Jamie Rentoul, Department of Health, CfWI Annual Conference 2013
CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
Transcript of CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
1/27
Cardiology
This summary sheet contains
recommendations informed by the factscollated by the CfWI in close collaborationwith specialty stakeholders. Thereferences in this summary sheet refer tothe reference section at the end of thefact sheet for this specialty, available at
http://www.cfwi.org.uk/.
http://www.cfwi.org.uk/http://www.cfwi.org.uk/http://www.cfwi.org.uk/ -
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
2/27
Medical Specialty Workforce Summary SheetCardiology
CfWI| August 2011 1
Specialty group: General MedicineSpecialty: Cardiology
Recommendation The CfWI recommends that no change is made to either the numberof training posts or the current geographical distribution of trainingplaces over the next three years.
Although no geographical changes are recommended, stakeholdersneed to be aware of geographical inequalities of accessibility toconsultants and trainees.
A further review of this specialty will take place in 2013 whengeographical allocation will be considered in more detail.
Introduction
The purpose of this document is to make recommendations to inform planning for futuremedical training numbers in Cardiology in England over the next three years. Whenformulating these recommendations, we considered factors such as demographics, lifestyleissues and the views of key stakeholders.
The policies and issues affecting Cardiology include:
The Independent Public Service Pensions Commission: Final Report(2011)recommends switching public sector pensions from existing final salary schemes to anew career-average salary scheme, with existing members moving to the new schemefor future accruals. At Budget 2011, the Government accepted Lord Hutton'srecommendations as a basis for consultation with public sector workers, unions andothers. Depending on its implementation, this may create an incentive for manyconsultants of pensionable age to retire earlier that otherwise planned.
CfWI research and engagement with the specialty has identified the following issue:
Changing methods of investigation and treatment: Currently, consultantcardiologistsduties include carrying out invasive procedures, including fittingpacemakers and diagnostic catheterisation. However, NHS Medical Careers (2011)states that in future,
New imaging modalities such as magnetic resonance and CT scanning are likelyto complement and challenge the invasive investigations performed in thecardiac catheter laboratory.
This has implications for the future working patterns of consultant cardiologists, whowill need to have expertise in using the new technologies. The changing prevalence of
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
3/27
Medical Specialty Workforce Summary SheetCardiology
CfWI| August 2011 2
cardiological conditions and the changing practices in treatment and technology usewould need to be quantified in order to deduce resulting workforce demands.
The reported activity for Cardiology is expected to increase if the Hospital Episode Statistics(HES) finished consultant episode (FCE) and outpatient figures are extrapolated.
Key findings
The most recent data from the NHS Information Centre for Health and Social Care (IC) census(NHS IC, 2011a) records a headcount of 893 (862 full-time equivalent) consultants inCardiology employed in England on 30 September 2010.
College and/orspecialty associationviews
It is possible that due to errors in coding of the medical workforce,the IC figures may not capture all consultant cardiologists, therebyunderestimating the size of the workforce. The CfWI will in future
consider census data from the British Cardiovascular Society, whichis thought to be more accurate but is as yet unpublished.
The Royal College of Physicians (RCP) estimates that for Englandthere should be 2,5904,127 consultant cardiologists, whichequates to 1321 per 250,000 population.
Figure 1, based on data from the IC census, shows that the full-time equivalent (FTE)consultant workforce has expanded by 22.3 per cent during the past five years.
If demand is modelled from a baseline of the consultant supply in 2010 and increases at therate of population growth, it will increase to about 789 FTE in 2020, and constantly remainbelow the level of supply predicted for the consultant workforce. The supply of consultantsover the next ten years is forecast to increase to 1,574 FTE in 2020 (approximately 1,635headcount), an average increase of 5.9 per cent annually. However, this does not reach theRCP (2008) recommendation of 2,5904,127 (the mid-point in this range is modelled below).
