Developing Workforce Strategies in Children's Services

Sample output graph

Paed consultant outputWe worked with a national group of clinicians, policy advisers and representatives from the Royal College of Paediatrics and Child Health (RCPCH).

Previous work by the RCPCH had identified the need for a doubling in the consultant workforce to deliver a required consultant led service. Our modelling showed that at current training rates, it would take 20 years to get there. The critical issue was that a training period of 8 years actually took over 11 years in practice, due to career breaks and other planned gaps.

Fearing an over-provision of trainees and insufficient consultant posts, the previous national plan had been to start reducing training places. It was clear that rather than reducing them, there needed to be an increase in trainees. This finding was counter to the prevailing view and was a real testament to System Dynamics based modelling.

This then provided a background to an option appraisal, with a focus on delivering a Working Time Directive compliant service in the short term. The increases in trainee numbers, and in due course consultant numbers, would help but only in the longer term; the problem needed more immediate action.

We worked through a series of 23 options in total. Some of those for the shorter term would not be sustainable (increasing the proportion of Direct Clinical Care sessions worked as urgent care; offer an increase for full-time Consultant contracts from 10 to 12 PAs; offer transfer from a part-time Consultant contract to a ‘less’ part-time contract); so any strategy would need to include parallel work with medium to longer term effects (fast tracking trainees; increased Primary Care services; wider development of the nursing role etc). In the process, of course, we were also able to help hospitals rule out some options which they were planning to rely on for short term impact, but which in practice would only deliver in the medium to long term.

Download the full project report below

Workforce strategies in Children's Services Full Report

Download a copy of our full report.