insights into future skills and competences
TRANSCRIPT
Insights into future skills and competences
Matt EdwardsHead of Horizon scanning & International / EU JA HWF WP6 Leader, CfWI
John FellowsHorizon scanning Consultant / EU JA HWF WP6 Content Lead, CfWI
Joint Action Health Workforce Planning and Forecasting:
Conference on improving planning methodologies & data across Europe 4 December 2014
Funded by the Health Programme of the European Union
Horizon scanning work at CfWI
Approaches to futures thinking and horizon scanning, using scenarios to describe challenging but plausible futures that workforce planners need to address.
Systems dynamics modelling and simulation of these scenarios, and policy analysis to identify workforce options that are robust against future uncertainty.
www.cfwi.org.uk | www.horizonscanning.org.uk
Big Picture Challenges
International Responses to Big Picture Challenges
Horizon 2035 Progress Update
Horizon 2035 Prezi
Robust workforce planning
Understand the system
Explore the future
Simulate the possibilities
Make robust decisions
Focal question
Transparent and participatory
Nu
mb
er
of
ph
arm
acis
ts (
full
-tim
e e
qu
ival
en
t)
20
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100,000
80,000
60,000
40,000
20,000
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20
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100,000
80,000
60,000
40,000
20,000
0
20
12
20
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20
16
20
18
20
20
20
22
20
24
20
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20
28
20
30
20
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20
34
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36
20
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20
40
100,000
80,000
60,000
40,000
20,000
0
20
12
20
14
20
16
20
18
20
20
20
22
20
24
20
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20
28
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30
20
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100,000
80,000
60,000
40,000
20,000
0
Year
Scenario 1
Scenario 3
Scenario 2
Scenario 4
CfWI outputs: Pharmacy exampleHow uncertain is the future?
A new challenge: multiple workforces
What skills and competences do we have?
What might we need in future?
Not just workforce numbersWhat skills and competences are needed?
Competences
Skills
FacilitationLeadershipWellbeing
Knowledge Personal
Types of skill
Level of skill
Po
pu
lati
on
Learning disabilities
Oral health
Singular demand for service
Maternal and perinatal
Infectious disease
Mental long-term conditions
Physical long-term conditions
Skill level: 1 2 3 4 5
A new framework
Prevent
Enable
Assess
Plan
Treat
Rehabilitate
Relieve
Link
Midwives
Nurses
Dentists
Pharmacists
Doctors
Volunteer care and support workforce
Other workforce groups
Horizon 2035 workforce groups
Increasing concentration and experience
Framework + system = insights
NumbersSkillsCosts
Supply Demand
People and skills?
Workforce groups?
Training?
Education?
Money?
Future challenges?
Skills gap and
overlaps?
Idea skill mix?
Future demand for skills Sk
ill h
ou
rs/Y
ear
(B
illio
ns)
2012 2016 2020 2024 2028 2032 2036
Time (Year)
Probability: 80% 100%Central estimate:
Illustrative analysis
European perspective
Work package 6
Horizon scanning and qualitative
Qualitativemethods
Pilotstudy
Future skills
User guidelines – qualitative methods
Published November 2014
Examples of methods in use across EU e.g. scenarios
Helps deal with inherent complexity and uncertainty of workforce planning
Descriptions of health workforce planning and forecasting approaches for Belgium, Finland, Germany, Hungary, Netherlands, Spain and the United Kingdom
Horizon scanning and qualitative
1
2
3
User guidelines – qualitative methods
Published November 2014
Use alongside quantitative methods to achieve integrated approaches across Europe
Recommends taking into account the different useful approaches for different contexts
Methods can be used to systematically investigate different workforce futures and deal with uncertainty
Horizon scanning and qualitative
4
5
6
Robust workforce planning: EU JA HWF
Understand the system
Focal question
Transparent and participatory
Future drivers and skills across Europe?
D062: Report on Future Skills and Competencies
Provide an estimation of the future needs of skills and competencies needed in the health workforce and their distribution.
Drivers and trends
Future drivers and skills across Europe?
54Horizon scanning
interviews
264Drivers collected
and grouped
Investigated systematically7 CLDs
Wellbeing skills
Visual keyTo visually communicate the framework and begin to consider spheres of control and influence in workforce planning we have adapted a diagram from Van der Heijden (2005) Scenarios – the art of conversation and linked this to a description of the contextual, transactional, working and focal environments.
7 indicative causal loop diagrams to summarise the interview information at a high level.
These guide the identification of megatrends.
FocalSkills and
competence of the health workforce
in 2035.
1. Connecting and enabling technologyEnable. Effective engagement with engaged ‘consumers’. Patient engagement/partnership/ empowerment. Interpretation of data/statistics. Interpersonal and communication skills.