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
4/27
Medical Specialty Workforce Summary SheetCardiology
CfWI| August 2011 3
Figure 1: Historical workforce supply (FTE) and future consultant supply and estimation of the number of filled posts for
service delivery Cardiology
Source: Historical supply data is taken from the IC census, 30 September 1997 to 2010. Supply forecasts are based on NHSElectronic Staff Records (ESR) data from November 2010, deanery monitoring data from 2009 and workforce assumptions.Estimates of number of posts to achieve full service delivery use Office for National Statistics (ONS) population projections(2010a) and RCP estimated number of posts to achieve full service delivery (2008).
Recommendations
The IC census data is likely to underestimate the size of the Cardiology consultant workforce.However, the true figures are unlikely to suggest an oversupply of consultants, as the RCP
recommendation is rather higher than forecasts based on the IC census would reach by 2020.
The evidence available does not take account of changes to future service delivery models orthe impact of productivity and new ways of working, which are likely to impact on the futureconsultant workforce.
Cardiology is currently undergoing changes in its methods of treatment and investigation. Atthis stage, the workforce implications of these changes have not been quantified.
The CfWI therefore recommends that no change is made to either the number of trainingposts or to their current geographical allocation.
A further review of this specialty will take place in 2013.
0
500
1000
1500
2000
2500
3000
3500
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
FullTimeEquivalent(FTE)
Year
Cum ulative historical workforce supply (FTE) and future consultant supplyest imation of the number of future filled posts for service delivery - Cardiology
Consultants (FTE) Historic Supply
Specialty Trainees
Staff, Specialty and Associate Specialist Grade (SSASG) Doctors
Royal Co llege estimation of the future number of filled co nsultant posts to deliver service based on a fixed total
Consultants (FTE) CfWI Supply Forecast
Estimation of future number of consultant posts to deliver service du e to population growth only (0.8% for 20+ yr olds)
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
5/27
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
6/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 5
CONSIDERATIONS FOR FUTURE DEMANDS
Current training route
Specialty training in Cardiology commences at ST3, after the trainee has successfully completed Core Medical Training (CMT).
Specialty viewpoints1
Based on British Cardiovascular Society figures, the Royal College of Physicians (2008) estimates that for England there should be 2,5904,127consultant cardiologists, which equates to 1321 for a 250,000 population. The NHS Information Centre (IC) census (NHS IC, 2011a) reports thatthere are 893 headcount (HC) (862 full-time equivalent (FTE)) cardiology consultants in England as at September 2010. It is thought that due toerrors in coding of the medical workforce, the IC figures may not capture all consultant cardiologists, therefore underestimating the size of theworkforce.
Policy drivers
There are no new Government policies specific to Cardiology that will impact on future demand for consultants.
1The CfWI conducted a series of stakeholder engagement meetings with representatives from each specialty. This report will use the term specialty representative to creditinformation presented during these meetings. Although in some cases the source is not e xplicitly named, this information is available on a case by case basis. Ple ase contact theCfWI if more information is required.
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
7/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 6
Demographics
The charts in Figure 1 display the population age distribution in England in 2011 and 203, based on Office for National Statistics (ONS, 2010)forecasts for both males (left chart) and females (right chart). Hospital Episode Statistics (HES) data for inpatient finished consultant episodes(FCEs) (NHS IC, 2011b) were analysed to identify the age range(s) which appear to use the specialty the most. The shaded bars show the subgroupsof the population which use the specialty more. The darkest shaded bars represent those that fall in the upper quartile (the top 25 per cent) of the
parts of the population that use the service the most, when compared with the equivalent age bands of the overall population. The unshaded barsindicate the population percentage for that age group in 2031.
Figure 1 indicates that, based on FCE data, males aged 6084 and females aged 65 and over are the patients who use Cardiology services the most.Additionally the data suggests that males aged 3559, males aged 84 and over and females aged 2064 also use the service, but to a lesserdegree. Patients outside these age ranges do not appear to use the service on a regular basis and account for only occasional use.
