FORESIGHT

The R&D team shares its knowledge of best practice through an ongoing series of technical papers which focus on a variety of areas of workforce planning. This series of papers is also used to share new approaches that the R&D team has developed and may potentially include papers commissioned from external organisations and experts on topics of particular interest in the future.
Robust workforce planning framework: An introduction
The health and social care system is complex. It is made up of many organisations and professions, and different parts of the system respond to change in different ways. The environment that the system has to operate in is uncertain. In this context, planning the right workforce for the future is challenging. The risks of not planning effectively are huge: lives can be put in jeopardy, morbidity may increase and huge sums of money wasted.
This paper introduces a new method developed by the CfWI called robust workforce planning (RWP). We think first about what health and social care may look like in the future, and create a set of scenarios to capture the inherent uncertainty. We then focus on policies to deliver the required workforce, and test them against these scenarios. This allows us to select the policy that is the most robust against unexpected change.
This paper describes the model used to quantify the future supply and demand of doctors. The model was developed as part of project for the UK Department of Health (DH) to inform a Health and Education National Strategic Exchange (HENSE) review of the intake to medical and dental school. The purpose of the work was to provide intelligence to inform recommendations of the HENSE review group on future student intakes to medical and dental schools looking forward to 2040.
Due to the complexity of the model scope and scale it was decided that the system dynamics approach was best suited to meeting the modelling requirements. System dynamics is a simulation method that enables the behaviour of complex systems over time to be understood and simulated. System dynamics models represents changes to a system over time by using the analogy of system flows accumulating and depleting over time in stocks. Historically, the CfWI has developed Excel-based models to represent these complex systems.
The CfWI informs health and social care planners, clinicians and commissioners seeking workforce planning and development expertise to improve health and social care services. With the aim of supporting long-term and strategic scenario planning for the whole health and social care workforce, the CfWI relies on research, evidence and analysis to build strong leadership and capability in workforce planning.
 There are three key areas on which the CfWI focuses: leadership, workforce intelligence, and, last, the support and resources to improve the effectiveness of workforce planning.
This technical paper addresses improvements to the horizon scanning stage of the CfWI RWP framework around the use of systems thinking to understand the system under investigation.The CfWI uses horizon scanning (the exploration of possible futures) to investigate likely future developments that may occur within the health and social care system and impact on workforce supply and demand.
Horizon scanning is part of wider range of activities concerned with a systemic and systematic analysis of the system under investigation, and its past, present and future. It is important that the horizon scanning process integrates with this approach, and in particular with the scenario generation stage of the framework. Improvements may be needed to how horizon scanning ideas or issues are analysed to determine the key factors of interest in the system, and to the horizon scanning website or ‘hub’ (www.horizonscanning.org.uk) that is used to capture them.
A consistent set of definitions has been produced and tested. It is presented in this paper. The review of the hub confirms the utility of a web-based approach for collecting data about the system under investigation.Detailed analysis of hub data has identified areas where improvements can be made. Causal loop diagrams have proved a simple and effective method for mapping the system and highlighting areas of interest. They are a promising basis for the analysis of system factors.
Developing robust system-dynamics-based workforce models: A best-practice approach
Central to the RWP framework are workforce models developed using the system dynamics (SD) method that calculate workforce supply and demand. System dynamics modelling is used since it is most appropriate for complex systems with feedback, such as health and social care workforce planning.