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Applying scenario methods to health and social care workforce planning
Dr. Graham WillisHead of Research and Development, CfWIE: [email protected]: +44(0)78 1234 0405
What we used to do…
Do we trust this?
Trai
ne
d h
osp
ital
d
oct
ors
(K
)
60
50
40
30
Year2014 2040
Supply
Demand
?
Policy
What if the future is not what we expect?
Failure
Megatrends
ProblemSystem
Events
Scan the horizon
Imagine challenging futures
Stress test interventions
Shape your future
High degree of stakeholder involvement in all stages
Define the enquiry
Robust workforce planning
Horizon scanning
Contextualanalysis
Issues
Factors
Events
Ideas about the future
Systemic analysis
Scenario generation
Influencing factors
Keyfactors
Consistency check
Narrative scenarios
Delphi to quantify
Modeling and simulation
Demand side
OutputsSupply
side
Nu
mb
er
of
ph
arm
aci
sts
(fu
ll-ti
me
eq
uiv
ale
nt)
20
12
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14
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16
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28
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100,000
80,000
60,000
40,000
20,000
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100,000
80,000
60,000
40,000
20,000
0
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20
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20
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20
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20
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20
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30
20
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20
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20
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20
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20
40
100,000
80,000
60,000
40,000
20,000
0
20
12
20
14
20
16
20
18
20
20
20
22
20
24
20
26
20
28
20
30
20
32
20
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36
20
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20
40
100,000
80,000
60,000
40,000
20,000
0
Year
Scenario 1
Scenario 3
Scenario 2
Scenario 4
Pharmacy: how uncertain is the future?
Policy options
-20%
-35%
-50%
-5% -10%-15%
A B C D E F
+3%
One-off supply reduction Phased supply reduction
then balancing increase
5 Years 10 Years
Polic
y o
utc
om
es
Pharmacy examplePolicy analysis
2
31
4
Policy options: A
B
C
DE
F
A new challenge: Horizon 2035
What skills and competences do we have?
What might we need in future?
What had we modelled in 2013?
HealthPublic healthSocial care
2%
98%Workforces not yet
modelled
Workforces modelled to date
What about the rest of the system?
HealthPublic healthSocial care
10% Other health and support
21% Paid adult care and support
24%
Volunteer adult care and support
43%
Unpaid adult care and support
2% Workforces modelled to date
1. Too many Delphi questions!2. Only four scenarios?3. We don’t know what skills are
needed to meet future demand.
Some embarrassing problems……mostly resolved!
Solution 1: SHELF
Sheffield Elicitation protocol
Monte Carlo simulation P
rob
abili
ty
Value
Solution 1: Expert elicitation framework
SHELF
EFSA Delphi
Traditional Delphi
Intensity of effort
Number of parameters
Solution 2: GBN method
‒A
+A
‒B +B
+C
‒C
+D‒D
Solution 2: CIB Analysis
Population GDP growth Energy usageCarbon
emissions
High
LowCA
B
Solution 3: Skills framework
Competences
Skills
FacilitationLeadershipWellbeing
Knowledge Personal
Types of skill
Level of skill
Quantitative skills
Qualitative skills
What skills do you have today?
Prevent
Enable
Assess
Plan
Treat
Rehabilitate
Relieve
Link
Skill types
Adult social care
Nurses
Dentists
Medical generalists
Medical specialists
Volunteer care and support
Other workforce groups
Workforce groups
What drives the demand for skills?
Po
pu
lati
on
Population
Learning disabilities
Oral health
Singular demand for service
Maternal and perinatal
Infectious disease
Mental long-term conditions
Physical long-term conditions
Demand
How do our skills met demand?
Po
pu
lati
on
Population
Learning disabilities
Oral health
Singular demand for service
Maternal and perinatal
Infectious disease
Mental long-term conditions
Physical long-term conditions
Demand
1 2 3 4 5
Levels
Prevent
Enable
Assess
Plan
Treat
Rehabilitate
Relieve
Link
Skill types
Adult social care
Nurses
Dentists
Medical generalists
Medical specialists
Volunteer care and support
Other workforce groups
Workforce groups
How do our skills meet demand?
Po
pu
lati
on
Population
Learning disabilities
Oral health
Singular demand for service
Maternal and perinatal
Infectious disease
Mental long-term conditions
Physical long-term conditions
Demand
5
Levels
Prevent
Enable
Assess
Plan
Treat
Rehabilitate
Relieve
Link
Skill types
Unpaid adult social care workforce
Nurses
Dentists
Medical generalists
Medical specialists
Volunteer care and support workforce
Other workforce groups
Workforce groups
Different futuresSix narrative and quantified scenarios
How does skills demand change?Reference future
9.3 billion hours FTE: 5,735,000
12.7 billion hoursFTE: 7,772,000
Change:Hours: 3.3BnFTE: 2,037,000 +36%
How does skills demand change?Monte Carlo simulation
x
Change in demand
Demand (B) Skill level (B)2.1
LTC Physical health
0.7
LTC Mental health
0.4
Learning disabilities
0.3
L3
0.6
L2
2.3
L1
Next steps
1. Multi-scale scenarios and reuse.2. Probability of scenarios?3. Presenting findings to policy makers.
More information
Horizon 2035 Future demand for skills: Initial results
http://www.cfwi.org.uk/publications/horizon-2035-future-demand-for-skills-initial-results
Applying scenario methods to health and social care workforce planning
Dr. Graham WillisHead of Research and Development, CfWIE: [email protected]: +44(0)78 1234 0405