Transcript GP workforce predictions: through a glass darkly?

GP workforce predictions:
through a glass darkly?
AUDGPI, 27th February 2009
Dr. Conor Teljeur
Prof. Tom O'Dowd
Prof. Fergus O’Kelly
Dr. Aisling Ní Shúilleabháin
Dept. of Public Health & Primary Care,
Trinity College Dublin
Aims of the workshop:
• Estimate numbers of GPs needed to
2021
• To identify interventions that will
address workforce issues
Agenda
• What do we know?
• What do we forecast?
• How might we deal with the issues?
Sources of information
Age profile of GPs
Training places
Buttimer Report (2006), recommendation
47:
"the HSE should implement the policy
previously adopted by the Department of
Health and Children to increase the annual
intake of GP Trainees from the current 88
to 150 by 2008."
Attrition
• Approximately 10% of trained GPs do not
practice as GPs – that represents an
investment of ~ €2.3m lost each year
• Intention to retire early:
– 13% intend to retire before 60
– 43% intend to retire before 65
Agenda
• What do we know?
• What do we forecast?
• How might we deal with the issues?
Assumptions
• No change in patient behaviour – that is,
total demand will be in proportion to the
age-sex distribution of the population
• Demography of trainees to remain stable
• Sessions and retirement age of GPs to
remain stable
GP numbers – demand
3,100
3,000
Number of GPs
2,900
Demand
2,800
2,700
2,600
2,500
2008
2010
2012
2014
2016
Year
2018
2020
2022
GP numbers – fixed intake/120 per annum
3,100
3,000
Demand
Number of GPs
2,900
Stable intake
2,800
2,700
2,600
2,500
2008
2010
2012
2014
2016
Year
2018
2020
2022
GP numbers – reduced drop-out to 5%
3,100
Demand
3,000
Stable intake
Number of GPs
2,900
2,800
Stable intake +
reduced drop-out
2,700
2,600
2,500
2008
2010
2012
2014
2016
Year
2018
2020
2022
GP numbers – increase intake to 150 annually
3,100
Demand
3,000
Stable intake
Number of GPs
2,900
2,800
Stable intake +
reduced drop-out
Increased intake
2,700
2,600
2,500
2008
2010
2012
2014
2016
Year
2018
2020
2022
GP numbers – increased intake + reduced drop-out
3,100
Number of GPs
Demand
3,000
Stable intake
2,900
Stable intake +
reduced drop-out
Increased intake
2,800
Increased intake +
reduced drop-out
2,700
2,600
2,500
2008
2010
2012
2014
2016
Year
2018
2020
2022
Trainee contribution to sessions
5.5%
existing intake
% sessions provided by trainees
5.0%
increased intake
4.5%
4.0%
3.5%
3.0%
2008
2010
2012
2014
2016
Year
2018
2020
2022
Ratio of male:female GPs
2.5
Ratio of male:female GPs
2.0
1.5
1.0
0.5
0.0
2008
2010
2012
2014
2016
Year
2018
2020
2022
Impact of M:F ratio on sessions
Average sessions per GP
10
9
8
7
2008
2010
2012
2014
2016
Year
2018
2020
2022
Agenda
• What do we know?
• What do we forecast?
• How might we deal with the issues?
Options for additional training places
Other options
• Increase role substitution - nurses
• Clinical pharmacy - bigger role
• Recognition of prior hospital experience
• Recruitment from EU & Non EU countries
• Anything else?...