Figure 1 also indicates that the population in all age bands from 65 and over is predicted to grow over the next 20 years. This is likely to have adisproportionate effect on demands for Cardiology in comparison with other specialties.
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
8/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 7
Figure 1: 2031 population estimate and indication of age and gender of the 2011 population using Cardiology
Source: HES Data provides the specialty specific age range that is applicable to the population using Cardiology (NHS IC, 2011b). Population statistics updated July 2008 (ONS, 2010).
6%5%4%3%2%1%0%
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
% Total population
Agegroup
Male high service use group2011 Male population % &
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
9/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 8
Health and lifestyle
Lifestyle Influences
The lifestyle and health of the population are major drivers for the cardiology workforce. Smoking and poor diet can cause many diseases thatrequire treatment by this specialty. The table in Annex 2 shows the trends for a select number of behaviours which are relevant to Cardiologyservices.
Tobacco Smoke
Figure 2: Lung cancer incidence and smoking trends, Great Britain by sex 1948-2009 (Cancer Research UK, 2011c)
According to Cancer Research UK (2011a), the single greatest cause ofpreventable illness and premature death in the UK is smoking. Smoking is seenas a factor towards lung cancer, coronary heart disease and chronic obstructivepulmonary disease (COPD) (NHS Choices, 2010a). Cancer Research UK (2011a)reports that in 2009, approximately 10 million adults smoked cigarettes inBritain, 22 per cent of men and 20 per cent of women. Cancer Research UKs
data indicates that although smoking prevalence has been gradually decliningsince the early 1970s, the proportion of current cigarette smokers (21 per cent)has not changed significantly in recent years (Figure 2). According to Action onSmoking and Health, men were more likely than women to have given upsmoking cigarettes with 30 per cent male ex-smokers compared to 22 per centfemale ex-smokers (ASH, 2011).
0
20
40
60
80
100
120
140
0
10
20
30
40
50
60
70
1948
1952
1956
1960
1964
1968
1975
1979
1983
1987
1991
1995
1999
2003
2007
Rateper
100,000
%
ofadultpopulationwhosmokedcigarettes
Year
Mal e sm oki ng p re va len ce Fe ma le sm oki ng pre val ence
M al e l un g c an ce r i nc id en ce Fe ma le l un g c an ce r i nc id en ce
Lung cancer incidence and smoking trends, Great Britain, by sex, 1948-2009
Smoking data weighted after 1998, so urce: GHS, ONSSmoking data prior to 1974 from Wald and Nicolaides-
Bouman, 1991Actual lung cancer incidence data 1975-2008 from CR-UK
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
10/27
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
11/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 10
Diabetes
People with diabetes are more likely to develop coronary heart disease compared with those without diabetes. The majority of people withdiabetes die from cardiovascular disease. Cardiovascular disease accounts for 44 per cent of fatalities in people with type 1 diabetes and 52 percent of fatalities in people with type 2 diabetes (Diabetes UK, 2010). Diabetes UK suggests that the number of adults diagnosed with diabetes inthe UK amounts to 2.6 million and approximately half a million people do not realise that they have diabetes. It is predicted that by 2025 the UK
diabetes population will reach more than four million people. Studies show that diabetes has the strongest association with obesity.
Hypertension
NHS Choices (2010c) indicates that 18 per cent of adult men and 13 per cent of adult women have high blood pressure but are not receivingtreatment for it. NHS Choices identify the following as risk factors for high blood pressure:
agepoor dietlack of exercisebeing overweightexcessive alcohol consumption.
Diet
The NHS IC (NHS IC, 2011c) reports that in 2008, 25 per cent of men, 29 per cent of women and around 20 per cent of children in aged 515reported meeting the Governments 5 a day guidelines of consuming five or more portions of fruit and vegetables a day. NHS Choices lists ahealthy diet as a means of preventing coronary heart disease (NHS Choices, 2010d) and hypertension (NHS Choices, 2010c).
