Workforce Planning – Can we Face the Future Without it?

Workforce planning aims to creat a sustainable workforce that is centred around patient need, provides quality outcomes and is both deliverable and affordable.

The health sector in the UK employs almost 2.3 million people (Labour Force Survey 2016), and workforce spend accounts for an estimated 70% of the National Health Service (NHS ) healthcare budget (NHS England 2014). Employers in the UK and in Europe are faced with financial challenges, increasing demands being put upon services from people living longer with more complex conditions, the development of new technologies and new drug therapies. It is now more important than ever that organisations analyse how they are using their workforce and ensure that they use that workforce in the most effective and efficient way to provide good quality healthcare.

Workforce plans are required to ensure that people with the right skills, competencies and behaviours are able to meet patient needs both now and in the future. The overarching aims should be focused on creating a sustainable workforce that is centred around patient need, provides quality outcomes and is both deliverable and affordable.

At Skills for Health, we have a proven track record of working with employers to review their workforce planning processes and support them to develop operational and strategic workforce plans. Plans are developed working in partnership with a range of personnel across organisations, including a diverse mix of clinical staff, finance, learning and development and human resources professionals.

 
Planning for Service Sustainability

Over the last 18 months Skills for Health has worked with a number of organisations to develop robust workforce plans and is well placed to help the health sector (and beyond) with developing robust plans to ensure service sustainability for now and the future.

These have included:

1. Working with Oxford University Hospitals Foundation NHS Trust (OUH) to review its workforce planning processes and support them to develop divisional level workforce plans and a strategic fiveyear organisational workforce plan. For the first time ever, OUH have a workforce plan that is linked to service development, is based upon evidence of best practice in workforce utilisation and provides a clear rationale for change linking with their financial projections and assumptions. A key outcome of the work was building capacity and capability within OUH in order that they could build on the current plans to develop and embed workforce planning into their business planning cycle year on year. 
2. Working with States of Jersey-Health and Social Services Department (HSSD ) to develop a strategic workforce plan for its entire health and social care economy in light of substantial shifts in service provision from acute hospitals to primary and community care. This work also developed operational workforce plans for every service area and has clearly articulated scenarios and new ways of working that will ensure effective delivery of services for the future. The work has also supported the outline business case for a brand new acute hospital facility, and this demonstrates that Skills for Health’s ways of working support capital planning and investment decisions for major projects. 
3. Working with Bath and Nor th East Somerset (BANES ) Enhanced Medical Services+ and the 27 GP Practices within Bath & North East Somerset to develop a comprehensive workforce development initiative aimed at supporting the sustainability of general practice given the major challenges being faced. The work focused on identifying, alongside practices, key workforce priorities, which were felt could have maximum impact within the locality. As a result five areas were developed in detail (including sharing back office functions, increasing the supply of practice nurses, and freeing up clinical staff time through development of a personal assistant role), which provided practices with a comprehensive set of tools, resources and guides, which are supporting workforce change within primary care. 
4. Working with Health Education West Midlands to develop strategic workforce frameworks for integrated working across five health and social care local economies. The work used a ‘scenario planning’ approach, which challenged stakeholders to explore, using a set of ‘possible futures’ and population analysis, how both services and the workforce would need to change to support integrated working in the future. As a result of the process, each locality has been provided with a set of strategic workforce priorities, linked to key actions, which will form the basis of future planning for an integrated workforce across the West Midlands. 

Six Steps Methodology to Integrated Workforce Planning

At Skills for Health, we use the Six Steps Methodology to Integrated Workforce Planning as a means to develop a comprehensive and integrated workforce plan for a clinical pathway, organisation, individual service (clinical or non-clinical) or team (Skills for Health n.d.). Our Six Steps Methodology to Integrated Workforce Planning is a practical approach to planning that ensures you have a workforce of the right size with the right skills and competencies.

The Methodology identifies those elements that should be in any workforce plan, taking into account current and future demand for services, the local demographic situation and the impact on other services, whilst helping you work to the budget you can afford.

The Six Steps Methodology offers:

• a systematic practical approach that supports the delivery of quality patient care, productivity and efficiency
  
• assurance that workforce planning decisions taken are sustainable and realistic
  
• a scalable approach, from small ward-based plans to large organisations
  
• a joined-up approach with social care, where the same approach has been adopted
  

The Six Steps Methodology is based on:

• defining the plan
  
• mapping out the ser vice changes needed in response to demography, epidemiology and organisational priorities
  
• defining the workforce required to meet patient needs in the future
  
• exploring how to maintain an effective workforce supply
  
• action planning
  
• implementation, monitoring and review
  

The model integrates finance and service planning and incorporates evidence of best practice, the use of workforce data, national and international benchmarks, available tools and professional judgement. Workforce planning can be scaled to whatever the need be: strategic; looking at how health economies plan their future, or scaled down for specific services or teams at a more localised level.

A key element of effective workforce planning is a review of how roles are used now and how existing and new roles can be used in the future to improve productivity, efficiency and service quality. A key element of Skills for Health’s approach to workforce planning aims to:

• alleviate recruitment issues and supply shortages
  
• create additional workforce capacity
  
• develop attractive and interesting roles and careers to support retention
  
• improve patient outcomes
  
• improve workforce utilisation, by ensuring staff with higher level skills have the time to undertake the most complex activities
  

The Six Steps recognise not only the importance of the design of the workforce for the future but also the importance of the development of the current workforce. Sixty percent of the workforce that are employed now will still be employed in the healthcare sector in 10 years’ time, so it’s crucial we recognise them as a valuable asset, investing in their development so they can adapt according to changing needs. Workforce plans provide the means to systematically identify priority areas of skills development required to meet those changing needs.

The Six Steps methodology gives those who are using it the ability to:

• integrate finance, service and workforce planning and help to prevent silo thinking and planning
  
• ensure decisions that are taken are based on evidence and information
  
• ensure workforce decisions will meet service needs and that the workforce can be delivered in an affordable manner
  
• ensure workforce sustainability by examining workforce supply issues
  
• encourage innovative thinking and prompt individuals to question and not to accept the status quo as a default
  
• focus o n w hat i s n eeded r ather t han w hat w e currently have or want
  
• consider how best to meet the needs of a service
  
• enable consistency across services, divisions, organisations, pathways—a common language
  
• use straightforward terminology—doesn’t rely on ‘expert’ terminology
  
• provide for better communication and dialogue between those who are providing services on a day-to-day basis and those who are responsible for senior operational and strategic management No-one can foresee the future, but more effective integrated workforce planning puts us in a much better place to respond to the challenges the healthcare workforce faces now and in the future.
  

Skills for Health is well placed to work with all types of organisations around the important subject of workforce planning and its approach and methodology can be shaped to support the needs of all.

Six Steps lies at the very core of what we do as an organisation and we stand ready to support all sectors improve their workforce planning to meet the needs of tomorrow.

 
Further Information

For further information on the six steps methodology, please email [email protected] or visit skillsforhealth.org.uk .