Dr Graham Willis - Modelling sustainable urban transitions dynamics presentation

A system dynamics approach to developing robust policies and its application to sustainable urban transition dynamics

Dr Graham Willis – Head of Research and Development

The CfWI produces quality intelligence to inform better workforce planning that improves people’s lives

1

Contents

1. Background2. Challenges3. Robust workforce planning4. Results5. Conclusions

1. Background

NHS budget per year?£109 billion

How many people employed?1.4 million

Years to train a hospital specialist?15 years

2. Challenges

Complex factors and feedbacks in the system

Many plausible but challenging futures

What are the critical uncertainties?

What is the most robust policy? What might push our chosen

policy off-course?

Forecasting is difficult, even when looking just a few days ahead, and the level of uncertainty rises the further forward we look. Workforce planning needs to take this into account, as planning timescales extend over many years, even decades for medical professions.

How much can we control?

Focalissue

Degree of influence

Lower Higher Lower

External uncertaintiesDriving forcesTEEPSEWhat we have no Influence over Health & social care

systemTransactions

Factors and issuesWhat we can influence

Our area of the systemKey question of concernPolicy leversWhat we can control

Reducing complexity

Detailed, quantified scenarios for modelling

Critical uncertainties

Assumptions

Data

Policy leversOutline

scenarios

Scope stakeholder

s

Identify future risks,

issues and Big Picture Challenges

Causal mapsCritical

uncertaintiesPre-determined

factors

High impact, high

uncertainty variablesEmerging

stories

Scenario stories

describing challenging

futures

Risks

Structured risks and

issues

Impact

Likelihood

Low

High

Cert

ain

tyIssues

Events

Driving forces

3. Robust workforce planning

Horizon scanning informs scenario generation (framing the uncertainty) and workforce modelling

Policy analysis shows the effectiveness of policy interventions across the range of scenarios

High degree of stakeholder involvement at every stage – including model development – workforce, trainees, employers, policy makers, lay people

System dynamics is the key

Better understanding – dynamic behaviour of system over time

Simplify complexity – rich picture of causality, feedback and delays

High stakeholder involvement – process provides as much value as end-product

Robust decisions – can model and avoid policies that lead to unexpected consequences

Health of the nation

Healthy diet

Exercise Quality of

healthcare

provision

Demand for

healthcare

Healthcare

provision per

person

The health and social care system can be considered as composed of a set of interrelated factors.The factors are linked to each other through cause and effect relationships. A change to a factor will influence one or more other factors in the system.