Availability of health
information
System performance
data
Patient activation
Policy and regulation
Professional interpretation
Remote consultations
Connectivity between
patients and professionals
Health and care data
Remote monitoring
ICT
Population health literacy
‘Big Data’
+
+
+
+
+
+
+ +
+
+
+
+
+
+
Working
Transactional
Contextual
Focal
2. Demographic demandRelieve. Enable. Link. Chronic disease management/supported self-management. Coordination/linking skills. Multidisciplinary coordination and team working allied with generalist skills. Long-term care skills. Challenge to single disease framework. Communication skills.
Working
Transactional
Contextual
Focal
Multi-morbidity
Chronicconditions
EU fertility rate
Healthy cohort of older
people
Prevention
EU life expectancy
+
=+
+‘Age’ of the population
+
=
+
-
Economic and social inequality
+
2. Demographic demand
Working
Transactional
Contextual
Focal
Multi-morbidity
Chronicconditions
EU fertility rate
Healthy cohort of older
people
Prevention
EU life expectancy
+
+ =
+‘Age’ of the population
+
=
+
-
Economic and social inequality
+
Attach indicators which describe the current state or trend
2. Demographic demand
Working
Transactional
Contextual
Focal
Multi-morbidity
Chronicconditions
EU fertility rate
Healthy cohort of older
people
Prevention
EU life expectancy
+‘Age’ of the population
+
+
Economic and social inequality
+
< 5
10 - 14
20 - 24
30 - 34
40 - 44
50 - 54
60 - 64
70 - 74
80 - 84
2035
2010
Source: Eurostat
Source: Barnett et al, 2012
3. MobilityEducation, registration, licensing and regulation of skills. Workforce planning skills. Health system and workforce system incentives.
Working
Transactional
Contextual
Focal
Mobile health professionals
National skillsdistribution
European skills distribution
Healthoutcomes
National skillsrequirements
Mobile patient
‘consumers’+
+ +
European health market
for skills
+
Freedom of movement
+
4. ProductivityEnable. Self-care and self-management. Task allocation. Leadership skills. Productive teams.
Working
Transactional
Contextual
Focal
Location of care
GDP allocated to ‘healthcare’
Skill mix
Resistanceto change
Complexcomorbidities
Public health expenditure
Health systemefficiency
Patient/public expectations
Gross DomesticProduct
Access to care
Quality of care
+
--
5. PersonalisationAssess. Enable. Treat. Communication of risk. Shared decision making. Translation of research developments. Task allocation.
Working
Transactional
Contextual
Focus
Workforceproductivity
Behaviouralsciences
Population health literacy
Personalised care
Innovation genomics, Pharmaco-
genetics
Diagnostics Decision aids
Industrialinnovation
Riskstratification
+
+
Therapeutics+
+
+
+
+
+
+
+
Data collected by individuals
+
6. Future patientsAssess. Enable. Prevent. Communication skills. Coaching skills. Broader skill base and competence of healthcare in the population. Mobility. Role changes or partnerships. Defensive medicine.
Working
Transactional
Contextual
Focus
Proportionof types of
care
Ageingpopulations
Complexdemand
Diversepopulations
Proportion of generalists to specialists
Climate change
+
+
+
Diseaseprofiles
+
+
Patientactivation
Informedpatients
+
+
7. SupplyLink. Cooperation. Task allocation. Supply of skills and competences. Workforce planning skills. Leadership skills. Multidisciplinary teams/integration. Workforce flexibility. Skill mix. Task shifting.
Working
Transactional
Contextual
Focus
Mobile healthprofessionals
Workforce roles
Healthworkforceheadcount
Attractiveness of career
Labour forceWork-lifebalance
expectations
Age of the population
- -
Induced demand
-Workforceinteraction
Quality of care
7. Supply
Working
Transactional
Contextual
Focus
Mobile healthprofessionals
Workforce roles
Healthworkforceheadcount
Attractiveness of career
Labour forceWork-lifebalance
expectations
Age of the population
- -
Induced demand
-Workforceinteraction
Quality of care
Competence
Europe
MS
Pre-workforce trainingWorkforce group practising in a MS
Workforce group practising in a different MS
ExperienceExperience
Key shifts and possible solutions?
Integrated care
24/7 and tech enabled working
24/7
Care model shifts
Secondary Care
Patient and service user empowerment/activation/
self-management
New workforce roles and prototyping
Prototyping and discovering
New roles and skills
Next steps
Further processing of evidence.
Funded by the Health Programme of the European Union
1
2
3
4
Produce a long report ahead of the 23rd April 2015 London meeting.
Thanks to the continued support from EU JA and DG SANCO and WP6 partners.
Identify and draft 5 policy briefs with partners.
Contact details
Matt EdwardsHead of Horizon Scanning & InternationalCfWI, England
@
+44(0)7834 800 393
www.cfwi.org.uk | www.horizonscanning.org.uk
John FellowsHorizon Scanning ConsultantCfWI, England
+44(0)7795 452 972
[email protected]@cfwi.org.uk
Funded by the Health Programme of the European Union