8 Appendices

Appendix I Appendix II Appendix III Appendix IV Appendix V


Appendix III - WORKFORCE PLANNING IN THE NHS
 (Modified from: Davies, Health Service Journal, June 2000 6/00)

DOCTORS

Medical students
The medical workforce standing advisory committee decides how many medical students there should be. The Higher Education Funding Council (HEFC) of England and the NHS Executive set long-term targets for medical school student intakes. The General Medical Council and universities decide content of training. The education of medical students is paid for largely by the HEFC. The Service Investment for Teaching (SIFT) helps to provide the clinical facilities in teaching hospitals and DGH's used for student attachments.

Pre-registration House Officers
Postgraduate Deans identify and approve post-registration House Officer posts, with 100% funding coming from the Medical and Dental Education Levy (MADEL) which is held by the Deaneries.

Senior House Officer
Postgraduate Deans agree the number of posts, taking into account educational and service needs, keeping these in line with the needs of the Specialist Registrar grade. 50% of funding comes from MADEL and 50% from Trusts. SHO posts need educational approval from the Royal Colleges with training content set by the Specialist Training Authority (STA) of the medical royal colleges.

Registrars (GP or specialist)
Prospective GPs do one year's GP registrar training with content set by the joint committee on postgraduate training in general practice. Funding is 100% from MADEL and the distribution of GPs is controlled by the Medical Practices Committee.

Prospective consultants/hospital specialists train as Specialist Registrars for up to six years for a certificate of completion of specialist training (CCST), which qualifies them to apply for consultant posts.

Specialist Registrar posts are funded 50% from MADEL and 50% by the employing Trust, and are approved by the STA. The number and distribution of all registrar posts (including GPs) - which, in the case of Specialist Registrars are allocated as national training numbers - are decided by the Specialist Workforce Advisory Group. SWAG is a national body and is a sub-committee of the Advisory Group on Medical Education, Training and Staffing. Specialist Registrars can only stay in post for six months, or in exceptional circumstances 18 months, before gaining a consultant or other permanent appointment.

Consultants
Trusts advertise for consultants according to service need, with advertisements approved by the relevant royal college. Local Medical Workforce Advisory Groups, which are mainly regional, advise Trusts on their current and planned staffing levels. Education consortia, in theory, work through regional education and development groups to advise on numbers and types of doctors needed.

NURSES AND PROFESSIONS ALLIED TO MEDICINE
The focus of planning for all staff, including nurses and everyone from physiotherapists to laboratory staff and clinical psychologists, is at Trust level. For nurses, 'bottom-up' five year workforce plans from Trusts feed up to educational consortia, which then aggregate plans from Trusts and other employers, such as nursing homes and private hospitals. The consortia commission training on the basis of these plans, after the NHS Executive has decided final numbers of training places via regional offices, which collate consortium plans on their behalf. Training is funded from the non-medical education levy or, in the case of pre-registration pharmacists, the Higher Education Funding Council of England. For other staff, national advisory groups provide the 'top down' element of planning.