1. education
2. adult education

Workforce Plan for
Health Education Kent,
Surrey and Sussex
Proposed Education and Training Commissions for 2015/16
Produced by:
Jo Woolgar – Head of Quality and Intelligence
Richard Lee-Wright – Intelligence Manager
Ashley Joyce – Workforce and Education Information Analyst
Angela Fletcher – Head of Specialty Workforce
Stephen Lambert-Humble – Dean of Dental Professionals
“Through creative partnerships we shape and develop a workforce that impacts positively on health and wellbeing for all”
Version 1.6
2
Table of Contents
Section 1 Introduction
What is Health Education Kent, Surrey and Sussex?
The Population of Kent, Surrey and Sussex
The Workforce in Kent, Surrey and Sussex
Section 2 The Workforce and Education Planning Process 2015/16
Stakeholder Engagement
The Development of the Demand Forecast
The Development of the Supply Forecast
Section 3 The Results: Non-Medical
Staff Group Factsheets: An Explanation
Acute, Elderly & General Nursing
Ambulance Paramedics
Ambulance Technicians
Clinical Psychology
Dietitians
District Nurses
Registered Health Visitors
Learning Disabilities Nursing
Mental Health Nursing
Registered Midwives
Occupational Therapists
Orthoptists
Paediatric Nursing
Pharmacists (NHS)
Pharmacy Technicians
Physiotherapists
Podiatrists
Radiography (Diagnostic)
Radiography (Therapeutic)
Speech & Language Therapists
Registered School Nurses
Healthcare Science
Improving Access to Psychological Therapies (IAPT)
Medical and Dental Workforce Education and Training
Medical and Dental Overview
Graph: HEKSS Medical Workforce Growth 2010-2014 and HEKSS Provider and Trend Forecasts
2015-2019 (FTE)
Specialty
Dentistry
Graph: Dentist Age Profile
General Practice
Section 4 Improvements and Next Steps
Improvement Programmes
Further Development of the Process
Appendix 1
Education and Training Commissions for 2015/16: Non-Medical
Education and Training Commissions for 2015/16: Medical and Dental
3
3
3
3
5
5
6
6
7
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
29
30
30
30
31
31
32
33
34
34
36
37
37
39
3
Section 1
Introduction
What is Health Education Kent, Surrey and Sussex?
Health Education Kent, Surrey and Sussex (HEKSS) are a Local Education and Training Board,
authorised as a sub-committee of Health Education England.
Our aim is to ensure the effective planning, education and training of the NHS workforce within the
region. HEKSS was established in April 2013, taking over the functions of the old Kent, Surrey and
Sussex Deanery which includes the oversight of the work of the South Thames Foundation School.
As part of beyond transition HEKSS has been geographically joined to work in collaboration with the
London LETBs.
Our vision, developed together with health and care providers, commissioners, educational
institutions, learners, patients and the public is that:
“Through creative partnerships we shape and develop a workforce that impacts positively on health
and wellbeing for all.”
Our work is focused around our comprehensive skills development strategy, which addresses local
needs and national priorities set out in the Health Education England mandate.
The Population of Kent, Surrey and Sussex
The population of Kent, Surrey and Sussex is in the region of 4.45 million with the overall health
better than the average for England. Despite this, the varied geography has patches of health
inequalities with disparities faced in areas such as Thanet, Hastings and Brighton & Hove being
below the England average. This contrasts with some of the more affluent areas such as Elmbridge,
Waverley and Guildford where health is predominantly better. HEKSS recognises the challenges
that this diversity brings and therefore is able to plan and train a workforce that is suitable to the
local needs of its population.
It is expected that the Kent, Surrey and Sussex population will grow by around 4% over the next five
years rising to 8% over the next 10 years. By 2030 the population is forecast to be over 5 million.
Within this overall growth there are significant shifts in the age structure by 2030. The population
under 19 will grow by 10%, the relatively health population aged 20-49 will change comparatively
little compared to those aged 65-84 seeing more than a third increase. Most notably those aged 85
plus will almost double. With the population age demographic becoming older, it is likely the need
to improve screening and detection rates will rise in an effort to reduce cancer mortality and
improve health outcomes associated with an increase in prevalence of long term conditions. It is
forecast that incidences of dementia are to grow by 50% in some areas in the period to 2030 and
the numbers of people living longer with disabilities and learning difficulties are also forecast to rise
markedly. The changing population and its needs demonstrate the importance of planning a fit for
purpose future workforce.
The Workforce in Kent, Surrey and Sussex
Across Kent, Surrey and Sussex there are over 100,000 NHS staff providing care to its population,
there is also a significant number of staff based in the non-NHS workforce. When conducting
workforce planning we take into account the entire known workforce, whilst also factoring in the
unknown (where possible) to ensure security of supply.
Within core NHS services:

Circa 55,000 NHS staff are involved in the delivery of acute services – this includes all
managerial and administrative staff, estates and other support staff;

Circa 15,000 staff working in core community services.
4

Circa 10,000 individuals work in core mental health provision. There are significant
numbers (currently not quantified) working in organisations providing tertiary mental health
services and learning disability services provided in the independent and voluntary sector.