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
12/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 11
Physical inactivity
A report published by the NHS IC (NHS IC, 2011c) indicates that lack of physical activity has decreased amongst both men and women since 1997,with 39 per cent of men and 29 per cent of women meeting the recommended levels in 2008 (at least 30 minutes of moderate or greater intensityactivity, 5 times per week). In 2008, boys aged 215 were more likely than girls to meet the recommended levels of physical activity with 32 percent of boys taking part in 60 minutes or more of physical activity on each of the seven days in the preceding week to the survey compared with 24
per cent of girls. It can be assumed that physical inactivity will be decreasing in the future. NHS Choices lists physical activity as a means ofpreventing coronary heart disease (NHS Choices, 2010b) and hypertension (NHS Choices, 2010c).
Alcohol
The National Audit Office (2008) reports that more than 10 million people (31 per cent of men and 20 per cent of women) are now regularlydrinking above the guidelines set by Government. The importance of tackling this problem has been reported particularly in the Choosing HealthWhite Paper (2004) and in Lord Darzis review of the future of the NHS, High Quality Care for All (DH, 2008). NHS Choices lists keeping alcoholconsumption within recommended levels as a means of preventing coronary heart disease (NHS Choices, 2010d) and hypertension (NHS Choices,2010c).
Coronary heart disease
The NHS IC (NHS IC, 2007) summary of the National Coronary Angioplasty Audit states that coronary heart disease accounts for around one in fivedeaths in men and one in six deaths in women. It is also estimated that there are over 1 million men and 840,000 women l iving in the UK who haveor have had angina (British Heart Foundation, as cited by NHS IC, 2007).
The British Medical Journal (BMJ, 2011) reports that Body Mass Index (BMI) in young adults and adolescents has been linked to heart disease,predicting future risk in later life, after adjusting for age, family history, lifestyle and blood biomarkers. The BMJ notes that some BMI scores predicta higher risk of heart disease currently fall within the normal BMI range (New England Journal of Medicine, as cited by BMJ, 2011).
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
13/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 12
Congenital heart disease (CHD)
Patient UK (2011) states that:
The incidence of congenital heart disease in full term live born infants is between 4 and 9 per 1,000.
Each year there are about 1.5 million new cases worldwide.
It is the most common congenital condition diagnosed in newborns.
As more of these children survive into adulthood, there are more adults now requiring surgery for this condition. Although this is often carried outby paediatric surgeons, ongoing care is required from consultant cardiologists with expertise in Adult CHD. The factors in this section will need tobe quantified, and the relative influences assessed before an overall level of demand can be gauged.
Changes in activity
Changing methods of investigation and treatment
Currently, consultant cardiologists duties include carrying out invasive procedures such as fitting pacemakers and diagnostic catheterisation.However, NHS Medical Careers (2011) state that in future, new imaging modalities such as magnetic resonance andCT scanning are likely tocomplement and challenge the invasive investigations performed in the cardiac catheter laboratory. This has implications for the future workingpatterns of consultant cardiologists. The changing prevalence of cardiological conditions and the changing practices in treatment and technologyuse would need to be quantified in order to deduce resulting workforce demands.
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
14/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 13
Finished Consultant Episodes (FCEs)
Figure 4a shows Finished Consultant Episode (FCE) data for Cardiology up to 2009.
Figure 4a: FCEs per year for Cardiology
Source: (NHS IC, 2011b). The data shows annual number of FCEs. FCEs were recorded in the tax year in which they finished, the date on the graph indicates the starting year for each tax year.
It is assumed that the recording and definition of FCEs in this speciality has not changed significantly over this time period, and therefore the rise inFCEs indicates an increase in activity in the speciality. The majority of cardiology FCEs are for outpatients. Figure 4b shows the trend in outpatientattendances from 20032009; it also indicates a trend of an increase in activity.
