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.
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.
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.
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.
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.
In the CfWI’s robust workforce planning methodology, the engagement of subject matter experts and their continual consultation throughout rigorous horizon scanning and scenario generation phases allows the CfWI to have confidence in the models developed during the later workforce modelling phase. Research and output validation further underpin the value of the policy analysis results these exercises deliver. This process has enabled the CfWI to execute a number of successful workforce policy studies. This technical paper explores how additional focus on retrospective policy testing and the adoption of a wider range of scenarios could add further value to the CfWI’s workforce planning research.
This paper reviews the latest development and provides a revision to the framework. The structure is unchanged but each stage now reflects practical experiences from projects, and key findings from our research and technical papers.
View/Download this paper at http://www.cfwi.org.uk/publications/robust-workforce-planning-framework-update-from-practice.
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.
Here we present the framework for RWP and explain the
key steps in the process. Guidance is given on how the framework might
be used in practice, based on learning from recent projects. We show how
horizon scanning and scenario generation can be used to produce
plausible but challenging futures, and how these may be quantified for
modelling.This approach is new for health and social care workforce
planning in England, and provides policymakers with a new way of
thinking about the future, testing prospective policies and avoiding
unexpected consequences.
View/Download this paper at http://www.cfwi.org.uk/publications/robust-workforce-planning-an-introduction.
Robust workforce planning: Experiences and best practice
Rather than attempt to predict the future, RWP
recognises the intrinsic uncertainty and complexity of factors
influencing workforce demand and supply. Decisions made about workforce
requirements need to work well across a range of futures in order to be
robust against uncertainty. By analysing the key issues and
uncertainties, we generate a set of plausible and highly challenging
scenarios.
Workforce demand and supply is then forecast for each
scenario to understand how workforce numbers or skills might change
over time. Prospective policies can be tested against these scenarios to
see which one is the most effective. This paper describes key learning
points in applying the framework across a number of projects.
View/Download this paper at http://www.cfwi.org.uk/publications/robust-workforce-planning-examples-and-best-practice.
Robust workforce planning: Medical model technical description
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 system dynamics approach meant that robust,
evidence-based supply and demand models could be created to test
potential policies and their impact. It also meant the model was
“transparent” and enabled expertise of several hundred stakeholders from
the healthcare system to be synthesised. As a result of these benefits,
the system dynamics approach is considered fundamental to the CfWI’s
ongoing workforce modelling strategy. The approach is being used by the
CfWI to develop additional supply and demand models for other workforces
across the health and social care systems, including nursing,
midwifery, pharmacy and a range of medical specialties.
View/Download this paper at http://www.cfwi.org.uk/publications/robust-workforce-planning-medical-model-technical-description.
Literature review guidelines
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.
The purpose of this summary on writing literature
reviews in this field is to support analysts delivering research and
workforce intelligence in the field of health and social care. It is a
brief synthesis of the extensive literature on how to conduct a
literature review. Highlighted are the elements to consider when
undertaking a literature review for an organisation such as the CfWI.
The overall process of a research project includes research question
formulation, literature search, data evaluation, analysis and
interpretation.
View/Download this paper at http://www.cfwi.org.uk/publications/cfwi-literature-review-guidelines.
Horizon scanning: Analysis of key forces and factors
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.
View/Download this paper at http://www.cfwi.org.uk/publications/horizon-scanning-analysis-of-forces-and-factors.
Developing robust system-dynamics-based workforce models: A best-practice approachCentral 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.
This technical paper describes the formal approach
adopted by the CfWI for the development of workforce based system
dynamics models. The benefits of having a formalised approach to
workforce model development include models that are better designed,
easier to use, more focussed and more efficient. Applying a rigorous
formal approach also results in increased stakeholder confidence in
model outputs.
The approach is composed of four steps: model
scoping, model construction, model documentation and model testing. Each
stage is described in detail in this report and supported by best
practice guidance.
View/Download this paper at http://www.cfwi.org.uk/publications/developing-robust-system-dynamics-based-workforce-models-a-best-practice-guide.