Just over 3,000 staff working in the ambulance service.
Most of these professions will be explored in greater detail within the results section.
HEKSS engages with our stakeholders to ensure that healthcare providers across the region have
the right staff, with the right skills.
HEKSS works to deliver the national Health Education England Mandate locally by identifying and
agreeing national and local priorities with the local health community and then planning and
commissioning education and training on their behalf. In addition, we are a forum for developing
the whole health and public health workforce.
The context for the public health landscape is also changing with increasing prevalence of ‘lifestyle’
diseases. Examples include adult and child obesity associated with low physical activity rates and
poor diet, increase in alcohol related conditions and increasing rates of alcohol-related hospital
admissions, and generally low routine immunisation and MMR uptake rates across Kent, Surrey and
Sussex. This coupled with the increasing pressures faced in the social care workforce is likely to put
ever increasing strain on the healthcare workforce.
5
Section 2
The Workforce and Education Planning Process 2015/16
Stakeholder Engagement
HEKSS is a provider led organisation that adopts an extensive approach to stakeholder engagement.
There are a range of formal means we use to obtain feedback and gain insight from our
stakeholders. Our Governing Body consists of a significant number of our NHS provider Chief
Executives together with a range of other stakeholders and meets quarterly. The second have been
quarterly, county specific Partnership Councils, which were made up of a broader circle of
representatives including providers (NHS and private), Health Education Institutions and social care.
The focus of these have been to cover a broad range of HEKSS education and training areas,
however following a review of the effectiveness of these Councils the decsion was taken in
November 2014, to broaden the membership and concentrate on specific workforce issues by
County and be known as Workforce Summits and include CCGs, and Area Teams. The aim is to
address a broad range of local workforce issues, for example difficulties in recruitment to
facilitating 24/7 working.
To support the robustness of the workforce plans, HEKSS also commission training programmes to
develop capacity and capability in workforce planning. This has included an accredited
“Introduction to Workforce Planning” course and a master class for, “Selecting and Using Ward
Staffing Methodologies.” Both received extremely positive feedback. Throughout the year, HEKSS’s
workforce planning team continually engage with providers, CCGs and Area teams to support the
delivery of their workforce plans and challenge their assumptions to ensure quality of returns. We
have seen improved overall quality of plans this year as a result.
There is regular stakeholder engagement around workforce development, education and training
through the various HEKSS functions and programmes. All relevant stakeholders are engaged in
delivering the Primary Care, Children and Young Peoples, Dementia, Compassionate Care, Career
Progression, Technology Enhanced Learning and Emergency Care Programmes. Our quality
improvement process monitors compliance with the Learning Development Agreements and
requires extensive engagement with all providers and HEIs to support improvement in the overall
quality of the placements and programmes run within Kent, Surrey and Sussex.
HEKSS also is part of a number of networks nationally to ensure consistent, standardised and best
practice approaches are adapted to workforce planning. These networks include national workforce
planners, workforce modelling collaborative, analysts, education commissioners and data quality
improvement groups. As a consequence HEKSS is ensuring that more nationally focused or
profession specific work is being incorporated into the local context. This may come from bodies or
organisations such as the Royal Colleges, National Institute for Clinical Excellence guidelines or
Centre for Workforce Intelligence and Kings Fund.
The Development of the Demand Forecast
In order to achieve a standardised approach, HEE use a uniform collection template to gather the
demand forecasts from providers. It covers all professions including nursing, allied health
professions, health care scientist, support staff and management with medical forecasts to a
granular level based on specialty or level of training. The template requests the current Staff in Post
(SIP) figures for each profession within the organisation and then requests that they predict future
workforce SIP numbers for the next 5 years based on expected service demand.
6
Each profession uses an agreed set of occupation codes based on the Electronic Staffing Record
(ESR). Issues arise when non-ESR providers complete the return, this can slightly decrease the
reliability of the data, albeit most of the profession definitions are fairly clear.
All NHS providers (and as many non-NHS as is feasible) complete their return between April and
July. Between August and September HEKSS review the returns, which involves sense checking,
challenging assumptions and triangulating the demand with narrative and the CCGs and ATs
strategies. During this process the returns made by providers may change many times as various
errors are found or assumptions altered. The outcome is that the demand forecast starts to become
more reliable, however despite this, no guarantee can be made on the accuracy given the vast
number of variables and inconstancies at play. For example some Trusts focus their demand on
what their financial allocation will be and others, what they believe the SIP requirement should be.
Therefore the demand forecast is a proxy prediction with varying degrees of accuracy based on
profession.
The Development of the Supply Forecast
In putting together the supply forecast we needed to look at the current staff in post and apply
various inputs and outputs based on historical data to predict future staffing levels. The inputs into
the workforce profile include completers from education commissions and an average 3 year joiner
rate percentage based on ESR data. When modelling the education commissioning completion rate,
historical commissioning numbers and their fill rates are taken into account. Course attrition is then
factored in before being able to forecast course outturn. Naturally not all of the students will join
the Kent, Surrey and Sussex workforce and so a locally employed rate is also applied.
The previous 3 year average leaver and retirement rate are calculated before applying it to the total
supply figure. Finally not everyone works full time some work more, some less, therefore we
applied the average participation rate based on profession within Kent, Surrey and Sussex to give a
realistic figure as to the actual availability of staff to work.
Caution must be used when attempting to quickly affect supply through altering education
commissions. To increase the nursing workforce purely through education commissioning would
take a four year period. One year to plan and recruit students and three for the programme to run.
There are limitations as to the amount of students that can be trained at any one time due the
placement availability within providers. Care must be taken not to adjust commissioning numbers
too quickly or significantly. This is because the providers will also be using short term initiatives to
resolve these issues. These might include activities such as international recruitment campaigns or
return to practice courses. The short term initiatives may affect long term supply, highlighting the
need for thoughtful and informed planning.
7
Section 3
The Results: Non-Medical
Sta in ost TE s at arch
Sta in ost H
s at arch
This ge ro le gives an age breakdown by pay band in
year age
groups and details informa on regarding possible future re re
ment s and the average age of re rement for this sta group.
ength of Training rogramme
nnual ri on from Training rogramme The number of stu
dents leaving the course annually before comple on and not
being replaced, expressed as a percentage of the total student
popula on at the end of the acade mic year
- .
Training rogramme omple on ate The number of students
that completed the course in ugust
, expressed as a per
centage of those that started.
Workforce ged
and ver The percentage of the workforce
that is aged
or over. This gives an indica on of possible re
rements over the next years.
verage e rement ge
This graph shows the ar cipa on ate, headcount compared to
full me e uivalent, as a percentage of the current workforce in
year age groups.
oiners ate The number of employees oining the workforce,
expressed as a percentage of the total current workforce, ex
cluding those oining from educa on.
on- e ring eavers ate The number of employees leaving
the workforce, expressed as a percentage of the total current
workforce, excluding those leaving through re rement.
e rement ate The number of employees leaving the work
force through re rement, expressed as a percentage of the to
tal current workforce.
The on dence a ng gives an indic a on of our con dence
in the supply and demand forecast graph based on the data
that we have.
This sec on is a summary of the supply and demand forecast
graph. The de mand forecast line is modelled using year
demand data returned by the Trusts in Kent, Surrey and Sus
sex. The supply line is based on the assump on that educa
on commissions will con nue based on the current rate
past the earliest impact of change, but this would ac tually be
ad usted to accommodate over and under supply. The earli
est impact of changes line shows where any changes to edu
ca on commissions will start to have an impac t on supply.
ny issues regarding the sta group that may not be evident
in the informa on above is explained here.
revious ommissions shows the number of educa on com
missions and course starters over the past years. The com
missions for
and
are also shown. The annual pro
posed commissions for
- are given as a number and as
a percentage of the current workforce.
This sec on details the decisions made regarding educa on
commissions for
and any other ac ons that will
e ect the supply of the future workforce.
8
ength of Training rogramme
Sta in ost TE
nnual
.
Training rogramme omple on ate
Sta in ost H
Workforce ged
ri on from Training rogramme
and ver
years
.
.
.
verage e rement ge
Has a signi cant number of non- HS providers as well as
all HS providers, within the model, although social care
is not fac tored into this supply. oing forward it would be
useful to model the e ect of other healthcare professions
drawing on this supply as a pre -re uisite to entry for oth
er professions, eg Health isi ng.
There appears to be a substan al gap between supply and
demand. This is supported by reports of shortages being
faced in adult nursing from providers across Kent, Surrey
and Sussex. arious ini a ves are being undertaken by
providers to close this shor all uickly including interna
onal recruitment and return to prac ce programmes.
This model is not accoun ng for agency bank nursing
numbers, which is used to ensure exibility to react to
changes in ac vity.
oiners ate
.
on- e ring eavers ate
e rement ate
.

.





nnual commissions of
the current workforce.
places represent .
of
Trusts are recrui ng from abroad to meet immedi
ate sta ng needs as they can not wait for more
nurse places to be commissioned.
The number of nurse commissions we can support
is constrained by placement capacity, especially in
community.
Some newly uali ed nurses do not stay in KSS on
comple on.
egistered urses working in social care across KSS
are approx.
S-S . Both Social
care and the I sector are not modelled directly.
verall the workforce need indicates that higher
growth is re uired, but the current level
rec
ognises placement and
nancial constraints
beyond
nancial year . In par cular place
ment capacity within the community provision is a
key limi ng factor.
or
we have shi ed the cohort balance to
support higher intakes within the September o
hort, which is where the ll rate has been histori
cally higher.
9
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
With one lead service provider across Kent, Sur
rey and Sussex, the main aramedic workforce
is accounted for, albeit with a very small I
presence.
oiners ate
ver recent years, the main areas of interven
on for mbulance Trusts has evolved re
ec ng the growing ageing popula on e.g.
falls in the home, mental health, demen a,
long-term condi ons .
South East oast mbulance Trust SE mb
is the main provider of ambulance services
across Kent, Surrey and Sussex. aramedics
are being u lised to support the increasingly
strained emergency care services, which
echo’s the con nued growth in demand. Sup
ply is being carefully planned to ful l demand
which is apparent in the closely matched tra
ectories each follow.
.
on- e ring eavers ate
.
e rement ate
.


nnual commissions of
of the current workforce.
places represent
.
We need to work closely with SE mb to
make sure the an cipated reduc on in the
founda on courses support the growth in
BSc.
This is in-line with Emergency are remit
ful lling the need for con nued growth of
aramedics. ll of these gures are driven
by returns from Workforce Intelligence.
10
Sta in ost TE
.
n a
nnual
n a
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
n a
.
verage e rement ge
This workforce is extremely well accounted for
given the coding in ES , therefore it is an cipat
ed that the model is fairly robust.
oiners ate
.
on- e ring eavers ate
e rement ate
The aramedic Technician is no longer commis
sioned and this workforce is gradually being
converted into aramedic rac oners. This is
supported by the demand forecast provided by
SE amb and is echoed in the increase of com
missions for Technician to rac oner conver
sion.
.
.
This course is no longer commissioned and
is being replaced in the future with the
Emergency are ssistant role.