0
100000
200000
300000
400000
500000
600000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009FinishedConsultantEpisodes(FCEs)
Year starting
Finished Consultant Episodes for Cardiology
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
15/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 14
Outpatient attendances
Figure 4b: All outpatient attendances per year for Cardiology
Source: (NHS IC, 2011d). OAs were recorded in the tax year in which they occurred, the date on the graph indicates the starting year for each tax year.
0
200000
400000
600000
800000
1000000
12000001400000
1600000
1800000
2000000
2003 2004 2005 2006 2007 2008 2009
Outpatientappo
intments
Year starting
Outpatient attendances per year for Cardiology using specialtycodes 320.
First appointment Subseque nt appointments All appointments
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
16/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 15
CURRENT AND FORECAST SUPPLY
Existing Workforce
Supply and age profile
The most recent data from the Information Centre census (NHS IC, 2011a) records a headcount (HC) of 893 HC (862 FTE) consultants employed inEngland as at 30 September 2010. The latest available data records 915 FTE consultants (955 HC), including 25 locums, as at February 2011(extracted via iView from Electronic Staff Records (ESR), May 2011).
The age profile of the current consultant workforce as at September 2010 is shown in Figures 5a and b.
Figures 5a and b: (a) Consultant age profile (FTE), and (b) Consultant age profile (HC) Cardiology
Source: (NHS IC, 2011e).
050
100
150
200
250
300
under30
30to34
35to39
40to44
45to49
50to54
55to59
60to64
65to69
70andover
FullT
imeEquivalent(FTE)
Age bracket (years)
Consultant age profile (FTE) - Cardiology
050
100
150
200
250
300
under30
30to34
35to39
40to44
45to49
50to54
55to59
60to64
65to69
70andover
Headcount(HC)
Age bracket (years)
Consultant age profile (HC) - Cardiology
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
17/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 16
The chart shows a plentiful supply of younger staff and a small proportion of staff working beyond typical retirement age. There appears to be noimpending retirement bulge in the near future.
The IC three-month vacancy rate for all general medicine consultants is 0.0 per cent as of March 2010 (the latest available data); the three-monthvacancy rate for cardiology consultants is higher at 0.5 per cent (NHS IC, 2011f).
Vacancies and locum staff
Data extracted via iView from ESR, December 2010 (ESR, 2010), records that 2.6 per cent of the practising consultant workforces are locums (25locums out of a total of 930 consultants).
The NHS IC vacancy survey (NHS IC, 2011f) records a three-month vacancy rate of 0.5 per cent for cardiology consultants in England.
Geographical distribution
Tables 1a and b below show the geographical distribution of doctors and trainees in absolute values and in relation to the weighted capitation ofeach Strategic Health Authority (SHA), a description of weighted capitation is given below*.
Tables 1a and b suggest that, out of the ten SHAs, NHS London is significantly over-capitated, i.e. the only area with a significantly greaterproportion of Englands doctors in training and consultant grade doctors than if provision were to follow weighted capitation. This indicates askewed geographical distribution of the workforce.
*The Department of Health uses a weighted capitation formula (WCAP) to distribute resources to primary care trusts (PCTs) based on the relativehealth needs of each PCTs catchment area (DH, 2011a). If qualified doctors and trainees were equitably distributed according to the formula, allother columns in Table 1b would be zero. Values greater than zero indicate that the SHA has more doctors than would be included by WCAP; valuesless than zero indicate that the SHA has fewer doctors than would be included by WCAP. However, the CfWI recognises that weighted capitationdoes not reflect that specialist services are not equally distributed throughout England. It is also important that all training posts are of high quality,and high-quality training placements may not be equally available across England.