Formal model specification Independent testing Comparison with other

models Reviews with stakeholders Sensitivity & uncertainty

analysis

Stock and flow supply model

Medical school34,150

34,100

34,050

34,000

33,95010 15 20 25 30 35 40

Foundation 16,400

6,300

6,200

6,100

6,00010 15 20 25 30 35 40

Core training6,600

6,500

6,400

6,30010 15 20 25 30 35 40

Higher speciality training12,300

12,250

12,20010 15 20 25 30 35 40

Career post40,000

20,000

010 15 20 25 30 35 40

GP50,000

010 15 20 25 30 35 40

Foundation 26,400

6,200

6,000

5,80010 15 20 25 30 35 40

2011 = 34,069* 2011 = 6,081 2011 = 6,341 2011 = 6,524 2011 = 12,252

2011 = 35,803

2011 = 19,687

Run-through training7,500

7,400

7,30010 15 20 25 30 35 40

2011 = 7,346

GP training8,000

7,500

7,00010 15 20 25 30 35 40

2011 = 7,765

Trained hospital doctors100,000

50,000

010 15 20 25 30 35 40

2011 = 39,088

Medical SchoolEnglandStart Medical

School English

Start MedicalSchool From OOC

Medical SchoolAttrition

CompleteMedical School

Medical SchoolComplete Attrition

Leave System

FoundationYear 1

Start F1

Resit F1

FoundationYear 2

Start F2

Resit F2

Foundation 1Attrition

Foundation 2Attrition

Finish F1 Finish F2

Start F1 FromOES

Start F2 FromOES

SeekingTraining orCareer Post

Core TrainingHigher

SpecialtyTraining

Run ThroughTraining

GP Training

Career PostWithout CESR

GP

HospitalConsultant

Start GP TrainingFrom English

System

Start Core TrainingFrom English Medical

System

Start Run ThroughTraining From English

System

Complete CoreTraining

Start HigherSpecialty

Training fromEnglish Medical

System

Complete HigherSpecialty Training

Complete GPTraining

HospitalConsultant toGP Training

Start HospitalConsultant to GP

Conversion Training

Complete HospitalConsultant to GP

Conversion Training

Seeking GPPosition Start GP Position

Following Training

SeekingHospital

ConsultantPosition

Complete RunThrough Training

Start HospitalConsultant PositionFollowing Training

Start GP TrainingFrom OES

Start Core TrainingFrom OES

Start Run ThroughTraining From OES

Start HigherSpecialty Training

From OES

Start GP PositionFrom OES

Start HospitalConsultant Position

From OES

Start CareerPost

Career PostWith CESRCareer Post

Gains CESR

Career Post With CESRBecome Hospital

Consultants

Start Seeking Trainingor Career Post After

Career Post

Start SeekingGP Position

Complete GPTraining Leave

System

Complete HigherSpecialty Training

Leave System

Start Seeking HospitalConsultant Position after

Run Through Training

Complete RunThrough Training

Leave System

Complete CoreTraining Leave

System

Complete ConsultantTraining Core Start

Seeking Career Post

GP Training AttritionLeave Medical System

GP Run Through TrainingAttrition Rate Start Seeking

Training Or Career Post

Run Through TrainingAttrition Rate Leave

SystemRun Through TrainingAttrition Rate Start Seeking

Training Or Career Post

Higher SpecialtyTraining Attrition Rate

Leave System

Higher Specialty TrainingAttrition Start Seeking

Training Or Career PostCore Training

Attrition Rate LeaveSystem

Core Training AttritionStart Seeking Training

Or Career Post

Career Post AttritionRate Leave System

Career Post WithCESR Leave System

Start Career PostWith CESR From

OES

Start CareerPost From OES

GP AttritionLeave System

Hospital ConsultantAttrition Leave System

