Applying scenario methods
to health and social care
workforce planning
Dr. Graham Willis
Head of Research and Development, CfWI
E: graham.willis@cfwi.org.uk
T: +44(0)78 1234 0405
Trained hospital
doctors (K)
What we used to do…
Supply
60
Demand
50
40
30
2014
2040
Year
?
Do we trust this?
What if the future is not what we
expect?
System
Problem
Failure
Policy
Events
Mega
trends
Robust workforce planning
Shape your
future
Scan the
horizon
Define the
enquiry
Stress test
interventions
Imagine challenging
futures
High degree of stakeholder
involvement in all stages
Horizon scanning
Contextual
analysis
Ideas about
the future
Issues
Factors
Events
Systemic
analysis
Scenario generation
Influencing Key
factors
factors
Consistency
check
Narrative
scenarios
Delphi to
quantify
Modeling and simulation
Supply Demand
side side
Outputs
Number of pharmacists (full-time equivalent)
100,000
100,000
80,000
80,000
60,000
60,000
40,000
40,000
20,000
20,000
0
0
100,000
100,000
80,000
80,000
60,000
60,000
40,000
40,000
20,000
20,000
0
0
Scenario 3
Year
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
Scenario 1
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
2012
2014
2016
2018
2020
2022
2024
2026
2028
2030
2032
2034
2036
2038
2040
Pharmacy: how uncertain is the
future?
Scenario 2
Scenario 4
Policy options
One-off supply reduction
-50%
Phased supply reduction
then balancing increase
-35%
-20%
-5% -10%
A
B
C
D
E
5 Years
-15%
+3%
F
10 Years
Policy analysis
2
1
Policy options: A
B
C
D
E
F
4
3
Policy outcomes
Pharmacy example
A new challenge: Horizon 2035
What skills and
competences
do we have?
What might we
need in future?
What had we modelled in 2013?
Health
Public health
Social care
2% Workforces modelled to date
98%
Workforces not yet
modelled
What about the rest of the system?
2% Workforces modelled to date
Health
Public health
Social care
10%
Other health and
support
21%
43%
24%
Paid adult care
and support
Volunteer adult
care and support
Unpaid adult care
and support
Some embarrassing problems…
…mostly resolved!
1. Too many Delphi questions!
2. Only four scenarios?
3. We don’t know what skills are
needed to meet future demand.
Solution 1: SHELF
Monte Carlo
simulation
Probability
Sheffield
Elicitation
protocol
Value
Solution 1: Expert elicitation
framework
SHELF
Intensity
of effort
EFSA Delphi
Traditional Delphi
Number of
parameters
Solution 2: GBN method
+A


‒D
+C


‒C
‒B




‒A
+D
+B
Solution 2: CIB Analysis
Population
High
B
Low
A
C
GDP growth
Energy usage
Carbon
emissions
Solution 3: Skills framework
Competences
Skills
Wellbeing
Leadership
Knowledge
Personal
Facilitation
Types of skill
Level of skill
Qualitative skills
Quantitative skills
What skills do you have today?
Workforce
groups
Skill types
Prevent
Adult social care
Enable
Nurses
Assess
Dentists
Plan
Medical generalists
Treat
Medical specialists
Rehabilitate
Volunteer care and support
Relieve
Other workforce groups
Link
What drives the demand for skills?
Demand
Population
Learning disabilities
Singular demand for service
Maternal and perinatal
Infectious disease
Mental long-term conditions
Physical long-term conditions
Population
Oral health
How do our skills met demand?
Workforce
groups
Skill types
Levels
Demand
Population
Prevent
Learning disabilities
Adult social care
Enable
Oral health
Nurses
Singular demand for service
Plan
Maternal and perinatal
Medical generalists
Treat
Infectious disease
Medical specialists
Rehabilitate
Mental long-term conditions
Volunteer care and support
Relieve
Physical long-term conditions
Other workforce groups
Link
1 2 3 4 5
Population
Assess
Dentists
How do our skills meet demand?
Workforce
groups
Skill types
Levels
Demand
Population
Prevent
Learning disabilities
Unpaid adult social care workforce
Enable
Dentists
Medical generalists
Medical specialists
Assess
Singular demand for service
Plan
Maternal and perinatal
Treat
Infectious disease
Rehabilitate
Mental long-term conditions
Volunteer care and support workforce
Relieve
Physical long-term conditions
Other workforce groups
Link
5
Population
Oral health
Nurses
Different futures
Six narrative and quantified scenarios
How does skills demand change?
Reference future
12.7 billion hours
FTE: 7,772,000
9.3 billion hours
FTE: 5,735,000
Change:
Hours: 3.3Bn
FTE: 2,037,000 +36%
How does skills demand change?
Monte Carlo simulation
x
Change in demand
Demand (B)
2.1
Skill level (B) 2.3
LTC Physical health
LTC Mental health
Learning disabilities
0.7
0.4
0.6
0.3
L3
L2
L1
Next steps
1. Multi-scale scenarios and reuse.
2. Probability of scenarios?
3. Presenting findings to policy makers.
More information
Horizon 2035
Future demand for skills:
Initial results
http://www.cfwi.org.uk/publications
/horizon-2035-future-demand-forskills-initial-results
Applying scenario methods
to health and social care
workforce planning
Dr. Graham Willis
Head of Research and Development, CfWI
E: graham.willis@cfwi.org.uk
T: +44(0)78 1234 0405