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
18/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 17
Tables 1a and b: a) Actual number of doctors by grade and SHA, across ten SHAs for Cardiology, b) Number of FTE above or below that recommended by weighted capitation alone
Number of doctors (FTE) by grade and SHA,shown for cardiology - Based on IC census datafor 2010 and deanery monitoring data for 2009
Number of doctors (FTE) over or under thenumber recommended by weighted capitation
alone
Table (a) Table (b)
SHA WeightedCapitation
Doctorsintraining
SSASG Consultant Doctors intraining
SSASG Consultant
North East 5.80% 34 4 56 0 -3 6
North West 15.00% 78 21 132 -10 2 3
Yorkshire & The Humber 10.70% 47 19 82 -16 4 -10
East Midlands 8.60% 32 9 63 -18 -3 -11
West Midlands 11.00% 50 21 87 -14 5 -8
East of England 10.30% 57 14 83 -3 -1 -6
London 14.20% 178 23 173 95 3 51
South East Coast 7.70% 29 7 51 -16 -4 -15
South Central 6.80% 42 5 52 2 -5 -7
South West 9.90% 38 18 84 -20 4 -1
Total 100.00% 585 142 862Source: Weighted capitation (DH, 2011b), Consultant/SSASG numbers (NHS IC, 2011a) and deanery monitoring (NHS IC, 2009).Note due to rounding sum of data may not match presented totals
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
19/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 18
Recruitment
Table 2: 2010 Specialty recruitment for Cardiology at ST3, by Deanery
The level of recruitment to further medical training is shown in Table 2.The table illustrates the situation at point of entry in 2010. The datacorrespond to posts openly advertised.
The table shows a successful fill rate at ST3. The data implies anuneven distribution geographically, with the East Midlands deaneryexhibiting a fill rate of less than 100 per cent of the available posts.However, it is thought that all posts were filled in reality. Manydeaneries overfilled their positions possibly due to candidatesdeferring entry.
Source: (DH, 2010).Note: London recruitment includes recruitment to London, London/KSS andLondon/KSS/EoE
Deanery AvailablePosts
AcceptedPosts
Fill Rate
East Midlands 9 8 89%
East of England 5 6 120%
Kent, Surrey and Sussex 0 0 -
London 20 21 105%
Mersey 4 6 150%
North West 0 0 -
Northern 3 3 100%
Oxford 5 6 120%
Peninsula 4 5 125%
Severn 0 0 -
West Midlands 7 7 100%Wessex 3 5 167%
Yorkshire and the Humber 5 10 200%
Total 65 77 118% (avg.)
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
20/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 19
Consultant projections
The supply and forecast of doctors in Cardiology is shown in Figures 6a and b. Historical data is taken from the NHS Information Centre (IC) MedicalCensus (19972010) (NHS IC, 2011a).
The objective of the medical workforce configuration data in Figures 6a and b is to show how the service has historically been delivered inCardiology, with a combination of consultants, staff, specialty and associate specialist grade (SSASG) doctors, and trainee doctors (who may be intraining towards another specialty, but are providing service in Cardiology). The figures are based on the latest data available (SSASG data datesback to 2005).
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
21/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 20
Figures 6a: Historical workforce supply (FTE) and future consultant supply and estimation of the number of filled posts for service delivery Cardiology
Figure 6a shows that the consultant workforceexpanded by 22.3 per cent during the past five yearsbased upon the information centre (IC, 2011a) census.The trend is reflected by middle-grade medical stafftogether with trainees (which are defined as those inthe SHO and registrar groups and therefore includemore than just doctors in training to CCT in
cardiology, but are forming part of the cardiologyservice delivery). These staff groups now constitute58.1 per cent of the medical cardiology workforce.The supply of cardiology consultants over the next 10years is forecast to increase to 1,574 FTE in 2020(1,635 HC), an average increase of 5.9 per cent
Source: Historical Supply Data (NHS IC, 2011a), Su pply forecast (ESR,2010), (NHS IC, 2009) and workforce assumptions. Estimates of numberof posts to achieve full service delivery use population projections (ONS,2010).