Some technicians may not want to, or
need, addi onal study skills support to be
come a aramedic rac oners causing
problems with skill mix.
To con nue to support in upskilling techni
cians into rac oners as per provider
commissioning re uests.
11
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
na
.
.
verage e rement ge
Being a fairly specialist workforce believed to be
predominantly si ng within the HS, this mod
el has a fairly high con dence ra ng.
oiners ate
.
on- e ring eavers ate
.
e rement ate
nnual commissions of
of the current workforce.
The apparent gap between supply and demand
for clinical psychology is gradually being re
duced. E orts have been taken in recent years,
to increase supply through increased commis
sions. There is a well balanced workforce in
terms of banding, although the general par ci
pa on rate is seemingly lower than other pro
fessions. s clinical psychologists are one of
the more costly non-medical professions to
train, possibili es will be explored to under
stand where par cipa on rate can be in
creased. If this can successfully be achieved,
then the supply gap may be further reduced.
.
places represent
.

ot all ETB regions commission training. The
supply is therefore part of na onal discussions
and decisions taken in one area may impact on
the supply of ad oining services.

Salary support is provided for the full three
year training, making this one of the most cost
ly non-medical training routes.

ommissions are in line with provider re uests
and are suppor ng closing the gap in demand.
12
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
.
.
.
verage e rement ge
The unknown propor on and in uence of the
I sector dilutes the overall con dence of this
model.
oiners ate
iven the uncertain es surrounding the un
known non- HS propor on of the diete c
workforce, the supply and demand forecasts
must not be wholly relied upon. It appears as
if the reduc on in previous years educa on
commissions will have an impact on supply for
the next few years. Whether it is feasible for
the HS to a ract workforce from the private
sector to reduce the gap is ues onable as it
is reported that many sta leave the HS
aged between and . This is supported by
the apparent sudden drop in the HS age pro
le around those groups. Therefore this work
force needs to be monitored closely over the
next few years to ensure the gap between
supply and demand will not become greater
as forecast.
.
on- e ring eavers ate
.
e rement ate
.

pproximately
of die
side of the HS.
 It is reported that many sta
aged between and .
 There are a growing number
port workers delivering nutri

nnual commissions of
of the current workforce.
places represent
.
ans work out
leave the HS
of diete c sup
onal care.
ommissions have been made in line with
provider re uests.
13
Sta in ost TE
.
year
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
roblems with the coding of the data, means istrict
urses o en are incorrectly recorded. urther more the
oiner rate will be too conserva ve, due to previous year
averaging of assump ons when the course was not run
ning.
oiners ate
s a postgraduate uali ca on, the entry re uirement
is for a rst nursing registra on. istrict nurses are
specialist nurses who lead community teams and are
skilled in managing pa ents with complex needs.
With demand increasing against the supply’s sharp
decrease, this is a workforce area that needs careful
a en on. reviously in
district nurse train
ing changed to a modular approach, however over the
last year we have started formally commissioning the
course again. The result of which is that the incoming
supply has been e ected. It is further compounded by
the age pro le leaning towards the older age groups,
with the average re r ement age being
and over
of the workforce over
, it is evident how this
profession is not well balanced and is at serious risk of
supply shortages in the short to medium term.
istrict ursing is seen as an important workforce in
suppor ng agendas to take workload away from cute
hospitals and into community care. It is of concern
that the demand pro ec on from providers is there
fore poten ally s ll too conserva ve.
It is understood though that there have been some
coding issues with this workforce that are being exam
ined, these need to be thoroughly understood and
validated before any dras c changes are made.
.
on- e ring eavers ate
.
e r ement ate
.



nnual commissions of
of the current workforce.
places represent
.
Some workforce could be hidden in primary care.
The course is fairly new, therefore supply will take a
while to be restocked.
ack of placement capacity is poten ally restric ng
rapid growth.
ommissions in line with provider re uests, however go
ing forward we need to consider an increase of over and
above the
proposed.
14
Sta in ost TE
.
year
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
iven the rapid increase in health visitors over the previ
ous years, the decline in supply may seem surprising,
however the leavers rate will have been gathered from
previous years data, when there were smaller numbers.
This is possibly e ec ng the supply, causing a larger de
cline than will ac tually occur.
oiners ate
rom
Health isitors have been steadily grown in
line with the government drive to increase the number
na onally by
by arch
. onse uently once
the con nued growth e ort is reduced the impact of
supply is not sustainable unless the higher level of com
missions are maintained. The providers have clearly
iden ed a demand for health visi ng, however their
educa on commissioning re uests on the whole have
not re ected this. The outcome of this is that the
shor all can not be closed in this years planning cycle.
nother issue facing this post graduate workforce is that
it re uires its entrants to already be uali ed nurses
. s already seen, the dult ursing work
force within KSS is also facing supply di cul es, mean
ing in order to increase the health visi ng workforce,
the dult ursing supply will become further strained.
.
on- e ring eavers ate
.
e rement ate
.





nnual commissions of
of the current workforce.
places represent
.
ollowing the recent drive in training, the pool of
those wan ng to become health visitors has been
depleted. The e ect of this is that we are struggling
to ll re uested commissions, even at the
levels.
The recruitment of available health visitors has also
been exhausted in many cases, making the most
viable source for growth educa on commissioning.
lacement capacity to enable rapid growth is an
issue with many providers
abour market becoming vola le in order for em
ployers to meet workforce target by arch
.
To ful l provider commissioning re uests in-line
with placement capacity and the feasible trainee
pool.
15
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
With a large propor on of this workforce within the
I rivate, oluntary and Independent sector, we
have only modelled the HS workforce. Some of the
in uences of the I sector have not been factored
in as they are unknown.
oiners ate
The learning disabili es workforce has a strong private
healthcare provision making it di cult to fully rely on
the accuracy of the data. espite a concerted e ort
taken by KSS to gather the informa on on the learning
disability workforce, we were unable to obtain a signi
cant response on the private provision. This supply and
demand purely focusses on the HS workforce, which is
being in uenced by the shi in commissioning of learn
ing disability services into the private sector. This may
explain the apparent reduc on in supply. To counteract
this, we have increased commissions in previous years
but it s ll appears to be moving away from demand. We
will con nue to a empt wider stakeholder engagement
and closely monitor this workforce because if services
are shi ing into the private sector, the demand should
also reduce going forward.
.
on- e ring eavers ate
.
e rement ate
.
training commissions between
uali ca on have decreased since


nnual commissions of
of the current workforce.
places represent
.
and
.
.
rowth in commissions supports Workforce need.
Improved recruitment and reten on will also in
crease supply and reten on.
urther work will be undertaken to uan fy the so
cial care and independent sector demand and
whether employers an cipate any further changes
resul ng from service recon gura on, the impact of
increased popula on need and whether there are
currently vacant posts that need to be built into the
model going forward.
16
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
.
.
.
verage e rement ge
This model is only factoring the HS workforce and with a
known propor on of service provision moving into the
I sector over recent years, it is unclear how this has
e ected the model.
There is a clear gap between the mental health supply
provision and its demand, which needs closing rapidly.
ental health services have par ally been e ected by
some service provision shi ing to the private sector.
The shor all is being tackled using various recruitment
ini a ves, including going abroad to recruit. Therefore
care must be taken to ensure the commissions this year
will not push the profession into a state of oversupply
should these recruitment ac vi es be successful. We
believe this is a low risk though and will seek to increase
the newly uali ed number readily as the age pro le for
this workforce suggests it leaning towards an older bal
ance, which inherently could be a greater risk.
oiners ate
.
on- e ring eavers ate
.
e rement ate
.





nnual commissions of
of the current workforce.
places represent .
lacement capacity restricts rapid growth
There is a con nuing need for dual- uali ed nurses
in mental he alth and adult nursing, re ec ng
growth in the elderly popula on and the move of
more services into the community
There are di cul es with ll rates and high a ri
on. re uently mental health student nurses can
come from service user backgrounds and can nd
the course too challenging.
ue to the irca
shor all of de mand to
supply, proposed
growth in commissions is
inline with the Educa on ommissioning re uests
Trusts and universi es need to con nue to work
together to ensure full recruitment to commissions
and increase the training programme comple on
rate. urthermore working closely together should
op mise su cient numbers of high uality prac ce
placements. for all mental health students.
17
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
.
.
.
verage e rement ge
We are not con dent that the demand has been
accurately forecast by the providers, we believe it
is poten ally conserva ve. urthermore when
considering birth rate plus ra os, the supply fore
cast is actually closing the gap on the recom
mended levels.
oiners ate
The idwifery supply looks like it may well be
heading for an oversupply, however this de
mand line does not take into account the grow
ing popula on demographic nor birth rate plus
midwifery ra os. onse uently the perceived
demand is poten ally not en rely accurate and
is more likely to be in-line with the supply steer.
This will be closely monitored in the coming
years. Within the HEE andate there is a re
uirement to maintain midwifery commissions
to
levels. This is because na onally it is
understood that a shortage exists. This further
supports the no on that if an oversupply were
to occur within KSS, there is s ll demand in oth
er locali es across the K that may consume
this.
.
on- e ring eavers ate
.
e rement ate
.