Complete F2 StartSeeking Training or

Career Post

Pass F2 LeaveSystem

Percentage of MedicalSchool Intake That Will Drop

Out

<100 Percent>

Percentage of the Studentsthat start F1 that will Drop

Out

<100 Percent>

Percentage Students FailFoundation 1 and Resit

<100 Percent>

Initial Foundation 1

<100 Percent>

Percentage Students FailFoundation 2 and Resit

<100 Percent>

Initial Foundation 2

Pass F2

Percentage Student PassF2 And Leave System

<100 Percent>

GP Attrition Rate

<100 Percent>

Initial GP

Initial Hospital Consultantsin GP training

Hospital Consultant AttritionRate

Initial Hospital Consultant

<100 Percent>

Percentage Career PostGain CESR Per Year

Initial Career Post

<100 Percent>

GP Training Attrition RateLeave Medical System

<100 Percent>

GP Training Attrition RateSeeking Training or Career

Post

<100 Percent>

Percentage Complete GPTraining And Leave System<100 Percent>

Time to find GP Position

Run Through TrainingAttrition Rate Leave Medical

System

<100 Percent>

Run Through TrainingAttrition Rate SeekingTraining or Career Post

<100 Percent>

Start SeekingHospital ConsultantPosition after Higher

Specialty Training

Percentage Complete RunThrough Training And Leave

System

<100 Percent>

Percentage CompleteHigher Specialty Training

And Leave System

<100 Percent>Time to find HospitalConsultant position

Initial Seeking HospitalConsultant Position

Initial Seeking GP Position

Core Training Attrition RateLeave Medical System

<100 Percent>

Core Training Attrition RateSeeking Training or Career

Post

<100 Percent>

<100 Percent>

Percentage Complete CoreTraining And Leave System

<100 Percent>

Higher Specialty TrainingAttrition Rate Leave Medical

System

Higher Specialty TrainingAttrition Rate SeekingTraining or Career Post

<100 Percent>

Initial Seeking Training orCareer Post

Initial Career Post WithCESR

Average Time to find CareerPost

<100 Percent>

<100 Percent>

<100 Percent>

Annual Medical SchoolIntake From England

FLAG StartAccademic Year

<Time>

<TIME STEP>

Accademic YearStart Date

Time Spent In MedicalSchool By DelayLength

Annual Medical SchoolIntake From Outside Of

Country

<TIME STEP>

<100 Percent>

1 Year

<100 Percent>

Complete F2Including Attrition

Percentage of the Studentsthat start F2 that will Drop

Out

<100 Percent>

<100 Percent>

<Percentage Students FailFoundation 1 and Resit>

<Percentage Students FailFoundation 2 and Resit>

<100 Percent>

GP Training LengthIncluding Delay Percentage

Start GPTraining

Start and Continue GPTraining By Remaining

Delay

<100 Percent>

<FLAG StartAccademic Year>

Complete GPTraining

Accademic Year

<TIME STEP>

<TIME STEP>

<TIME STEP>


Complete GP Trainingand Progress To Next

Year

Start RunThrough Training

Start and Continue RunThrough Training By

Remaining Delay Run Through Training LengthIncluding Delay Percentage

<TIME STEP>


<TIME STEP>

Complete RunThrough TrainingAccademic Year

<TIME STEP>

Complete Run ThroughTraining and Progress To

Next Year

<100 Percent>

Start CoreTraining

Start and ContinueCore Training ByRemaining Delay

<TIME STEP>


<TIME STEP>

Complete Core TrainingAccademic Year

<TIME STEP>

Complete CoreTraining and Progress

To Next Year

<100 Percent>

Start HigherSpecialty Training

Start and Continue HigherSpecialty Training By

Remaining Delay

Higher Specialty TrainingLength Including Delay