0
500
1000
1500
2000
2500
3000
3500
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
FullTimeEquivalent(FTE)
Year
Cu mulative historical workforce s upply (FTE) and future consultant supplyes timation of the number of future filled posts for service delivery - Cardiology
Consultants (FTE) Historic Supply
Specialty Trainees
Staff, S pecialty and Associate Specialist Grade (SSASG) Doctors
Royal College estimation of the future number of filled consultant posts to deliver service based on a fixed total
Consultants (FTE) CfWI S upply Forecast
Estimation of future number of consultant posts to deliver service due to population growth only (0.8% for 20+ yr olds)
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
22/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 21
Figure 6b: Historical workforce supply (HC) and future consultant supply and estimation of the number of filled posts for service delivery Cardiology
The supply forecast is based on the followingmodelling assumptions*:
There is higher specialty training of 5 years (ST3to ST7) after trainees complete core training (CT1-CT2)in core medical training.
The total national training numbers (NTNs) intraining are split evenly across the higher specialtytraining years, and NTNs are recycled upon traineesgaining a CCT. All recycled NTNs are assumed to befilled in the next application process.
Every new CCT holder is assumed to start workas a consultant within the same year.
The only source of joiners to the consultantworkforce is through the training system. Themodelling of this route takes into account the age oftrainees, length of training, likely delays and attrition.
The only leavers modelled are permanentleavers from the consultant workforce e.g. retirements.A distribution of retirements is modelled which reflectsthe variation in age of retirement between consultants.
*These assumptions were reached by analysing past
trends, and engaging with the specialty in order to
identify indications that trends may change in the
future.
0
500
1000
1500
2000
2500
3000
3500
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Headcount(HC)
Year
C um ulative historical workforce supply (HC) and future consultant supplye stima tion of the number of future fil led posts for service delivery - Cardiology
Consultants (HC) Historic Supply
Specialty TraineesStaff, Specialty and Associate Specialist Grade (SSASG) Doctors
Royal College estimation o f the future number of filled consultant posts to deliver service based on a fixed total
Consultants (HC) CfWI Su pply Forecast
Estimation of f uture number of consultant posts to deliver service due to population growth only (0.8% for 20+ yr olds)
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
23/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 22
REFERENCES
Action on Smoking and Health (2011) The ASH Fact Sheet series. [online] Available at: http://www.ash.org.uk/information/facts-and-stats/fact-sheets[Accessed June 2011].
Aveyard P. West R. (2007) Managing smoking cessation. British Medical Journal. 335: 3741.[online] Available at:http://www.bmj.com/content/335/7609/37.short[Accessed June 2011].
British Medical Journal (2011) BMI in adolescence independently predicts later heart disease but not diabetes. British Medical Journal. 342 (April),pp. 847.
Cancer Research UK (2011a) Smoking statistics. [online] Available at: http://info.cancerresearchuk.org/cancerstats/types/lung/smoking/[Accessed 11 June 2011].
Cancer Research UK (2011b) All cancers combined statistics - Key Facts.[online] Available at:http://info.cancerresearchuk.org/cancerstats/keyfacts/Allcancerscombined/[Accessed 11 June 2011].
Cancer Research UK (2011c) Diet, alcohol and cancer in the UK statistics. [online] Available at:http://info.cancerresearchuk.org/cancerstats/causes/lifestyle/diet/[Accessed 11 June 2011].
Department of Health (1998) Smoking kills a white paper on tobacco. [online] Available at:http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4006684[Accessed April 2011].
Department of Health (2000) Cancer plan. [online] Available at:http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009609 [Accessed April 2011].
http://www.bmj.com/content/335/7609/37.shorthttp://www.bmj.com/content/335/7609/37.short -
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
24/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 23
Department of Health (2004) Choosing Health: Making healthy choices easier. [online] Available at:http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4094550[Accessed April 2011].
Department of Health (2008) High Quality Care for All,June 2008. [online] Available at:http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825 [Accessed April 2011].
Department of Health (2010) DH monitoring of recruitment, Oct 2010.
