Future Medical Workforce Project Annex C: Technical assumptions and approach

Model 2: postgraduate specialty training and consultant and GMP workforce

The second part of the model covers specialty training and consultant and GMP workforce. Data for specialty training is sourced from Turas Training Programme Management,^[4] and workforce data are sourced from Scottish Workforce Information Standard System^[5] for Consultants and National Primary Care Clinicians Database^[6] for GMPs.

Specialty training

Data from TPM allows trainees to be identified by their programme, start date and end date. It covers trainees in Scotland and spans 2014 to 2024.

The intake is number of doctors who are first observed in a specialty training programme. The intake during the forecast interval (2025 to 2045) is assumed to be the same as the last year of the sample period.

Time to event statistics are used to estimate the time to complete training (or CCT).

During the sample period the observed number of CCTs is calculated using the date of CCT. During the forecast period, the expected number of CCTs is the sum of the product of the intake and the CCT probabilities.

All estimates are by PMQ source, sex, specialty and first observed grade.

Transition from CCT to Consultant or GMP workforce

Consultants are assumed to start in post immediately following CCT.

The transition between CCT and NPCCD is estimated from sample data. Estimates are available by country of PMQ and sex.

Stock and flow of the Consultant or GMP workforce

The individual-level data for Consultants (SWISS) and GMP (NPCCD) workforce are decomposed to calculate the inflows and outflows for each specialty during the sample period (2013 to 2024). Note that the numbers of consultants and GPs can vary depending on source used due to timing of data point. For example, the Primary care Workforce Survey takes workforce as at 31 March whereas official workforce statistics measures the workforce as at 30 September. Numbers may also subsequently be revised.^[7]

The inflow measures the number of people who enter the workforce each year. There are three sources of inflow: inflow from outside the workforce, inflow from people returning to the workforce, and inflow from newly qualified staff. The outflow measures the number of people who leave the workforce each year.

• The inflow from outside, measures the number of people who are previously not in Scotland as a trainee or a consultant or GMP, e.g. international recruits or trainees from outside Scotland. The mean inflow from outside over the last five years of the sample data is estimated.
• The inflow from training, measures the number of people who were observed as a consultant or GMP for the first time and were previously observed as a trainee in Scotland. The inflow from trainees to the GMP workforce is the product of the number of CCTs (in Scotland) and the CCT to workforce transition probability.
• The outflow measures the number of people who have left each year. A general linear model is used to estimate the probability of leaving. Data over the last ten years. The probability of leaving is set to 1 for age groups 70 and over.
• The inflow from return measures the number of people who had previously been recorded as an outflow and subsequently returned. The probability that someone will return each year after leaving is estimated by applying time to event statistics to the full sample data. The probability of returning is set to 1 for age groups 70 and over.

The above is calculated by specialty, sex, country of PMQ and age.