nnual commissions of
of the current workforce.
places represent
.
emand forecast thought to be too conserva
ve.
isk of oversupply needs monitoring.
ery small growth over previous year with the
reduc on of the
month programme being
absorbed into the year course. This is based
broadly in line with provider re uest and sup
port the mandate re uirement to maintain.
18
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
.
.
.
verage e rement ge
With a large propor on of this workforce with
in the I rivate, oluntary and Independent
sector, we have only modelled the HS work
force. Some of the in uences of the I sector
have not been factored in as they are un
known.
oiners ate
.
on- e ring eavers ate
e rement ate
.
.
The supply and demand are following rela vely
parallel tra ectories, albeit with a slight gap be
ginning to occur. espite this, ccupa onal
Therapists exist in a number of non- HS
se ngs, which could be drawn upon to ful l
supply, although this could also work the other
way too . To ensure it the gap therefore will
not widen by too much, we will be closely mon
itor changes in this workforce in the years to
come.

a onally, the supply forecast es mates
supply marginally exceeding demand.

necdotally there are reten on issues in
the T workforce across both health and
social care
nnual commissions of
of the current workforce.
places represent .

growth supports gap in supply and de
mand.
19
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
n a
.
verage e rement ge
Being a smaller specialist profession, the coding and
service forecas ng ensure the reliability of the
model.
oiners ate
.
on- e ring eavers ate
e rement ate
rthop sts are a crucial members of the HS
eye care team and work closely with ophthal
mologists, optometrists and vision scien sts.
The si e of the workforce is small, which
makes it a more accurate profession to moni
tor. With such small professions though, it
means they can be very suscep ble to uctua
ons in supply in demand. The age pro le sug
gests close monitoring is re uired because
ust short of of the workforce are eligi
ble to re re.
.
.


ging workforce pro le
isk to uctua ons in supply and demand
due to si e of workforce
 Sudden growth re uirements would be re
stricted by supervised clinical placements
capacity.

nnual commissions of
the current workforce.
places represent .
of
In line with commissioning re uests.
20
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
It is thought that the service provision demand fore
cas ng is too conserva ve given the pro ected in
crease in the birth rate.
oiners ate
aediatric nursing is made up of many specialist
areas of children s nursing, making it at mes di
cult to code. espite the apparent shi towards
seemingly an oversupply, we believe the demand
forecast to be too conserva ve and will also be in
creasing over the next years. This is supported by
the birth rate forecasts increases across KSS in the
coming years. This workforce is also a feeder for
community specialist nurses suppor ng children
with long term condi ons and closer to home.
.
on- e ring eavers ate
.
e rement ate
.

an be seen as a feeder profession to other
nursing growth areas such as Health isi ng.
This is why there was an increase in starters be
tween
over commissions.
 There has been a net ou low from the K of
children’s nurses in recent years.

nnual commissions of
of the current workforce.
places represent
.
In line with provider re uests. This has not been
challenged as the belief is that the demand
growth has been under es mated.
21
Sta in ost TE
.
year
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
The e ect and in uence of the rivate sector pro
por on on this workforce, produce associated risks
to the assump ons made within this model.
With the re- eg harmacy being a one year
course, there is scope to ad ust workforce gures
fairly uickly to manage demand if re uired. ver
recent years commissioning decisions have been
made to reduce the gap generally, however this is
a small gap of around
and is likely to be in
place as a service bu er to manage demand being
lled by bank agency sta . signi cant propor
on of the pharmacy workforce sits within the
private sector ac ng as both a risk to and an op
portunity for supply.
oiners ate
.
on- e ring eavers ate
e rement ate
necdotally it is understood that the younger
workforce are leaving the HS to oin the private
sector, which is supported by the reduced work
force propor on a er the - age groups. ur
ther work needs to be conducted to validate and
understand the reasoning behind this.
.
.

isk of oversupply of HE E funded graduates,
this can also dilute the uality of graduate as
entry re uirements are dropped.

ounger workforce balance means there may
be a lack of more experienced sta to recruit
from for the more senior posts.

umbers entering workforce from E .

nnual commissions of
the current workforce.
places represent .
of
Supports provider re uests from harmacy
teams. There is a long lead me for commis
sioning numbers as recruitment occurs well in
advance.
22
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
The e ect and in uence of the rivate sector propor on
on this workforce, produce associated risks to the as
sump ons made within this model.
The supply and demand line follow similar tra ectories of
a slightly downward trend. The pharmacy workforce as a
whole has a signi cant propor on of private provision,
the impact of which can mean in mes of shor t supply,
the HS may look to recruit from it. The risk being that it
can also go the other way. ecrui ng harmacy techni
cians can be di cult for some community providers.
Supply is opera ng in the region of
of the demand
expecta on. The remaining
is easily explainable by
the mobilisa on of a more exible workforce to allow for
Trust demand capacity bu ering. This would be lled by
bank and agency sta .
oiners ate
.
on- e ring eavers ate
e rement ate
.
.






nnual commissions of
the current workforce.
places represent .
of
ost partly funded by Trusts, which makes it open
to risk of short term reduc ons
To support the placements of har macy Techni
cians there is a re uirement for a well-e uipped
infrastructure within Trusts, if this has not
been e ec vely installed, it may reduce commis
sioning opportunity.
urther work is re uired to assess the impact of
automa on and robo cs on the workforce re
uired.
We need to understand the impac t of de mand and
changes to community pharmacy contractors and
their sta .
se of non-registered sta or pharmacy assistants
instead of technicians.
In line with commissioning re uests, we are lim
ited by the placement capacity in trying to reduce
the supply demand gap.
23
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
.
.
verage e rement ge
The e ect and in uence of the rivate sector propor on
on this workforce, produce associated risks to the as
sump ons made within this model.
oiners ate
.
on- e ring eavers ate
e rement ate
In previous years hysiotherapy was heading towards
oversupply. To curb this na onally we temporarily
reduced commissions in. The increased demand visi
ble, is likely to have arisen as a result of the various
strategies to move more care into the community.
hysiotherapy is a key profession to support this, es
pecially as employers consider skill mix reviews i.e. to
decrease delayed discharge and increase reenablement services.
The present gap between supply and demand is not a
signi cant concern at this me as hysiotherapy has a
lower than average par cipa on rate within the HS,
o en with the extra hours being worked for the pri
vate sector. It is highly likely therefore that this de
mand shor all will be largely closed by an increase
TE. This will also poten ally be coupled with an in
crease in migra on from other ETBs, as na onally we
are on the fringe of oversupply with this profession.
inally the age pro le supports the no on that senior
hysiotherapists are leaving the service and shi ing
into the more lucra ve private sector. The impact
could be di culty in recrui ng senior posts and an
imbalanced workforce that is losing valuable experi
ence within the HS.
.
.
 Senior hysiotherapists con nue to seek roles outside
of the HS due to service recon gura ons and some
mes a lack of career progression.

nnual commissions of
the current workforce.
places represent .
of
n increase in commissions have been made primarily
due to service transforma on within Kent and to re
spond to modelled gap in supply.
24
ength of Training rogramme
Sta in ost TE
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
nnual
and ver
years
.
.
.
verage e rement ge
The e ect and in uence of the rivate sector
propor on on this workforce, produce associat
ed risks to the assump ons made within this
model.
With supply seemingly dri ing away from de
mand, this may be a slight cause for concern.
However as the model u lises historical leav
ers data, this may be skewing the leavers rate
applied to the supply tra ectory as the service
has recently been shi ing from HS provision
to a private provision. It is therefore expected
that realis cally the supply will not be decreas
ing at such an extensive rate. This will be close
ly monitored in the coming years.
oiners ate
.
on- e ring eavers ate
.
e rement ate
.

