Workforce for the Future: Portfolio Careers to Address Workforce Gaps

Joanne PlattProject Manager: NHS Chorley and South

Ribble and NHS Greater Preston CCG

Context• A partnership between the CCGs in Central Lancashire and the two main

health care providers (Lancashire Teaching Hospitals Foundation Trust and Lancashire Care Foundation Trust)

• Business case based on assumed knowledge of the workforce challenges facing us as a local health economy

• Aging primary care workforce and difficulty in recruiting• Increased population due to City Deal investment exacerbating the

shortage • Aging population • Increased demands on primary care due to national agenda and local

strategy – care closer to home• Silo workforce planning that is not conducive to patient centric

healthcare

What did we do?• Commissioned two pieces or research (quantitative and

qualitative)• Identify the actual rather than the perceived gaps in the clinical

workforce using existing workforce data• Focus Groups to explore with clinicians (trainees and

established doctors and nurses) the things that would encourage clinicians to stay in the locality, to work more flexibly across the wider system and for trainees to choose General Practice as their specialism

• Focus Groups comprised clinicians from primary, secondary and acute care, including clinicians who had recently left Lancashire

What did we find?• Unreliable workforce data – lacks depth and demonstrates a lack of

engagement from healthcare providers with regional workforce tools (WRaPT)

• Higher than average numbers of admin and clerical staff in primary care workforce

• 28% of GPs will be aged 58-60 in 10-year’s time (the age cited nationally as being the most likely retirement age for GPs) and 59% of the primary care nursing workforce are aged over 50;

• Less than half the primary care nursing workforce are delivering long-term conditions care - 63% of those that are, are aged over 50

• Highest vacancy rates in secondary care amongst professional, scientific and technical, medical and dental staff - LTH and LCFT report almost 1600 leavers in 12 month period

• Provider approach to workforce planning is reactive and fragmented – silo working with few collaborative links

• Trainees are interested in portfolio careers as a career pathway but established clinicians are more dismissive about portfolio careers;

• Despite the fact that the North West is the leader in primary care placement for Foundation trainees, they say that exposure to primary care comes too late to affect their career choice

• Historic perceptions of primary care are being reinforced by some established clinicians

• The ‘business’ side of being a GP making learners nervous about their skill sets – opportunities to share skills across practices and federated approach to staffing?

• The remoteness of some of Lancashire’s communities creates fear amongst trainees that they could become isolated if they work in primary care. In secondary care some trainees perceive working in tertiary centres as a better option.

What will we do next?• Sharing Event in May to share and discuss the research findings• Seek commitment from key partners to engage fully with regional initiatives i.e.

WRaPT, Associate Physicians, work experience / apprenticeship opportunities• Meeting with key strategic leaders in our local health economy to agree the

priorities for Phase 2 of the project• Development of Advanced Training Practices • Work with local educational institutions i.e. schools / FE / HE to promote primary

care and portfolio careers in clinical training • Develop pilot portfolio job roles (for doctors and nurses) to test out on trainees –

supported by senior clinician mentors hand picked for their inspirational leadership skills – make primary care more attractive as a career

• Develop cross-economy secondments as career development tools (including the resources to undertake proper evaluation of pilot projects and secondment opportunities

Further Information:

Joanne Platt: Project Manager(joanne.platt@chorleysouthribbleccg.nhs.uk)

Dr Mohan Kumar: Clinical LeadMohan.kumar@nw.hee.nhs.uk)

Tracy Boustead: HR LeadTracy.Boustead@chorleysouthribbleccg.nhs.uk)

@workforcenhs