SHuRePlan

What services are required to meet the patients' needs and how are they planned to change?

Integrating workforce and service strategy

If the assessment of workforce demand is to be soundly based it must be based on planned service delivery. This assumes that there is:

• A clearly articulated service plan or strategy
• Working arrangements that bring together service, financial and workforce planners around a common planning process.
• That all three talk a common language. Workforce demand measures must be based on activity as it is expressed in the service plans.
• A willingness for service managers and planners to accept that workforce capacity will be a major factor in determining how services are delivered.

Planning by service units

The key to ensuring that service planning and workforce planning talk a common language is to plan in terms of the units through which the service is delivered - the ward, department, team etc. Typically commissioners will be identifying the health needs of their populations and the services they wish to commission to meet them. The same service can be provided in a number of ways and locations and increasingly both commissioners and providers are reviewing care pathways to see how services can be delivered more effectively.

The impact of this on the individual service unit will be that they should be able to identify the caseload and case mix that they can expect and how it will change. This can be used as the basis for assessing the size and composition of the team needed to deliver the service.

Moving to planning by service units has a number of implications for how planning is undertaken:

• SHAs often require plans aggregated to Trust level. If they are to understand the link between planned activity and workforce they will need information by service.
• Recent years have seen an emphasis on workforce planning by care groups in order to give it a patient focus. However, patients from a given care group access multiple services and services commonly draw patients from more than one care group. The only way to make sense of this is to plan in terms of the patient pathways and service units.
• Trusts normally build up their workforce plans by individual service unit but it is important that the managers of those units are enabled to do this on the basis of planned changes in caseload and case mix for their unit - not just a wish list or bidding process.

Measures of activity

The way in which activity is measured will vary according to the service. At a high level the normal statistical measures such as Finished Consultant Episodes, Appointments, Occupied beds etc may be sufficient. A more detailed analysis of skills and roles required may need information in terms of the specific interventions and activities carried out.

In the past commissioning has commonly been in terms of capacity making it difficult for managers to see how the workload of their service unit might change. With the move to Payment by Results, the currency will increasingly be in terms of spells by HRG. While this will increase the complexity, it will force increased clarity in the planning around expected changes in caseload and case mix.