a onally, there was a
decrease each
year in the number of educa on commis
sions from the
to
aca
demic years.
 The employment of newly uali ed podia
trists in the private sector is leading to a
skills gap as there is not always the oppor
tunity to deal with complex clinical cases.
This may lead to a reduc on in future sup
ply for the HS, as podiatrists will lack the
skills to deal with the more complex foot
condi ons treated within the HS.

nnual commissions of
of the current workforce.
places represent
.
uch of the workforce sits within the non
- HS provision, so supply and demand
seems reasonable based on commission
ing re uests.
25
ength of Training rogramme
Sta in ost TE
nnual
.
Training rogramme omple on ate
Sta in ost H
Workforce ged
ri on from Training rogramme
and ver
years
.
.
.
verage e rement ge
With this profession largely exis ng within the
HS and the model being based on HS provi
sion, it is believed to have good reliability .
oiners ate
iagnos c radiographers work mainly within
the radiology and imaging departments of hos
pitals but may also work in surgeries clinics.
We have increased commissions in recent
years to close the gap between supply and de
mand and will con nue to monitor changes in
the years to come. It is thought that the de
mand forecast may not be en rely accurate as
it is unlikely to reduce in the years to come
without service transforma on, of which none
of that level of signi cance was highlighted
within the workforce plans.
.
on- e ring eavers ate
.
e rement ate
.

a onally, actual training commissions
have been higher than those planned.
 In-course a ri on rates remain rela vely
high.
 Increased demand on services may put
pressure on prac ce placements.

nnual commissions of
the current workforce.
places represent .
of
rowth agrees with the Educa on ommis
sioning re uests and is in-line with closing
shor all in supply and demand.
26
ength of Training rogramme
Sta in ost TE
nnual
.
Training rogramme omple on ate
Sta in ost H
Workforce ged
ri on from Training rogramme
and ver
years
n a
.
.
verage e rement ge
It is thought the service provision demand fore
cas ng is too conserva ve.
oiners ate
Therapeu c adiographers are increasingly
known as radiotherapy radiographers. They
work closely with doctors and nurses and oth
er members of the oncology team to treat pa
ents with cancer. s with diagnos c radiog
raphy we believe the demand forecast is heav
ily underes mated. s this is a key profession
suppor ng the cancer strategy. There have
been di cul es in recrui ng therapeu c radi
ographers in some organisa ons and when
sense checking the validity of the demand
forecast with system providers, the feedback
was that it was too conserva ve in the fore
cas ng.
.
on- e ring eavers ate
.
e rement ate
.

a onally, the workforce is growing and is
forecast to match demand by
increase from
to
.

ri on from training remains rela vely
high.
 There is a lack of clinical prac ce place
ments possibly restric ng starter rate going
forward.

nnual commissions of
of the current workforce.
places represent
.
ommissioning decision is in line with pro
vider re uests. This workforce will be close
ly monitored in the years to come to limit
the poten al of an over-supply scenario.
27
Sta in ost TE
.
years
nnual
.
ri on from Training rogramme
Training rogramme omple on ate
Sta in ost H
Workforce ged
ength of Training rogramme
and ver
n a
.
verage e rement ge
This workforce has a signi cant private provi
sion, however the HS segment of the work
force modelled has remained fairly constant
in recent years increasing con dence in the
oiners ate
.
on- e ring eavers ate
e rement ate
lthough a seemingly a well-balanced work
force on the whole, there are organisa ons
within Kent, Surrey and Sussex who are strug
gling to recruit Speech and anguage Thera
pists. This is occurring par cularly with the
more remote areas of the geography . This
workforce has a signi cant non- HS workforce
associated with it. With na onal increases
planned, care must be taken to avoid being
caught up in an over-supply.
.
.

The na onal supply is forecast to increase
by
in the next ve years.

ommissioning in–line with provider re
uests.
To engage in na onal discussion regarding
a na onal or regional commissioning model
for speech and language therapy.
To work with educa on providers to verify
course a ri on and impact of over recruit
ment.


nnual commissions of
the current workforce.
places represent .
of
28
ength of Training rogramme
Sta in ost TE
nnual
.
Training rogramme omple on ate
Sta in ost H
Workforce ged
ri on from Training rogramme
and ver
year
.
.
.
verage e rement ge
The e ect of the service commissioning shi to ublic
Health cannot be factored into the model, leaving a large
unknown variable that might have a signi cant impact on
this workforce.
oiners ate
The gap in supply and demand is currently being re
viewed collabora vely with ublic Health England. It is
understood that there are di cul es in nding prac ce
teaching support to increase commissioning capacity, so
work is underway to resolve this issue.
With over a
h of the school nursing workforce over
the age of , there is a risk that the re rement rate will
increase in the years to come. urthermore there seems
to be a high number of leavers annually, which is also
not easily explained and re uires further work to under
stand why this is, for instance is it migra on, moving
into other professions or abroad
gain this is being
explored further. We do not get workforce demand for
independent and special educa on schools.
.
on- e ring eavers ate
.
e rement ate
.





