Better Health, Better Care: Planning Tomorrow's Workforce Today

ANNEX A
SUPPLY TRAINING NUMBERS FOR CONTROLLED GROUPS

Introduction

Scottish Ministers are responsible for determining supply training numbers for controlled NHS staff groups. This includes medical training numbers at both undergraduate and postgraduate level, dental graduate numbers, and nursing and midwifery pre-registration training numbers. The overarching principle in determining supply training numbers is to ensure sufficient output in order to supply NHSScotland's projected future demand thereby supporting the delivery of services in a way that is both affordable and sustainable.

Modelling of demand and supply at national level supports this aim, taking into account a range of factors such as:

• projected replacement demand, projected retirements and trends in less than whole time working;
• projected expansion demand, as assessed by NHS Boards in their workforce plans and by non- NHS organisations;
• changes in training programme length and trends in actual time to completion; and
• trainee attrition before completion of training.

THE MEDICAL WORKFORCE

Undergraduate Medical Training Places

The annual intake target for pre-clinical medicine at Scottish universities is 834, with an additional 66 places for overseas students. These targets have been consistent for a number of years, although the actual number of medical students in our universities has varied from year to year as universities manage their own recruitment and admissions.

Following the review of basic medical education undertaken by Professor Sir Kenneth Calman and Michael Paulson-Ellis in 2004, Scottish Ministers decided to provide up to 100 additional clinical places across Scottish medical schools to allow completion of training in Scotland by medical students from the University of St Andrews. St Andrews has just recruited its first cohort of students who will complete their clinical training in Scotland from academic year 2010 onwards. Up to 55 students from the 2007 intake cohort will be able to complete their training in Scotland, followed by up to a further 55 in 2008. Wider medical workforce analysis will be undertaken to inform undergraduate training numbers for future years.

Postgraduate Medical Training Places

There will be 800 places in each year of the 2-year Foundation Programme to provide generic postgraduate medical education for 2008.

In determining the number of specialty training places for 2008 (including general practice), and in addition to the evidence from the national model, we have sought advice from NHS Education for Scotland ( NES), medical Specialty Training Boards and the service in determining final training numbers. Our planning recognises that we are within the transitional phase for MMC implementation with a focus on moving towards service delivery by trained doctors. For this reason, the number of run through specialty training posts will be increased beyond demand for 2008 and there will be an increase in the number of postgraduate specialty training posts across a broad range of medical specialties. For the majority of specialities this coincides with a corresponding reduction in fixed term training posts in these areas. In due course the trainee supply will be aligned strategically with projected future demand for trained doctors.

The length of General Practice training programme rotations has also changed to enable GPs to spend more time in primary care during their training. To support this change in GP training, further investment will be provided to NHS Education for Scotland for 150 additional whole time equivalent posts to ensure that there is continuity in service provision and medical training.

Table 1 shows that:

• Overall, run-through Specialty Training ( ST) places have risen by 226. The increases in ST places coincide with a parallel reduction in Fixed Term Specialty Training ( FTSTA) numbers for most specialties
• No places have been removed in any specialty

Table 1: Medical 'Run-through' Specialty Training Numbers, 2007 and 2008 ²

Notes
1: Mental Health total ST Places 2007 is 15 less than the sum of the Mental Health Specialties due to an advance of 15 FTSTA conversions in 2007
2: All figures are in WTE funded establishment

THE DENTAL WORKFORCE

The Dental Action Plan, published in March 2005, set three year dental student numbers to achieve increased dental graduate numbers and to ensure a consistent graduate output of at least 135 graduates per year in Scotland from 2008.

The table below outlines the number of dental students in each year of study at the Scottish Dental Schools and the projected graduate output for the next 5 years. In addition, it is expected that the Aberdeen Dental School will provide 15 places in 2008, with a capacity for up to 20 places in due course.

The Dental Action Plan and dental workforce are due to be reviewed during 2008.

Table 2: Dental Student Intake by School and by Year

Source: NES

THE NURSING AND MIDWIFERY WORKFORCE

The Nursing and Midwifery Workforce Planning Process (formerly SNIP) is embedded within the arrangements for workforce planning across NHSScotland. Data and intelligence has been gathered from individual NHS Boards' workforce plans and from submissions made by non- NHS employers to determine future demand for nurses and midwives. Modelling and scenario planning, supplemented by the advice of a stakeholder group, informed decision making. The total intake numbers for 2008/09 are 3060 to ensure the appropriate supply of newly qualified nurses and midwives to meet future demand.

Although this represents a reduction in intake for training supply numbers on previous years', evidence suggests that more students will be retained by ensuring a better student experience. It is also intended that resources will be invested in taking forward the recommendations of the Facing the Future Sub Group report on Student Recruitment and Retention to support students in practice based learning and to ensure retention on their education programmes. This approach will ensure progression of as many students as possible to secure a supply of registered staff for the NHS.

Table 3: intake numbers for each Branch of nursing alongside the overall intake total.