits per week Hours per week
7
7
21
3
3
10.5
1
3
High
Medium
Low
Total per week
Capacity/WTE p.w.
WTE
133
36
10
179
25
7.2
133
36
0
169
40
4.2
399
126
30
555
30
18.5
New services WTE
13.8
5.1
n/a
Implicaciones de la mano de obra
asistencial-por dependencia
Weekly Input per Care Package
Input required to meet demand previously met in hospitals
19
12
10
41
Additional WTE to meet additional demand
Additional WTE introduced since survey date
Dependency Level
High
Medium
Low
Therapy
Nursing Care Assistants
Hours per week Visits per week Hours per week
7
7
21
3
3
10.5
1
3
High
Medium
Low
Total per week
Capacity/WTE p.w.
WTE
133
36
10
179
25
7.2
133
36
0
169
40
4.2
399
126
30
555
30
18.5
New services WTE
13.8
5.1
n/a
By staff grade and location
Grade
Senior 1
Senior 2
Assistant
Clerical
Total
Day
Community
Current Outpatient Hospital Inpatient Addition
0.5
0.5
0.62
0.31
1.5
1.5
0.83
1
0.5
0.22
0.78
2.22
2.78
0.83
1.62
0.81
Total
1.93
3.83
1.5
1
8.26
Potential consequences
• Importance of better - and more creative local ‘population management’ in primary
care
• Community-based services could broaden
scope to provide extended rehabilitation for
many patients
• Significant ramifications for staff recruitment,
training and location
Future care trends
• More ‘active rehabilitation’ in the community:
hospitals, care homes, clients’ own homes
• Blurring of boundary between health and social care
environments
• More flexibility and devolution of tasks within and
between care professions
• More active ‘upstream’ management
– chronic disease management
– risk management of frail elderly in the community
– health promotion
A whole system approach
• Symbiotic relationship between acute and
community services, and between health and
social care
• Understanding the potential for alternatives to
acute hospital capacity is crucial for workforce
planning
• Bed usage surveys provide a local picture and
data for modelling potential future workforce
requirements