nnual commissions of
of the current workforce.
places represent
.
The transi on of responsibility of school nursing
commissioning from health to public health has
raised issues around roles and responsibili es of
managing the workforce numbers. This is being
worked through.
There is no formal workforce sta ng guidance
good prac ce.
The school nursing role descrip on is not formal
ised.
rac ce teacher capacity.
commissions are in-line with commission
ing re uests. These are low in comparison to de
mand due to the placement capacity constraints.
The current commissioning gure may s ll increase
if this issue is resolved.
29
HEALTHCARE SCIENCE
The healthcare science workforce is a fundamental function in the provision of safe and effective
patient care. Its composition of circa 5% of the healthcare workforce in England can be attributed
to supporting 80% of all diagnoses.
With scientific and technological advances being developed all the time, coupled with changing
demands and the drive for more integrated working, there has been a need to simplify career
structures for healthcare scientists. In light of Modernising Scientific Careers, a new scientific career
pathway has been developed providing a clear science career framework. This has developed new
training and education programmes with associated awards and qualifications clearly defined.
In tandem with the development of the new training and education approach, a programme to
recode healthcare scientist professions into more relevant and useful categories has been
undertaken over the past 12 months. During this period the workforce collection was conducted
and due to the transition codes, the data collected unreliable. onse uently this year’s planning
cycle will support the forecasts of previous years and the education commissions will have been
based on provider requests. Currently, due to the complexities and granularity of the healthcare
science workforce, HEKSS is reliant on strong provider service workforce planning, however it is
anticipated that with the improvement in coding HEKSS will be able to support a more robust
approach.
IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES
Improving Access to Psychological Therapies (IAPT) is a national policy priority.
The aim is to develop talking therapy services that offer treatments for depression and anxiety
disorders approved by the National Institute for Health and Clinical Excellence (NICE) across
England by arch
as set out in “Talking Therapies – a Plan of ction”.
With a large proportion of the IAPT workforce now being situated within non-NHS provision and a
general ambiguity following post mandated growth; it has been difficult to gain a robust forecast
within this planning cycle. Furthermore, with a substantial proportion of the workforce sitting
within private provision, understanding the supply (and even workforce size) is challenging.
To support the mandated requirements we have continued to grow commissions by nearly 29%,
which fulfils the requests made by providers within the whole system.
30
Medical and Dental Workforce Education and Training
Medical and Dental Overview
The future medical and dental workforce has historically been planned at a national level. The
process has focused on assessing the future number of Consultants and Doctors the system will
need in order to determine how many postgraduate training posts to create. To be able to apply for
a consultant post, doctors need to be on the specialist register. The normal route to entry is via
training, leading to the award of a Certificate of Completion of Training (CCT). The following section
therefore focuses on how many post graduate medical and dental training places ultimately leading
to a CCT, we will commission in 2015/16.
The current level of Post Graduate Medical and Dental Education for secondary care medical
specialties within HEKSS is forecast to produce an average increase in the consultant workforce of
over 2.7% per annum, continuing the trend that has seen the consultant workforce grow by over
13% between 2010 and 2014.
Regardless of what we commission in 2015/16, this future supply is already in the education
system, so this level of growth is guaranteed until at least 2021 (see graph below). It is worth noting
that although CCT holders are trained, it will not necessarily mean that they will be employed as
consultants or employed locally.
HEKSS Medical Workforce Growth 2010-2014 and HEKSS Provider and Trend
Forecasts 2015-2019 (FTE)
10000
9000
Total M&D Trend Forecast
8000
7000
Total M&D Provider Forecast
6000
5000
Total M&D Staff in Post
4000
3000
Consultant Trend Forecast
2000
Consultant Provider Forecast
1000
0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Consultant Staff in Post
The difference in the provider forecast (which is based on demand) and the trend forecast (based
on historical trend). It is likely the reality will actually be somewhere in the middle. The spike and
then slight reduction for the provider forecast suggests that it is being heavily influenced by
financial viability.
31
Specialty
HEKSS will be reducing a further 5 core surgery posts this year which takes into account the HEE
requirement and allows the School to reduce the number of posts they held for remedial trainees.
The data is now sufficient to allow us to plan more logically and therefore reduce unfilled posts. It
has also been decided, for curricular reasons, to withdraw from the OMFS run through pilot
launched last year.
HEKSS are undertaking a scoping exercise on the feasibility of increasing higher training capacity in
6 specialties, which our providers have agreed are priority areas. These are Clinical Radiology,
Paediatrics – community, Emergency Medicine, Geriatrics & Endo & Diabetes ,Old Age
Psychiatry/Geriatrics/CAMHs and Oncology. These plans will focus on short, medium and long
term objectives to reflect the impact of the Broadening Foundation Programmes, Seven Day
service, and the future Shape of Training. In order to get a range of wider spectrum of Higher
Speciality Training placements (year one to Year five); educational/academic links with the local
Universities in Kent, Surrey and Sussex should be further developed. This is in recognition that
HEKSS as a region has a disproportionately low number of higher trainees and will allow curriculum
requirements to be developed further within the region.
In addition a small number of posts have been decommissioned or suspended due to local
supervision availability. The problems in emergency care are not due to a shortage of funded
training places but the ability to attract trainees to select emergency medicine as a specialism.
HEKSS continue to build on the programme of works developed in 2013-14 to improve recruitment.
This includes maintaining the three additional training streams introduced last year to ensure that
there will be increased trainees entering Emergency Medicine training in both 2016 and 2017.
Dentistry
HEKSS’s dental department recently undertook a dental workforce study. There are currently 2526
dentists and 4306 Dental Care Professionals (DCPs) across Kent, Surrey and Sussex, all of whom are
supported by the HEKSS lifelong learning and workforce development programme. 79% live and
work in the same local authority area. 26% of practices report recruitment difficulties of which 60%
relate to dental nurses. 57% report vacancies of which 52% are again dental nurses. The largest
percentages of referrals are for oral surgery and orthodontics, but the area of greatest unmet need
is endodontics. Access is not a problem overall, but this hides the areas of deprivation. The dentist
workforce has an age profile higher than the national average, but the numbers seem to be stable,
however this could prove an issue in the next ten years, as dentists tend to retire form clinical
practice by the time they are 60.
The number of dentist training places commissioned (nationally) will be reduced in the 2015 intake
by 10%, and a further reduction is anticipated but not yet agreed for 2018. Hygienists and
therapists are commissioned nationally, and a new national DCP workforce review is about to start.
Clinical Dental Technicians are a new registered group, and HEKSS is currently running the only
training course in the country. Dental Nurses are not commissioned, except for a small number in
dental schools. Most training courses are private and have developed around population centres
where it is easy to deliver the training. NHS England is in the process of reforming the dental
contract, a series of pilots have been commissioned that are now being transformed into
prototypes to test the complex factors involved in dental contracting. The contract will place the
emphasis firmly on prevention, and this will entail a much greater use of skill-mix. Dentists will be
concentrating on high-end complexity treatments especially for those over 40 years of age (the
32
heavy metal generation), and the bulk of the prevention can be performed by DCPs. Direct Access
of DCPs to patients is now allowed. The dental workforce is facing huge transformational change
over the next twenty years as treatment and care needs change.
The implications for HEKSS are that training needs to be provided to upskill and reskill dentists in
more complex dentistry, especially endodontics, in leading teams and understanding and utilising
skill-mix and in widening their patient base to include hard-to-reach groups such as those in care
homes. The provision of enhanced skills for DCPs in Direct Access, advanced dental nursing,
working in teams and collaborative practice are also seen as essential. A slow process of
empowering DCPs is underway. In all of these areas HEKSS is delivering high quality programmes,
providing for the transformational needs of the future dental workforce; however it is in the area of
DCP training that HEKSS would benefit from providing additional training support.
Dentist Age Profile
33
TE s per million popula on
TE Salaried s per million popula on
TE
artners per million popula on
s in training per million popula on
-
HEE’s andate re uires all ETBs to make sig
ni cant progress towards
of postgraduate doctor training being for eneral
rac ce thereby increasing na onal commis
sions for this group to
places per year by
. HEKSS has been working closely with
the South Thames ounda on School to sup
port
placements in ounda on ear .
eedback from ounda on doctors on these
placements is very posi ve and has been
shown to posi vely in uence career choice. In
the
school has supported placements
for
of
doctors and has been working
to support the targets in Broadening ounda
on and is suppor ng an addi onal
pro
grammes with
placements that will pro
vide
placements for
in
and
in
.
HEKSS was highly successful in the
na
onal
recruitment round lling
of
declared
programmes and of
cademic
programmes which was subse uently lled.
or
HEKSS is recrui ng to the higher tar
get gure of
. HEKSS is also suppor ng the
na onal Broad Based Training rogramme,
promo ng the development of generalist doc
tors in keeping with the direc on described in
Shape of Training with an increase in recruit
ment numbers to
programmes for ugust
entry.
34
Section 4
Improvements and Next Steps
Improvement Programmes
HEKSS has identified a number of key programmes tailored to the local challenges faced. The
following provides a brief update on each.
Dementia
 Time for Dementia: Medical, nursing and paramedic students will, as part of their
curriculum, visit a person with dementia and their family at least four times a year for the
duration of their course. Learning will be consolidated through individual reflection and
group work. This will provide a unique longitudinal experience for students of what it is like
to be an older person with a long term condition.
 Dementia Fellowship: Delivered in partnership with Brighton and Sussex Medical School, the
fellowship develops knowledge and skills to lead best practice and improve quality for
people with dementia and their families.
 Foundation Level Dementia Awareness Training: HEKSS is providing financial support for
foundation level dementia awareness training. The training familiarises staff working with
patients affected by dementia with the skills needed to recognise and understand the
condition and to provide effective care and interaction with patients
Emergency Care
 NHS 111/999 Clinical Advisor Specialist Practice Programme: This innovative project is
funded by HEKSS and delivered by South East Coast Ambulance Service and University of
Surrey in order to develop a training module based on an analysis of recorded calls. The
training will enhance clinical assessment and decision making skills for clinical advisors in
order to offer a more effective service. The pilot is currently being evaluated to measure the
impact on patient outcomes and outline next steps.
 Developing Emergency Department SAS/Middle Grade Doctors: With the assistance of
trainers from across the region, HEKSS delivered an EM SAS doctor training programme. Its
aim is to enhance this group of doctors’ ability to make senior decisions in the emergency
department, enhance their night rota competency and also to improve patient safety.
 Emergency Care Workforce Development: The project aims to identify gaps in the urgent
and emergency care workforce in East Kent Hospitals, local ambulance services and
community health care to ensure that the future workforce will have the required skills to
provide a seamless and integrated service.
Primary Care
 Development of Pre-registration Nurse Student Placements: HEKSS and all 20 of its
associated CCGs are developing pre-registration nurse student placements within the
general practice setting to understand the nursing role within this environment and the
patient pathway.
 Practice Nurse Pathway: The Universities of Surrey, Canterbury Christ Church, Brighton and
Greenwich have joined with HEKSS to develop a rolling programme for nurses new to
general practice. The programme will develop core skills and competencies as well as
additional negotiated elements that will benefit their practice.
35