Scenario generation: Enhancing scenario generation and quantification
This technical paper addresses improvements to the scenario generation stage and includes the following:
- a short review of the history of scenarios and scenario planning, the different types of scenario and methods for generating them
- a formal approach for creating a set of scenarios to present alternative, plausible and challenging visions of the future to inform workforce planning and generating scenarios at different levels of scale, where higher-level scenarios frame scenarios at a lower level of detail, enhancing the coherence of the overall set
- a best-practice method for checking the consistency of scenarios, so that only consistent ones are taken forward for quantification and modelling, eliciting uncertain scenario parameters (all scenarios contain parameters that are inherently unknowable but where values need to be defined for modelling and simulation; this requires input from experts using a formal and defined protocol)
- substantive improvements to the scenario generation process as a result of the above, and areas for future research.
View/Download this paper at http://www.cfwi.org.uk/publications/scenario-generation-enhancing-scenario-generation-and-quantification-3.
Policy analysis: Applying robust decision-making to the workforce planning framework
Policy analysis is a thread that runs throughout the Centre for
Workforce Intelligence (CfWI) robust workforce planning framework, from
the horizon scanning phase through to scenario generation and workforce
modelling. The literature review in this technical paper provides an
introduction to the subject of long-term policy analysis and its
specific NHS workforce planning context in the UK, allowing the reader
to clearly see the links between the CfWI’s methodology and the wider
robust decision-making process.In the CfWI’s robust workforce planning methodology, the engagement of subject matter experts and their continual consultation throughout rigorous horizon scanning and scenario generation phases allows the CfWI to have confidence in the models developed during the later workforce modelling phase. Research and output validation further underpin the value of the policy analysis results these exercises deliver. This process has enabled the CfWI to execute a number of successful workforce policy studies. This technical paper explores how additional focus on retrospective policy testing and the adoption of a wider range of scenarios could add further value to the CfWI’s workforce planning research.
View/Download this paper at http://www.cfwi.org.uk/publications/policy-analysis-applying-robust-decision-making-to-the-workforce-planning-framework-1.
Robust workforce planning framework: Update from practice
The Centre for Workforce Intelligence robust workforce planning
framework has existed largely unchanged for more than two years. This is
perhaps a testament to its simplicity and ease of understanding. Over
20 reviews of health and social care professions have used the
framework. Recent technical papers have reviewed and recommended
improvements to the core stages – horizon scanning, scenario generation,
workforce modelling and policy analysis – in some depth.This paper reviews the latest development and provides a revision to the framework. The structure is unchanged but each stage now reflects practical experiences from projects, and key findings from our research and technical papers.
View/Download this paper at http://www.cfwi.org.uk/publications/robust-workforce-planning-framework-update-from-practice.
Elicitation methods: Applying elicitation methods to robust workforce planning
The CfWI use expert
elicitation as part of our robust workforce planning framework, which we
use in all workforce reviews. The purpose is to provide workforce
planners with an understanding of how the future might evolve for
health, public health and/or social care professions. It can also be
used for groups of professions. This includes simulation of future
supply and demand, in terms of workforce numbers and skills. It also
includes an assessment of the effectiveness of different policy options,
for example, increasing the intake to training, altering working
patterns, or influencing the drivers of demand. This paper explores our
elicitation methods in more detail.
View/Download this paper at http://www.cfwi.org.uk/publications/elicitation-methods-applying-elicitation-methods-to-robust-workforce-planning.
Policy analysis update
Policy analysis is the thread that runs through the CfWI’s Robust
Workforce Planning Framework. The purpose is to determine which of a set
of alternative policies will best meet a specific set of goals.This
requires determining which policy is the most effective, according to
the measures used, against a set of plausible but challenging future
scenarios. Some workforce policies may perform well across all these
futures; we would then say that they are robust against future
uncertainty. However, other policies may not perform as a well. Specific
scenarios may be challenging and the outcome may not be good.
Decision-makers will then need to judge which policy to choose in
situations where several policies perform adequately, but no single
policy is outstanding.
This paper includes the following:
This paper includes the following:
- an updated review of the literature with particular focus on the importance of evidence in policy making and approaches to policy analysis
- selecting policies for analysis, including the conceptual steps to take
- structuring the analysis and the principles for a CfWI policy analysis tool
www.foresight.gov.uk (1990s – 2010)
www.bis.gov.uk/foresight (2010-13)
www.gov.uk/government/collections/foresight-projects (2014)