Percentage

<100 Percent>


<TIME STEP>


<TIME STEP>

Complete HigherSpecialty TrainingAccademic Year

<1 Year>

Complete HigherSpecialty Training andProgress To Next Year

<100 Percent>

Foundation Year 2TOTAL

Seeking Training orCareer Post TOTAL

GP Training TOTAL

Run Through TrainingTOTAL

Core Training TOTAL

Higher SpecialtyTraining TOTAL

Career Post WithoutCESR TOTAL

Career Post WithCESR TOTAL

Seeking HospitalConsultant Position

TOTAL

Hospital ConsultantTOTAL

Hospital Consultant toGP Training TOTAL

Seeking GPPosition TOTAL

GP TOTAL

<TIME STEP>


<100 Percent>

GP Training NewEntrants


<TIME STEP>

Foundation TOTAL

Training RunThrough New

Entrants

<TIME STEP><FLAG Start

Accademic Year>

Higher Specialty TrainingNew Entrants

<TIME STEP>


<TIME STEP>


Number of CCTConsultant Per Year

<TIME STEP>


Number CompletingCore Training

<TIME STEP>


Start ConsultantTraining Core TOTAL

<TIMESTEP> <FLAG Start

Accademic Year>

Pass F2 TOTAL

<TIME STEP>


Number of CompletingConsultant Training

HS

<TIME STEP>


<100 Percent>

<Time>

<INITIAL TIME>

<Time>

<INITIAL TIME>

<INITIAL TIME>

<Time>

<INITIAL TIME>

<Time>

<INITIAL TIME>

<Time>

<INITIAL TIME>

<Time><INITIAL TIME>

<Time>

<100 Percent>

<100 Percent>

<INITIAL TIME> <Time>

<INITIAL TIME>

<Time> <INITIAL TIME>

<Time>

<100 Percent>

<INITIAL TIME>

<Time>

<INITIAL TIME><Time>


<INITIAL TIME>

<Time><TIME STEP>

<INITIAL TIME>

<Time>

<TIME STEP>

<Time>

<INITIAL TIME>

<Time>

Annual F1 Intake FromOutside Of English System

<TIME STEP><FLAG StartAccademic Year>

Annual F2 Intake FromOutside Of English System

<FLAG StartAccademic Year> <TIME STEP>

Annual GP Training IntakeFrom Outside Of English

System

<TIME STEP>

<INITIAL TIME>

<Time>

Annual Run Through IntakeFrom Outside Of English

System

<INITIAL TIME>

<TIME STEP>


Annual Core Training IntakeFrom Outside Of English

System <INITIAL TIME>

<Time> <TIME STEP>

Annual Higher SpecialtyTraining Intake From

Outside Of English System


<TIME STEP>

Annual Career Post WithoutCESR Intake From Outside

Of English SystemAnnual Career Post With

CESR Intake From OutsideOf English System

Annual Hospital ConsultantIntake From Outside Of

English System

Annual GP Intake FromOutside Of English System


<TIME STEP>

<TIME STEP>

<TIME STEP>

GP TOTAL By Gender

Start Consultant or GPTraining From Career

Post

Start Higher SpecialtyTraining From Career

Post

<TIME STEP>

Time to CompleteConsultant to GP

Conversion Training

Annual Hospital ConsultantStart GP Conversion

Training

<TIME STEP>

<INITIAL TIME>

CompleteConsultant Core

Training AvailableFor Higher

Specialty Training

<TIME STEP>

Start Consultant or GPTraining Core Career Post

TOTAL


GP Training TOTALBy Gender

Career Post WithoutCESR TOTAL By Gender

Run Through TrainingTOTAL By Gender

Core Training TOTALBy Gender

<Initial Medical SchoolBy Completion Year>

<Start Core TrainingFrom F2>

<Start Core TrainingFrom Career Post>

<Start GP Training FromF2>

<Start GP TrainingFrom Career Post>

<Start Run ThroughTraining From F2>

<Start Run ThroughTraining From Career

Post>

<Initial GP Training ByDelay Length>


<Initial Run ThroughTraining By Delay

Length>



Length>

<Initial HigherSpecialty TrainingBy Delay Length>

<Initial Higher SpecialtyTraining By Delay

Length>

<Initial Core TrainingBy Delay Length>