Primary Care Workforce Tutors: HEKSS is working with CCGs and participating universities to
appoint Primary Care Workforce Tutors to develop a coherent and cohesive approach to the
education and training of practice staff (other than GPs). The tutors will come together
across Kent, Surrey and Sussex to share best practice and also to link with other roles and
organisations to develop multi-professional education and training around long-term
conditions and end of life care.
GP Workforce Tool: The tool has been purchased for GP Practices to capture the Primary
Care workforce picture. It will enable reporting of workforce numbers and skills to help
identify risks.
Children and Young People
 Health Visitors: HEKSS is supporting the national target to increase the number of health
visitors. We are also working on identifying the continuing professional development needs
of this workforce, and are also supporting resilience through mindfulness training and a
research project about developing communities of practice.
 Paediatric asthma: Working with the South East Coast Maternity, Children and Young
People Strategic Clinical Network, HEKSS has taken a pro-active approach to the recent
oyal ollege of hysicians’ report entitled “Why asthma still kills – the National Review of
sthma eaths”.
 Reducing Stillbirth: By working with the South East Coast Maternity, Children and Young
People Strategic Clinical Network, HEKSS identified that there are sonography workforce
gaps following a recent audit. We are now looking at innovative solutions to address this
issue, both within our own LETB and with other LETBs.
Compassion and Patient Safety
 Schwartz Rounds Pilots: HEKSS has recently commissioned nine organisations to become
pilot sites. The rounds will support staff to provide compassionate care and will provide a
support system to help to promote a culture of openness and strengthen personal
resilience. This project will be working in collaboration with the Point of Care Foundation
over a two year period (one year for hospices).
 Compassion Awareness Training: St atherine’s Hospice in collaboration with hospices
has been commissioned to develop and provide compassion awareness training sessions to
all NHS staff. The programme will explain the characteristics and importance of
compassionate care in practice, while providing examples. It will also highlight compassion
fatigue in themselves and others, and list approaches to proactively manage stress in the
workplace
 Newly Qualified Practitioners: The University of Brighton Research Department will
undertake a study to map the different types of preparation in different clinical professions.
This will provide a better understanding of all the different models to support nursing
quality & patient safety. This will allow multi-professionals to make a successful transition
from student to practice. The recommendations and findings of this project will be
completed in March 2015.
Technology Enhanced Learning
 Paediatric Simulation Centre: HEKSS funded a uni ue children’s simulation centre at the
Royal Alexandra Children's Hospital. The project was a collaboration of nine organisations,
including primary care, other acute trusts and education providers across the region. Mobile
36


