SHuRePlan

What are the options for closing the gap and how effective are they likely to be?

There are many options available for closing the gap by increasing supply and / or reducing demand. This stage involves a kind of 'brainstorm' of solutions that maybe suitable for the different staff groups or service areas that you are working with.

Increasing supply

Historically much workforce planning has been driven by the commissioning of pre-registration professional education. However, this puts the focus primarily on putting more people through training and increasing the supply of qualified staff. However, there are limits to this in terms of financial resources, people suitable for recruitment to such courses and clinical placement capacity. Such a solution also takes a long time (from 3 - 15 years) to produce results. It is important to develop a balanced supply strategy which also best use of alternative ways of improving supply such as:

• return to practice initiatives
• broadening the recruitment base
• attracting and retaining staff through flexible working
• improved retention through 'Improving Working Lives' and other measures
• internation recruitment

Reducing demand

The other set of options are around challenging the way care is delivered at present and questioning whether the traditional staffing patterns are still appropriate. This is where workforce planning and service planning are tightly aligned.

Increasing the productivity of the existing workforce can reduce demand for new and additional staff. This can be done by re-engineering the care processes or by creating new roles and adapting the skill mix. It can also be achieved by deploying the staff more effectively by changing shift arrangements or by using annualised hours or self-rostering methods. There is currently a significant emphasis on increasing productivity in both health and social care. (See Links)

An example of where new roles have helped reduce the supply demand gap is in implementation of the Cancer Plan. Serious blockages in patient pathways were occuring through shortages of Radiographers and Radiologists. A solution has been found through the development of assistant Radiography practitioners who are able to take on some of the work of radiographers under professional supervision. Similarly advanced Radiography practitioners have been able to take on functions previously undertaken by Radiologists. While numbers in professional training have also been increased, these measures have enabled some reduction in the workforce gap to be achieved in a shorter timescale as well as making more effective use of skilled practitioners.

How big is the likely impact of each option and much will it cost?

The list of options for increasing supply or reducing demand needs to be moderated by assessing what each solution is likely to achieve in terms of its impact. This is when you also try to cost the proposed solutions. Some solutions may incur additional costs while some may avoid wasting investments already made in the workforce.

Training courses and backfill can be expensive and of course, large-scale recruitment will have numerous direct and indirect costs. Retention measures on the other hand may be demonstrated to be saving the past investment made in training of staff by avoiding the recruitment and induction costs for new staff, as well as retaining the 'intellectual capital' of your current employees.

Some solutions will have an immediate effect while others may take years to be realised. So timeframes need to be developed as well at this stage.

How likely is each option to succeed?

A further stage in the assessment of options is to take consider how likely each option is to succeed in terms of reducing the gap and enhancing service delivery.

Again, this activity is best done with the managers concerned. You'll need to refer back to the impact assessment as well as the costs of the various solutions. But in addition, it's worth bearing in mind that some of the more radical solutions may encounter organisational resistance. Such forces need to be tested and factored in.

It can be helpful to do a Risk Analysis at this point. This means systematically identifying and prioritising the potential risks to the achievement of the selected workforce options and establishing an agreed action plan to manage those risks. By going through this process you can help to maximise the chances of plans becoming a success in the implementation stage.

The risk assessment makes the plans become less 'abstract' as it directly involves managers and other stakeholders and focuses on some of the practicalities.