Core Training LengthIncluding Delay Percentage

<Initial Core Training ByDelay Length>

Start GP PositionRejoiners

Annual GP Rejoiners

Start HospitalConsultant Position

Rejoiner

Annual Hospital ConsultantRejoiners

Start Career PostWith CESR Rejoiner

Annual Career Post WithCESR Rejoin

Start CareerPost Rejoiners

Annual Career Post WithoutCESR Rejoin


InputStringTimeLine

<TIME STEP>

<InputStringTimeLine>



<InputStringTimeLine> <InputString

TimeLine>

<InputStringTimeLine><InputString

TimeLine>




TimeLine>




TimeLine>
















































Start Consultant C RT orGP Training RT FromCareer Post TOTAL

<TIME STEP>

Start Career PostTOTAL

<100 Percent>

Annual Career Post WithCESR Become Hospital

Consultants


<TIME STEP>

SeekingTraining orCareer Post

Core Trained

Seeking Training orCareer Post Completed

Core Training TOTAL

Career PostCompleted

Core Training

Career PostCompleted Core

Training Gains CESR

Career Post CompletedCore Training Attrition

Rate Leave System

Start Career PostCompleted Core

Training From OES

<100 Percent>

Initial Career PostCompleted Core Training

<100 Percent>

Annual Career PostCompleted Core TrainingIntake From Outside Of

English System


Career Post CompletedCore Training TOTAL

By Gender


Training Rejoiners

Annual Career PostCompleted Core Training

Rejoin




Training

<Average Time to findCareer Post>

<Percentage Career PostGain CESR Per Year>

<100 Percent>

Initial Seeking Training orCareer Post Completed

Core Training <InputStringTimeLine>

<Number Start HigherSpecialty Training FromCareer Post Completed

Core Training>

Start Seeking HigherSpecialty Training From

Career Post

<TIME STEP>

<Number Start Higher SpecialtyTraining From Career PostCompleted Core Training>

Foundation Year 2TOTAL By Gender

<Start GP TrainingFrom Career Post>

<Start Run ThroughTraining From Career

Post>

<Start Core TrainingFrom Career Post>

Foundation Year 2TOTAL Gender Ratio

Start F2 TOTAL

<TIME STEP>


Start F1 TOTAL

<TIME STEP>

GP Training GenderRatio

Career Post CompletedCore Training TOTAL

<Time>

Initial Seeking Training OrCareer Post Age Profile

<100 Percent>

Annual GP Training IntakeFrom Outside Of English

System Age Profile

<100 Percent>

Initial Seeking GP PositionAge Profile

<100 Percent>

Initial GP Age Profile

<100 Percent>

Annual GP Intake FromOutside Of English System

Age Profile

<100 Percent>

Start GP Position RejoinersAge Profile

<100 Percent>

Initial Hospital Consultant toGP Training Age Profile

<100 Percent>

Initial Hospital ConsultantAge Profile

<100 Percent>Annual Hospital Consultant

Intake From Outside OfEnglish System Age Profile

<100 Percent>

Annual Hospital ConsultantRejoiners Age Profile

<100 Percent>

Seeking Hospital ConsultantPosition Age Profile

<100 Percent>

Annual Career Post WithCESR Rejoin Age Profile

<100 Percent>

Annual Career Post WithCESR Intake From Outside

Of English System AgeProfile

<100 Percent>

Initial Career Post WithCESR Age Profile

<100 Percent>

Annual Career PostCompleted Core TrainingIntake From Outside Of

English System Age Profile

<100 Percent>

Annual Career PostCompleted Core Training

Rejoin Age Profile

<100 Percent>

Initial Career PostCompleted Core Training

Age Profile<100 Percent>

Initial Seeking Training orCareer Post Completed

Core Training Age Profile

<100 Percent>

