South London Local Education and Training Board

Membership Council: Priorities Aurea Jones, Director of Workforce Martin Livesey, Head of Finance

Overview The aim of the session is to: • update the council on our workforce planning process for education commissions in 2014/15 • review how this has informed our emerging priorities for investment • debate our relative investment priorities between medical and non-medical future commissions and Workforce Development to inform the Board’s decision-making.

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Last time we met… We looked at the workforce planning process and ‘voted’ to: • protect ‘Continuing Personal & Professional Development’ or ‘Workforce Development’ funding • expand our planning to incorporate primary care and social care • Work with our Higher Education Institutions and Providers to improve attrition • Review salary support We provided background reading from the Kings Fund to support discussions today… Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Since June The Workforce Planning Advisory Group met and: • considered workforce and education planning processes for 2013/14 • looked at employer demand forecasts • considered the workforce supply model • reviewed outcomes from the process Medical workforce planning process is currently to: • Review quality data: GMC trainee survey, quality visit information, local specialty trainee surveys, performance indicators for commissioned specialties

• Review workforce forecast returns from lead employers • Once HEE finalise 2014 numbers, agree apportionment in London • Considered how changes to training may be implemented Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Since June During that time, we: • met approximately 250 stakeholders to test workforce demand and supply modelling, to arrive at a more accurate, and collaborative, vision of future workforce and education needs • met with other London LETBs and HEE national, and the Commissioning Board to ‘test’ our workforce planning assumptions • Held a Workforce Planning Board seminar to consider how we develop the process in future to meet our strategic challenges. This work is condensed to form our draft Investment Plan that the Board will consider in detail today.

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Informing our priorities Our HESL Five Year Workforce Skills Development Strategy •

Embedding a population health approach in all we do

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Developing Community Education Provider Networks

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Supporting service transformation through workforce development, excellent education and training

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Supporting the development of inter-professional training to improve the delivery of integrated care

The King’s Fund Analysis

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Workforce and service design go hand in hand: the workforce must be aligned to the work, not the other way round.

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Health and social care is a team game: developing effective teams is just as important as individual excellence.

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Reverse the ‘inverse training and investment law’: some funding should be switched from training the most highly qualified professionals to training health care assistants and other unqualified staff.

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Most of the future workforce is already working in the NHS: more of the training budget should be spent on continuing professional development of existing staff.

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Support nationally, act locally: locally led change supported by a national framework is the best way to redesign the workforce. 6

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Planned commissions Our commissions are largely unchanged from 2013, with the following exceptions: Type of commission Non-medical commissions Children’s nursing Learning Disability nursing Mental health nursing District Nursing Midwifery New commissions Practice Nurse Return to practice Emergency nurse practitioner Medical commissions Core Surgical Training posts Share of GP expansion Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

+ or - No. of commissions % terms 12 5 20 7 11

5% 20% 10% 20% 5%

70 50 24

9 24 7

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Finance 2013/14 • The chart below shows the spend profile for 2013/14 for an expected forecast outturn of £413m • This shows that the majority of funding is spent on the Future Workforce – 92% 2.16% 1.50%

Future Workforce: Non-Medical 4.28% 9.38%

21.15%

Future Workforce: Undergraduate Medical & Dental Future Workforce: Postgraduate Medical & Dental Future Workforce: Student Support

31.78% 29.75%

Workforce Development Education Support Running Costs

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Finance 2014/15 • The chart below shows the spend profile for 2014/15 for the base plan position of £417m • This shows only small changes in the percentage profile other than between undergraduate and postgraduate medical - largely due to funding changes resulting from national tariff movements 2.10% 1.41%

Future Workforce: Non-Medical 4.24% 9.16%

21.23%

Future Workforce: Undergraduate Medical & Dental Future Workforce: Postgraduate Medical & Dental

Future Workforce: Student Support 33.36%

28.50%

Workforce Development Education Support Running Costs

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Finance Key Facts Educational activity

Cost pa

Cost over 3 years

Student nurse without salary support

£20,000

£52,000

Student nurse with salary support

£32,000

£83,000

District Nurse

£38,000

Emergency nurse practitioner Practice Nurse Return to practice

£11,000 £5,000 £5,000

Undergraduate medical placement

£42,000

Postgraduate medical placements: Foundation year 1

£31,000

Foundation Year 2

£34,000

Core Specialty training

£36,000

Higher Specialty training

£41,000

GP (hospital)

£40,000

GP (practice)

£74,000

Dental Foundation Year 1

£101,000

Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Scenarios A 2% change to LETB spending would amount to £8.3m Modelling 2% up Increased workforce development spending, particularly:  Service reconfiguration in SW London and SE London  Further development/extended coverage of the Community Education Provider Network (CEPN) approach Modelling 2% down • Postgraduate medical decommissioning • Non-medical decommissioning - £3.0m • Contingency reduction to £0.5m £1.2m • Review of salary support criteria £0.3m Health Education • South London Workforce development reduction (one off) www.southlondon.hee.nhs.uk @HealthEdSL

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£1.5m

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£2.3m

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Discussion • Now that you’ve heard about possible priority areas for investment, we need your views • Each table will work together for the next 30 minutes • On your table please discuss the following question

Question: What are the 3 key messages you would like the board to take into account when reviewing the investment plan, and why? Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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Feedback sheet Question: What are the 3 key messages you would like to board to take into account when reviewing the investment plan, and why? #

Key Message

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Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL

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