Primary care workforce optimisation for the NHS using AI technology

The Challenge

General practice is under sustained pressure: demand is rising with an ageing population while GP recruitment and retention worsen, so practices default to scarce GP appointments even when another clinician could safely see the patient. Commissioners like BOB CCG needed a way to match practice capacity to patient demand across a whole region, not surgery by surgery.

The Solution

NQM applied its Care Workforce Analytics tooling — data import from practice staffing records, a Workforce Substitution Calculator, a Skills Calculator and workforce planning views at CCG and PCN level — to show which GP consultations could be undertaken by other suitably qualified staff roles, what the cost savings would be, and where vacancies, trainees and upcoming retirements create future capacity risk (service description).

Outcomes

The engagement delivered analysis and planning tools that helped BOB CCG’s GP surgeries gain efficiencies by flexibly using staff as alternatives to GPs — routing patients to the most appropriate clinician role rather than defaulting to GP appointments.

In Detail

Using data to match GP practice capacity with demand.

Care Workforce Analytics has been designed to determine the number of GP consultations which might be freed up by using the wider practice staff. It calculates the workforce mix required to meet the shortfall and the potential cost savings. It is based on national data sets and research, but all elements can be refined to account for local variations. It also allows PCNs and CCGs to plan future workforce requirements by examining aggregated GP practice level information on staff numbers, vacancies, trainees and upcoming retirements.

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Core benefits

• Secure — our technology uses state-of-the-art digital certificate-based security.
• Privacy — fine-grained permission levels ensure only the right people access sensitive information.
• Strategic Management — strategically manage the workforce and training for resilience and to meet future demand.
• Triage Demand — tactically triage and direct incoming demand to the most appropriate workforce across primary, secondary, social and community care.
• Cost Efficient — manage resources to optimise cost efficiency.
• Collaborative Resources — enable providers to share resources.
• Risk Analysis — understand the margin of error and risks entailed.
• Real Time Response — respond to real-time demand fluctuations with optimised use of existing resources.

Data import. Based on national data for the average number of consultations for each demographic band, trends in consultation rates in General Practice 2008/2009 (updated to reflect the average 3.3% annual increase in activity since then) and the percentages of these consultations which could be provided by other healthcare professionals. This data is used to calculate the estimated number of consultations which could be undertaken by these staff. The demographics, workforce and salary data are taken directly from the NHS portal, and can be updated subsequently for each practice, CCG or PCN.

Workforce substitution calculator. Calculates the number of GP consultations which can be undertaken by non-GP staff, along with the number of GP hours that could be substituted for this, presenting the results as both sessions and Full Time Equivalent (FTE). The population demographics, utilisation rates, substitution rates, appointment durations, salaries and appointment locations (home, online, phone, surgery) can all be edited with local data where available. Average costs for employment are also provided.

CCG & PCN views. Aggregated information about the potential for workforce substitution can be viewed at both PCN (primary care network) and CCG (clinical commissioning group) level.

Skills calculator. GPs perform a wide range of functions, some of which have been delegated to Practice Nurses and Health Care Assistants. A number of tasks undertaken by GPs could also be managed by the wider workforce (e.g. pharmacists, physiotherapists and physician associates). The skills calculator supports the identification of staff that can undertake a set of tasks: by adding skills to the ‘Gladstone Bag’, the tool returns the list of staff who can perform all the skills selected.

Succession planning. The Age and Sessions RAG Rating editor supports succession planning for the general practice workforce. It highlights (Red-Amber-Green) staff aged 50 to 60, assumes retirement at age 60 (based on current average retirement ages for GPs and Practice Nurses) and defaults session numbers to nil from that age. It also highlights any discrepancy — positive or negative — in session numbers in years 2 and 5, compared with now, and allows session numbers to be varied for planning purposes.

Vacancies editor. Uses national NHS data to estimate the number of FTEs for each workforce staff type in each practice. The data can be edited at practice level and allows saving the number of trainee placements and their remaining time.

Workforce reports. Show aggregated workforce data for each practice in a CCG or PCN for both the workforce substitution calculator and general workforce planning, giving an overview of the total headcount, FTE, vacancies, trainees and retirement information for the whole CCG or PCN.