Annual Career Post WithoutCESR Intake From Outside

Of English System AgeProfile

<100 Percent>

Annual Career Post WithoutCESR Rejoin Age Profile

<100 Percent>

Initial Career Post WithoutCESR Age Profile

<100 Percent>

Annual Core Training IntakeFrom Outside Of English

System Profile

<100 Percent>

<100 Percent>

Annual Higher SpecialtyTraining Intake From

Outside Of English SystemAge Profile

<100 Percent>

<100 Percent>

Annual Run Through IntakeFrom Outside Of English

System Age Profile

<100 Percent>

<100 Percent>

Career Post WithCESR Age Ratio

Career Post WithoutCESR Age Profile

<100 Percent>

Career PostCompleted Core

Training Age Profile

<100 Percent>

Number Complete CoreStart Seeking Career

Post

<TIME STEP>


<Career PostCompleted Core

Training Age Profile>

<TIME STEP>

<TIME STEP>

<100 Percent>

AgingS TCP

AgingGP T

AgingGP T

AR LS

AgingGP TAR

SToCP

GP Training TOTALBy Age

AgingS GP Aging

GP

<TIME STEP>

GP TOTAL By COO

AgingRT T

Aging RT T AR STorCP

AgingRT TAR

SToCP

AgingHCtoGP T

Start Hospital Consultantto GP Conversion Training

TOTAL

Complete HospitalConsultant to GP

Conversion TrainingTOTAL

<100 Percent>

AgingHCAging

S HC

AgingCP

AgingCPw

CESR

AgingCPwCT

AgingSCPoT wCT

AgingCT T

AgingCT ARSTorCP

AgingCT AR

LS

AgingHS T

AgingHS T

AR LS

Aging HS T AR SCPoT


Career Post WithoutCESR Age Profile By

Age Band

Career Post Attrition Rate

<Career Post Attrition Rate>

<Career Post Attrition Rate>


Core Training TOTALBy Age

Core TrainingRATIO Age

GP TOTAL By AgeGP RATIO By Age

<100 Percent>

<Start Seeking HigherSpecialty Training

From Career Post>

<Seeking Training or Career Post>

Career Post WithoutCESR TOTAL By COO

GP Training NewEntrants From English

System

<TIME STEP>


Training Run ThroughNew Entrants From

English System

<TIME STEP>

Start Core From EnglishSystem TOTAL

<TIME STEP>



<Percentage StartHigher Specialty

Training>


Hospital ConsultantTOTAL By COO

Hospital ConsultantTOTAL By Gender

<Percentage Complete RunThrough Training And Leave

System>

<Percentage of theStudents that start F1 that

will Drop Out>

<Start and Continue GPTraining By Remaining

Delay>

<Career Post WithCESR>

<Career Post WithCESR Age Ratio>

<Percentage StartHigher Specialty

Training>

F1 CompleteAttrition Leave

System

<100 Percent>

Pass F1

<100 Percent>

<Percentage CompleteF1 And Leave SystemIncluding F2 Limits>

<Percentage CompleteMedical School And Leave

System Including F1 Limits>

<INITIAL TIME>

<Time>

<INITIAL TIME>

<Time>

Start Consultant CT FromCareer Post TOTAL

Start Consultant RT FromCareer Post TOTAL

Start Consultant GP TrainingRT From Career Post TOTAL


<Time>

Annual Medical School IntakeFrom England Age Profile

Annual Medical SchoolIntake From Outside Of

Country Age Profile


Initial Foundation 1 AgeProfile


Annual F2 Intake FromOutside Of EnglishSystem Age Profile


Annual F1 Intake FromOutside Of EnglishSystem Age Profile


Initial Foundation 2 AgeProfile


<100 Percent>

<100 Percent> <100 Percent>

<100 Percent>

AgingF2

AgingF1

AgingMS

Start MedicalSchool


Complete Study Yearand Progress To Next

Year

Start AndContinue Medical

School

<TIME STEP>

Foundation Year 2TOTAL By Age

Finish F2 TOTAL

<TIME STEP>

Sum Finish F2 AgeMS F

Sum Finish F2 AgeWorkforce

<Flag Aging Trigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger> <Flag Aging

Trigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<Flag AgingTrigger>

<100 Percent>

<TIME STEP>

<Time>

<INITIAL TIME>

<GP Attrition Rate IncScn and Pol and Max

Age Adj>

GP Attrition RateTOTAL

<100 Percent>

<TIME STEP>

<1 Year>

<Hospital ConsultantAttrition Rate Inc Scn and

Pol and Max Age Adj>

<1 Year>

<Career Post AttritionRate Inc Scn and Pol and

Max Age Adj>

<Start Seeking Training orCareer Post After Career

Post>

<TIME STEP>

<1 Year>

<Career Post AttritionRate Inc Scn and Pol and

Max Age Adj>

<Career Post With CESRBecome Hospital

Consultants>

<TIME STEP>

<1 Year>

<Career Post Attrition RateInc Scn and Pol and Max

Age Adj>

<1 Year>

Pass F2 And StayIn System TOTAL

<TIME STEP>

Career Post With CESRBecome HospitalConsultant TOTAL

<TIME STEP>


Foundation Year 2TOTAL By Gender

and COO

GP Training TOTALBy Gender and COO

GP TOTAL By Genderand COO

Run Through TrainingTOTAL By Gender and

COO

Core Training TOTALBy Gender and COO

Higher SpecialtyTraining TOTAL ByGender and COO

Hospital ConsultantTOTAL By Gender and

COO

Career Post WithoutCESR TOTAL By Gender

and COO Career Post WithCESR TOTAL ByGender and COO

Career Post CompletedCore Training TOTAL By

Gender and COO

Hospital Consultant to GPTraining TOTAL ByGender and COO

<Start GP Training ToMeet Desired Places>

<Time>

<TIME STEP>

<Start Run ThroughTraining To Meet Desired

Places>

<Start Core Training ToMeet Desired Places>

<Start Higher SpecialtyTraining To Meet Desired

Places>

HospitalConsultant

Attrition RateTOTAL

<100 Percent>

Hospital ConsultantTOTAL Percentage

Increase

<100 Percent>

<TIME STEP>

Number CompletingRun Through

Training

<TIME STEP>


Number CompletingGP Training Core By

Gender

<TIME STEP>



<Percentage of theStudents that start F2 that

will Drop Out>

<Initial Hospital Consultant>

<Time>

GP Total By 10 YrAge Bands

Hospital ConsultantTOTAL By Age

Hospital ConsultantTotal By 10 Yr Age

Bands

Number CompletingGP Training Core By

Age<TIME STEP>

Number Completing GPTraining Core By AgeBy 10 Yr Age Bands

<Start Seeking HospitalConsultant Position after

Higher Specialty Training>

<Start Seeking HospitalConsultant Position after Run

Through Training>

<Start HospitalConsultant to GP

Conversion Training>

If this structure isimplemented may want toconsider using a different

delay type

<Initial GP Training ByDelay Length>


Length>

<Initial CoreTraining By Delay

Length>

<Initial Higher SpecialtyTraining By Delay

Length>

Hospital ConsultantAttrition Rate Fixed

for 12 Months

<100 Percent>

FlagAttritionTrigger

Fixed AttritionRate Start Date<Time>

<TIME STEP>

<INITIAL TIME>

GP Attrition Rate Fixedfor 12 Months

<FlagAttritionTrigger>

<100 Percent> <TIME STEP>

<1 Year>

Career Post WithCESR Attrition RateFixed for 12 Months


<100 Percent>Career Post WithoutCESR Attrition RateFixed for 12 Months

<FlagAttritionTrigger><100 Percent>

Career Post CompletedCore Training Attrition

Rate Fixed for 12 Months


<100 Percent>

GP TrainingAttrition Delayed by

1TS

<TIME STEP>

Run Through TrainingAttrition Delayed by

1TS

<TIME STEP>

Core TrainingAttrition Delayed by

1TS

<TIME STEP>

Higher SpecialtyTraining AttritionDelayed by 1TS

<TIME STEP>

Start HospitalConsultant PositionFollowing Training

TOTAL by Age

<TIME STEP>


<1 Year>

<1 Year>

<1 Year>

<1 Year>

<Percentage TrainingEntrants From English

System Start GPTraining>

Complete F1TOTAL

<TIME STEP>


Number Completing GPTraining Core

<TIME STEP>

Start GP TrainingFrom F2 TOTAL


Start GP TrainingFrom Career Post

TOTAL

Start Run ThroughTraining From F2

TOTAL


Start Run ThroughTraining From Career

Post TOTAL

Start CoreTraining From F2

TOTAL


Start Core TrainingFrom Career Post

TOTAL

Number Start HST fromCareer Post


Start HST fromEnglish System

TOTAL


<TIME STEP>

<TIME STEP>

<Higher Specialty TrainingAttrition Start Seeking

Training Or Career Post>

<Complete ConsultantTraining Core Start Seeking

Career Post>

<TIME STEP>

<GP Run Through TrainingAttrition Rate Start Seeking


<Run Through TrainingAttrition Rate Start Seeking


<Core TrainingAttrition Start Seeking

Training Or CareerPost>

<Start Seeking HigherSpecialty Training From

Career Post>

<TIME STEP>

Full supply model

Segmented by age & gender Can include country of

origin/qualification, skill & competences

Includes attrition, delays, exits & returns, migration, full/part-time working

Sense checking

4. Results

70,000

65,000

60,000

55,000

50,000

45,000

40,000

35,000

30,000

2010 2015 2020 2025 2030 2035 2040

Year

FTE

Demand

Baseline

Supply

Supply after : 50:50 GP ratio

Sensitivity & uncertainty analysis

2010

2014

2018

2022

2026

2030

2034

2038

20000

25000

30000

35000

40000

45000

50000

90% Confidence75% Confidence50% Confidence

YearFTE

0 - 11 - 3

3 - 55+

0

5

10

15

20

25

30

35

40

L

M

H

VH

Impact

No ofvariables

Data quality

Policy analysis

1 2 3 4 5

Scen

ario

s

Key Negative

Neutral

Positive

Not robustMore robustMost robustIf D is unlikely

A

B

C

D

Policies

CostSupply-demand gapAge profile

Medical and Dental Student Intakes

Review of current intakes against likely future requirements Insight provided into what policies work best High degree of collaboration, including senior policy makers Significant decisions made

2 percent reduction in medical school intakes for one yearNo change to dental school intakes due to data quality issuesRolling cycle of reviews

See https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/127339/medical-and-dental-school-intakes.pdf.pdf

5. Conclusions

What worked well Stakeholder engagement Futures thinking Use of SD modelling

Where further work is needed Quantifying uncertain parameters Greater range of scenarios

Further research

Whole health & social care model supporting DH’s 20 year strategic vision

Workforce skills and competences Portfolio of scenarios and policies Improving stakeholder participation Information visualisation

Thank you!

Dr Graham Willis – Head of Research and Development

The CfWI produces quality intelligence to inform better workforce planning that improves people’s lives

18

Dr Graham Willis - Modelling sustainable urban transitions dynamics presentation

Health & Medicine