simulation equipment and baby and child training mannequins will also be used for wardbased training and taken for outreach education in primary care and community settings.
Simulate Ambulance: HEKSS is supporting the development of a simulated ambulance so
multi-professional teams can learn how to provide the best care for patient in transit. The
fully functioning ex-fleet ambulance will be equipped with adult and child mannequins and
will travel to sites across the region.
“Looking out for Lottie”: A new tool to raise awareness of exploitation and online grooming
of young people. The interactive simulation has versions for both young people and for
professionals. It is hard hitting, but designed to tackle this difficult topic as sensitively as
possible. The simulation is based upon social media and video chats and follows Lottie as
she goes through the grooming process. Young people and professionals are invited to
evaluate the risks that Lottie is getting into and to analyse the motives of the groomer.
Career Progression
 Careers Advice Workshops: The pilot workshops highlight health and social care careers. The
sessions are delivered in conjunction with NHS providers, social care, school and college
careers advisors and Job Centre Plus staff.
 The Prince’s Trust Pre-employment Programme: The first programme ran in Medway
Community Healthcare. Students were trained in subjects including basic life support and
had placements in areas including community nursing and stroke services. Out of 12 young
people on the course, four have gone on to become apprentices in the trust.
 Care Certificate Pilot: The pilot will test a set of standards designed to help employers to
assess not only workers’ skills, but also the knowledge, behaviours and values that are
required to deliver compassionate and quality care. Achievement of the Care Certificate
should ensure that the support worker has the required values, behaviours, competences
and skills to provide high quality, compassionate care. The pilot will be run across Kent,
Surrey and Sussex with 12 organisations involved including a mixture of acute, mental
health, community, social enterprise and county councils.
Further Development of the Process
Over the next 2015/16 workforce planning cycle there will be a number of changes that will affect
the planning process and enable further developments. HEKSS has been grouped geographically
with the three London LETBs. This provides an opportunity to adopt more standardised approaches
and share best practice when workforce planning and education commissioning.
With more historical data now available and being built upon regularly, there is an opportunity to
engage improved intelligence techniques and tools to gain a more informed understanding of
workforce profiles. There are also a number of national projects progressing to support a more
standardised collection approach (possibly through an online means) and to utilise survey data to
help appraise commissioning decisions.
37
Appendix 1
Other
AHPs
Community
Midwifery
Nursing
Education and Training Commissions for 2015/16: Non-Medical
2013/14 2014/15 2015/16
Specialty/Branch
Adult
Child
Learning Disabilities
Mental Health
Total - Pre-registration Nursing
Adult
Child
Learning Disabilities
Mental Health
815
120
23
139
1097
848
122
23
133
1126
908
122
29
150
1209
18-month and 3-year
210
210
24
387
0
6
5
26
448
85
35
121
57
0
70
65
30
0
29
27
519
211
211
39
142
2
6
14
27
230
73
26
103
61
1
145
65
30
16
29
34
583
211
211
44
168
1
7
8
28
256
77
26
114
64
2
180
93
30
29
33
36
684
0
0
5
26
-1
1
-6
1
26
4
0
11
3
1
35
28
0
13
4
2
101
0.0%
0.0%
12.8%
18.3%
-50.0%
16.7%
-42.9%
3.7%
11.3%
5.5%
0.0%
10.7%
4.9%
100.0%
24.1%
43.1%
0.0%
81.3%
13.8%
5.9%
17.3%
18 month/3 yr
Total - Midwifery
District Nursing
Health Visiting
Occupational Health
Paediatric Nursing
Practice Nursing
School Nursing
Total - Community
Diagnostic Radiography
Dietetics
Occupational Therapy
ODP
Orthoptist
Paramedics (BSc)
Physiotherapy
Podiatry
Sonographers & Ultrasound
SALT
Therapeutic Radiography
Total - AHPs
District Nursing
Health Visiting
Occupational Health
Paediatric Nursing
Practice Nursing
School Nursing
Diagnostic Radiography
Dietetics
Occupational Therapy (MSc)
Operating Department Practitioners
Orthoptist
Paramedics (BSc)
Physiotherapy (BSc)
Podiatry
Sonographers
Speech & Language Therapy
Therapeutic Radiography
Child Psychotherapy
Child Psychotherapy
6
6
6
0
0.0%
Clinical Psychology
Clinical Psychology
62
40
42
2
5.0%
68
46
48
2
4.3%
Foundation Degree - Health & Social Care
207
191
157
-34
-17.8%
Foundation Degree - Critical Care Practitioner
92
299
122
313
172
329
50
16
41.0%
5.1%
STP in Informatics
0
22
13
-9
-40.9%
HSST in Informatics
0
3
6
3
100.0%
IAPT - High Intensity
119
143
185
42
29.4%
Pharmacy - Diploma
119
114
112
-2
-1.8%
7
245
2886
6
288
2797
3
319
3056
-3
31
259
-50.0%
10.8%
9.3%
Foundation
Degree
Total - Other
Health & Social Care/Scientists
Paramedics
Dental
Pharmacy IAPT HSST
STP
Total - Foundation Degree
0
Increase/ % Increase/
Decrease
Decrease
60
7.1%
0
0.0%
6
26.1%
17
12.8%
83
7.4%
Clinical Professional Education Programmes
STP
HSST
IAPT
Pharmacy
Dental Nursing
Dental Nursing
Total - Scientific, Technical & Therapeutic
Total
0
38
2013/14
2014/15
2015/16
815
120
23
139
1,097
848
122
23
133
1,126
908
122
29
150
1,209
10.27%
13.22%
0.00%
17.19%
Estimated output 17/18
based on 3 previous
year's average attrition
761
106
23
110
210
210
24
387
6
5
26
448
85
35
121
57
70
65
30
29
27
519
211
211
39
142
2
6
14
27
230
73
26
103
61
1
145
65
30
16
29
34
583
211
211
44
168
1
7
8
28
256
77
26
114
64
2
180
93
30
29
33
36
684
13.54%
182
Child Psychotherapy
6
Clinical Psychology
Total - Other
Foundation
Degree
Other
AHPs
Community
Midwifery
Nursing
Clinical Professional Education Programmes
Adult
Child
Learning Disabilities
Mental Health
Total - Pre-registration Nursing
18 month/3 yr
Total - Midwifery
District Nursing
Health Visiting
Occupational Health
Paediatric Nursing
Practice Nursing
School Nursing
Total - Community
Diagnostic Radiography
Dietetics
Occupational Therapy
ODP
Orthoptist
Paramedics (BSc)
Physiotherapy
Podiatry
Sonographers & Ultrasound
SALT
Therapeutic Radiography
Total - AHPs
Health & Social Care/Scientists
Paramedics
Dental
Pharmacy IAPT HSST
STP
Total - Foundation Degree
0
Calculated % from 14/15
Commissions
STP
HSST
IAPT
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
14.91%
0.00%
14.04%
20.37%
N/A
62
26
89
49
N/A
138
62
22
N/A
28
N/A
6
6 N/A
N/A
62
40
42 N/A
N/A
68
46
48
207
191
157 N/A
N/A
92
299
122
313
172 N/A
329
N/A
-
22
13 N/A
N/A
-
3
6 N/A
N/A
119
143
185 N/A
N/A
119
114
112
7
245
2,886
6
288
2,797
N/A
4.79%
0.046875
25.68%
N/A
2.88%
Pharmacy
0.00%
114
Dental Nursing
Total - Scientific, Technical & Therapeutic
Total
3 N/A
319
3,056
N/A
39
Education and Training Commissions for 2015/16: Medical and Dental
Specialty
Number of
Change in number of posts (inc TF) Number
posts including
at Sep 15 compared to Sep 14
of posts
MIN
Trust Funded
'+' indicates new posts
(inc TF)
posts at
'-' indicates decommissioned posts.
at
09/2014
Enter number +/-
Predicted
LATs
MAX
09/2015 TOTAL TOTAL
FOUNDATION PROGRAMME
TRAINING
Foundation Programme Year
1 (Inc. Academic Foundation)
Foundation Programme Year
2
FOUNDATION TOTAL
CORE TRAINING
Core Medical Training
Core Psychiatry Training
Core Surgical Training
Acute Care Common Stem Acute Medicine
Acute Care Common Stem Anaesthesia
E Med - Acute Care Common
Stem and run-through excluding National
Allocation
E Med - Acute Care Common
Stem and run-through National Allocation
E Med - Acute Care Common
Stem and run-through - Total
492
0
492
492
492
0
485
0
485
485
485
0
492
0
492
492
492
0
184
55
85
33
0
-1
217
55
84
92
12
39
102
22
39
0
0
0
13
0
13
3
4
0
32
0
32
10
13
0
20
0
20
9
14
0
3
3
6
3
3
0
23
3
26
12
17
0
Direct Recruitment into EM
at ST3
ST4
Core Anaesthetics Training
Broad Based Training
SUB TOTAL
0
0
0
0
4
0
27
77
12
508
0
1
4
40
27
78
16
548
3
34
12
217
8
38
16
263
0
0
0
0
ST3/ST4 UNCOUPLED
Intensive Care Medicine
Anaesthetics
SUBTOTAL
17
112
129
0
0
0
17
112
129
4
24
28
6
27
33
0
5
5
40
Specialty
Number of
Change in number of posts (inc TF) Number
posts including
at Sep 15 compared to Sep 14
of posts
MIN
Trust Funded
'+' indicates new posts
(inc TF)
posts at
'-' indicates decommissioned posts.
at
09/2014
MEDICINE
Respiratory Medicine
Dermatology
Neurology
Cardiology
Rheumatology
Genito-urinary Medicine
Clinical Pharmacology and
Therapeutics
Geriatric Medicine
Medical Oncology
Clinical Physiology
Clinical Neurophysiology
Renal Medicine
CNG: Nuclear Medicine both
single CCT and new
combined NM/Rad CCT
CNG: Nuclear Medicine
combined CCT with radiology
now combined with above
Endocrinology and Diabetes
Mellitus
Gastroenterology
Audio vestibular Medicine
Clinical Genetics
Clinical Oncology
Allergy
Acute Internal Medicine
Haematology
Immunology
Rehabilitation Medicine
Sport and Exercise Medicine
Occupational Medicine
Palliative Medicine
Medical Ophthalmology
Paediatric Cardiology
Stroke Medicine (see also
Med OTHER)
SUB TOTAL
Enter number +/-
Predicted
LATs
MAX
09/2015 TOTAL TOTAL
29
9
11
34
13
5
0
0
0
0
0
0
29
9
11
34
13
5
3
1
0
4
3
0
7
3
3
8
6
1
3
0
4
5
3
1
0
0
0
0
0
0
43
5
0
1
14
0
0
0
-1
0
43
5
0
0
14
5
0
0
0
1
11
0
0
0
3
4
0
0
0
2
4
-2
2
0
0
0
0
0
0
0
0
0
24
0
24
6
11
2
32
1
0
19
0
27
12
1
2
0
2
12
0
0
0
-1
0
0
0
0
0
-1
0
0
0
0
0
0
32
0
0
19
0
27
12
0
2
0
2
12
0
0
5
0
0
0
0
2
0
0
0
0
0
0
0
0
8
0
0
0
0
5
0
0
0
0
0
0
0
0
4
0
0
0
0
5
0
0
0
0
0
0
0
0
4
0
4
1
3
0
304
-5
299
31
69
33
41
Specialty
Number of
Change in number of posts (inc TF) Number
posts including
at Sep 15 compared to Sep 14
of posts
MIN
Trust Funded
'+' indicates new posts
(inc TF)
posts at
'-' indicates decommissioned posts.
at
09/2014
SURGERY
General Surgery
Paediatric Surgery
Otolaryngology
Trauma and Orthopaedic
Surgery
Urology
Plastic Surgery
Cardio-thoracic surgery (Inc.
Pilot)
Vascular Surgery
Oral and Maxillo-facial
Surgery (Inc. Pilot)
SUB TOTAL
PSYCHIATRY
Psychiatry of Learning
Disability
General Psychiatry
Child and Adolescent
Psychiatry
Forensic Psychiatry
Medical Psychotherapy
Old Age Psychiatry
SUB TOTAL
Enter number +/-
Predicted
LATs
MAX
09/2015 TOTAL TOTAL
85
2
17
-1
0
0
84
2
17
14
0
2
18
0
4
0
0
3
79
-1
78
14
16
5
19
13
0
0
19
13
2
0
4
0
0
0
2
0
2
0
0
0
2
1
3
0
1
0
12
0
12
0
4
0
231
-1
230
32
47
8
0
0
0
0
0
0
23
0
23
4
12
0
4
0
4
0
0
0
5
1
11
44
0
0
0
0
5
1
11
44
2
0
2
8
3
0
3
18
0
0
0
0
42
Specialty
Number of
Change in number of posts (inc TF) Number
posts including
at Sep 15 compared to Sep 14
of posts
MIN
Trust Funded
'+' indicates new posts
(inc TF)
posts at
'-' indicates decommissioned posts.
at
09/2014
DENTAL
Dental Foundation
Programme Year 1
Dental Core Training
0
Dental and Maxillofacial
Radiology
Oral and Maxillofacial
Pathology
Oral Microbiology
Oral Medicine
Orthodontics
Restorative Dentistry
Paediatric Dentistry
Enter number +/-
MAX
Predicted
LATs
09/2015 TOTAL TOTAL
61
-1
60
59
60
0
37
0
0
0
37
0
27
0
38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
2
2
0
0
0
0
0
0
0
10
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Additional Dental Specialties
0
0
0
0
0
0
Oral Surgery
Endodontics
Periodontics
Prosthodontics
Special Care Dentistry
Dental Public Health
DENTAL SPECIALTY TRAINING
TOTAL
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
16
0
0
0
61
-1
60
59
60
0
37
0
37
27
38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
4
0
DENTAL FOUNDATION TOTAL
DENTAL CORE TRAINING
TOTAL
0
Use this space for any
additional information
Dual Old Age and General
Psychiatry