Department of Health (2011a) Resource Allocation Weighted Capitation Formula (seventh edition). [online] Available at:http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124947.pdf [Accessed April 2011].
Department of Health (2011b) Weighted capitation values are for 2011-12, published 8/03/11 on DH website.
Diabetes UK (2010) Diabetes in the UK 2010 (Mar 2010): Key statistics on diabetes. [online] Available at:http://www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-in-the-UK-2010/[Accessed June 2011].
Electronic Staff Record (2010) Data Warehouse data extracted from NHS Information Centres iView, December 2010.
National Audit Office (2008) Reducing alcohol harm: Health services in England for alcohol misuse.[online] Available at:http://www.nao.org.uk/publications/0708/reducing_alcohol_harm.aspx[Accessed June 2011].
NHS Choices (2010a) Smoking (quitting) Introduction. [online] Available at: http://www.nhs.uk/Conditions/Smoking-(quitting)/Pages/Introduction.aspx [Accessed 12 June 2011].
NHS Choices (2010b) Smoking (quitting) Treatment. [online] Available at: http://www.nhs.uk/Conditions/Smoking-(quitting)/Pages/Treatment.aspx [Accessed 12 June 2011].
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825http://www.nao.org.uk/publications/0708/reducing_alcohol_harm.aspxhttp://www.nao.org.uk/publications/0708/reducing_alcohol_harm.aspxhttp://www.nao.org.uk/publications/0708/reducing_alcohol_harm.aspxhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825 -
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
25/27
Medical Specialty Workforce Fact SheetCardiology
CfWI| August 2011 24
NHS Choices (2010c) High blood pressure: Introduction.[online] Available at: http://www.nhs.uk/Conditions/Blood-pressure-%28high%29/Pages/Introduction.aspx [Accessed June 2011].
NHS Choices (2010d) Coronary heart disease prevention. [online] Available at:http://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspx[Accessed June 2011].
NHS Information Centre (2007) Summary of the national coronary angioplasty audit, January to December 2005. [online] Available at:http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/coronary-heart-disease/national-coronary-angioplasty-audit-january-to-december-2005.
NHS Information Centre (2009) Deanery Monitoring Data 2009 as at 31 March 2009. [online] Available at:http://www.cfwi.org.uk/resources/data/deanery-monitoring-2009[Accessed June 2011].
NHS Information Centre (2011a) Medical and Dental Staff Censusas at 30 September 2010. [online] Available at:http://www.ic.nhs.uk/webfiles/publications/010_Workforce/nhsstaff0010/Medical/Med_and_Den_Detailed_Results_Tables_2010.xls [AccessedApril 2011].
NHS Information Centre (2011b) Hospital Episode Statistics for England:Main specialty Finished Consultant Episodes for England 1998-2009.[online] Available at: http://www.hesonline.nhs.uk[Accessed April 2011].
NHS Information Centre (2011c) Statistics on obesity, physical activity and diet: England, 2011, Feb 2011. [online] Available at:http://www.ic.nhs.uk/pubs/opad11[Accessed April 2011].
NHS Information Centre (2011d) Hospital Episode Statistics for England: Outpatient attendances (main specialty) 2003-2009. [online] Available at:http://www.hesonline.nhs.uk[Accessed April 2011].
NHS Information Centre (2011e) Workforce data, consultant headcount and Full Time Equivalent breakdown by age bandas of 30 September
2010. [online] Available at: https://iview.ic.nhs.uk/[Accessed April 2011].
http://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspxhttp://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspxhttp://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspxhttp://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspxhttp://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspxhttp://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Prevention.aspx -
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
26/27
-
8/12/2019 CfWI medical fact sheets and summary sheets - August 2011 - Cardiology.pdf
27/27
www.cfwi.org.uk
The Centre for Workforce Intelligence produces qualityintelligence to inform better workforce planning that
improves peoples lives
CONTACT [email protected] T+44(0)1962 814 950
mailto:[email protected]:[email protected]:[email protected]:[email protected]