Expertise is too thinly spread Institutional Care > Community Care Burdens on Acute Care are too great Performance

1. Strategic Workforce Planning The Wanless Report – Key Findings • Expertise is too thinly spread • Institutional Care > Community Care • Burdens on Acute Care are too great • Performance varies widely • The workforce needs developing

2. Strategic Workforce Planning Designed for Life – The Strategy for Wales • Local Health Boards and Authorities Working in partnership to develop local health, social care and well-being strategies for life-long health in fast, safe and effective and world class services. • Whole-system user-centred approach delivered locally to clear standards organised in three networks. • Primary care networks and local resource centres for many services. • Modernised local acute services with high-tech links to specialist hospitals. • Specialized critical care centres including maternity and children’s hospitals.

3. Strategic Workforce Planning Designed for Life – Workforce Issues • Redesign workforce over next three years and embed Agenda for Change. • Improve services in modernising and reconfiguring service provision. • Embed innovation including use of high-tech diagnostic services and web-linked centres. • Secure best practice in accordance with new regulatory and legal framework (post-Shipman). • Build-up leadership capacity and capability.

4. Primary Focused – Community Based Care SPECIALIST SUPPORT SOCIAL & VOLUNTARY SERVICES • Finance • Personnel • Estates • Pathology • Support Staff • Education and Training • Social Services • Legal and statutory duties • Advice and information • Inspections • Carer support networks • Education and Training ACUTE HOSPITAL AIDED LIVING CENTRE (non-medical model) • Integrated Care Group in and outpatient services • Day Surgery and Treatment Centres • Specialist Centres • Intensive Care • Therapists led care • Rehabilitation and alternative therapies • Equipment Store • Carer support PRIMARY CARE • GP’s and practice based care • Aided Self Care • Advisory Services • Self Care COMMUNITY HOSPITALS/ HEALTH CENTRES NURSING HOMES & HOME • Maternity and Child Care Services • Overseeing medical discharge and MOT centre • Investigations and minor surgery • Mental Health Care • Nursing support and night sitting services • Home based treatments • Home based therapies • Respite services and carer support

5. Primary Care Led NHS Elderly Trauma Centre • Parkinson’s • ALC • Dementia Specialist Medical • Dermatology • Oncology • Diabetes M.I.U. Pain Clinic Carer Support • Acupuncture • Osteopathy • Chiropractice GPs Specialist Mental Health Day Surgery • CPN • Psychology • Psychotherapy • Counselling X-ray & Imaging

6. Regulatory and Legal Context • Practice & development • Education and training • Behaviour and attitudes Standards Regulations Education and Training • Revised legal context • Health Council & registration • Revalidation & accreditation • Core curricula • Post-basic programmes • Practice research

7. Modernising Medical Careers – New Junior Doctors’ Training Graduation Postgraduate Schemes under the aegis of the PG Deans and Specialist Clinical Tutors Traditional route “Fast” route   Medical Undergraduate Programme (2 streams) 4-6 years Registration @ mid-point Post-Graduate Foundation Programme (HO & 1st SHO) 2 yrs • GP Certificated Specialists • Basic Specialists (Staff Grade) • Alternative Career routes Basic Specialist Training Programmes(8+streams)*2-3yrs    Overseas doctors Return to Practice doctors EEC doctors • Basic Consultant (some spec) • Specialist Consultant (some spec) • Alternative Career routes HigherSpecialistTrainingProgrammes(50 + streams)2 – 6 yrs • *Basic Programmes (so far) • Medicine in General • Surgery in General • General practice • Child Health • Pathology in General • Anaesthetists • Mental Health • Obstetrics & Gynaecology

8. Strategic Medical Staffing Agenda • Staffing model for August 2004 – implementation of EWTD: • focusing on new shifts and rotas • assessing their likely impact on juniors’ training • Staffing model for August 2006 when the full impact of “Modernising Medical Careers” kicks in: • focusing on new “junior consultant’/staff grade posts • assessing their likely impact on juniors’ working patterns • Staffing model for August 2009 when the full impact of “GP-choice” DTCs and level 3GP Practices kick in: • focusing on setting-up joint appointments with Primary Care Trusts and the private sector DTC providers of surgical care • Focusing on developing accredited GP “Specialists” • Impact of new consultants Contract & post-Shipman Review? • Impact of feminisation of the Medical workforce?

9. Modernising the NHS in WalesIntegrated Service and Workforce Planning • Local Investment Plans • Financial Flows and Controls • Performance Management • Develop Local Service Strategy • Build Capacity • Support Clinical Networks Local Health Boards & Authorities Integrated Service and Workforce Planning Post-graduate Deanery & Specialist Advisers Employers – Workforce Development Groups • “Agenda for Change” and Knowledge and Skills Framework • Non-Medical Staffing groups workforce development strategies • Small specialist staffing groups workforce development strategies • EWTD and Work Intensity changes • Medical Act changes • Medical Standards Board and new Inspection Framework requirements.

10. Strategic Workforce Planning & Development • Are there any connections? Service vision and strategies Workforce numbers • Is there too much emphasis in one area? • Data crunching • Data modelling • Information synthesis Education andTraining Contracting • Is there any room for change? • Financial planning • Change management • Contract monitoring