Our approach to workforce planning Pressure on margins is relentless. So the need to reduce costs is constant. And for most companies, employment is the greatest single cost. Having too many people wastes their time, reduces the effectiveness and efficiency of the business, and costs a lot of money, especially if sustained. And the law on redundancy, severance pay, minimum notice and so on makes overstaffing costly to eliminate. Having too few employees is also a threat to the business. It can prevent economies of scale, restrict specialisation, and hinder the response to new orders, customers and business opportunities. Managers must try to have the right number of people. They may be permanent, temporary or casual – and the mix is also a factor. Our approach is to design and set up robust systems to define the numbers required and plan to provide them. To do so, we need to understand the demand for skills and competences now and in the future. And for that we need a detailed understanding of processes and activities. This knowledge rests with those who do the work. When products and services change, the volumes and nature of the work also change. This usually requires a redesign of the workforce - a process that demands considerable effort. So, workforce planning is not only for workforce planners or human resources specialists. All managers have a vested interest in shaping their workforces for the future and in increasing productivity. They have a responsibility to challenge the status quo. But they cannot do this without hard evidence. Collinson Grant (CG) has done a lot of workforce planning with the Department of Health in the UK. CG was instrumental in preparing the October 2008 DoH publication ‘Planning the pathology workforce – a guide for pathology managers’. Much of the material in these notes (in particular Chapter 4) was taken from this publication and from the CG report ‘Planning the Pathology workforce’. What is workforce planning? Workforce planning is a process that aims to predict the demand for different skills and considers how best to manage the supply of suitably qualified, competent and skilled people to meet that demand.

1. Workforce planning

2. Contents
Our approach to workforce planning
1
What is workforce planning?
1
The ‘six steps’ of workforce planning
3
Defining the required workforce
6
Appendices
Appendix
Collinson Grant – planning the pathology workforce – flowchart

3. Collinson Grant
Workforce planning
Our approach to workforce planning
Pressure on margins is relentless. So the need to reduce costs is constant.
And for most companies, employment is the greatest single cost.
Having too many people wastes their time, reduces the effectiveness and
efficiency of the business, and costs a lot of money, especially if sustained.
And the law on redundancy, severance pay, minimum notice and so on makes
overstaffing costly to eliminate.
Having too few employees is also a threat to the business. It can prevent
economies of scale, restrict specialisation, and hinder the response to new
orders, customers and business opportunities.
Managers must try to have the right number of people. They may be
permanent, temporary or casual – and the mix is also a factor. Our approach
is to design and set up robust systems to define the numbers required and plan
to provide them.
To do so, we need to understand the demand for skills and competences now
and in the future. And for that we need a detailed understanding of processes
and activities. This knowledge rests with those who do the work. When
products and services change, the volumes and nature of the work also change.
This usually requires a redesign of the workforce - a process that demands
considerable effort.
So, workforce planning is not only for workforce planners or human resources
specialists. All managers have a vested interest in shaping their workforces
for the future and in increasing productivity. They have a responsibility to
challenge the status quo. But they cannot do this without hard evidence.
Collinson Grant (CG) has done a lot of workforce planning with the
Department of Health. CG was instrumental in preparing the October 2008
DoH publication ‘Planning the pathology workforce – a guide for pathology
managers’. Much of the material in these notes (in particular Chapter 4) was
taken from this publication and from the CG report ‘Planning the Pathology
workforce’.
What is workforce planning?
Workforce planning is a process that aims to predict the demand for different
skills and considers how best to manage the supply of suitably qualified,
competent and skilled people to meet that demand.
Demand and supply
‘Demand’ is not just a short term requirement for people. Workforce planning
must provide a clear picture of the people required to accomplish the
organisation’s medium-term strategy. Similarly, the ‘supply’ side of the
equation requires a plan of action to ensure that the appropriate workforce
(numbers, skills and competences) will be available at the right time. An
assessment of the demand and supply of labour must take into account:
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Workforce planning
The make-up of the current workforce, including the distribution of
skills, age and service
Forecast volumes of goods or services and the effect on direct labour
The forecast turnover of labour
Potential changes in the organisation’s strategy, such as mergers,
acquisitions or closures of plants or offices
New products or technology, or other changes that might affect the
requirement for managerial, professional or scientific personnel
The essential attributes of the workforce that the organisation will
require to achieve its objectives.
Workforce plans can be prepared at many levels in the organisation. At a
team or departmental level, they might comprise monthly staffing rotas to
ensure that sufficient labour with the correct skills and competences is
available. At the most complex level, local plans might be aggregated into an
all-embracing document to support strategic and financial planning for the
business.
Human Resources (HR) policies
What will be the effect on the workforce of current HR policies and
programmes? What changes would eliminate gaps (shortages or excesses)
between the projection of current practices and the desired state? They might
include:
New arrangements for pensions or early retirement
Redesigning jobs and reallocating responsibilities
New or revised training and education programmes
More effective recruitment
Steps to retain key employees, including new or revised reward
programmes
Better planning for succession
New or more flexible working arrangements.
The challenge for HR professionals is to develop an aligned set of HR policies
and practices that will allow the supply of labour to meet the demand.
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Workforce planning
The ‘six steps’ of workforce planning
The ‘six steps’ process was designed for the National Health Service. It is
described in detail at www.healthcareworkforce.nhs.uk. It can, however, be
applied to most organisations. This section outlines the key principles.
The six steps are:
to define the plan
to map the change in the business
to define the required workforce
to understand the availability of the workforce
to plan to provide the required workforce
to implement, monitor and refresh the plan.
Defining the plan
This is the critical first step in any planning process. You must be clear why a
workforce plan is required and what it will be used for. You must determine
the scope of the plan and be clear who is responsible for it.
Purpose – what are the aims and objectives?
What is the problem you are trying to solve?
What will a good plan enable you to do?
Who initiated the plan and why?
Who will the plan affect?
Scope – what groups/services/organisations will it cover and over what
timescales?
What geographical area is covered by the plan?
What types of employee are covered?
What client groups does the plan cover?
Is the plan the solution to a short- or long-term problem?
Ownership – Who owns the plan and who are the stakeholders?
Who needs to be influenced if the plan is to be successful?
Do stakeholders understand their part in the plan and their
contribution to it?
Has everyone involved signed up to achieving the plan?
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Workforce planning
Mapping the change in the business
Define the purpose and shape of any proposed change in the business (such as
in production or services provided) that will affect the workforce required.
You must be very clear about current costs and outcomes and about the
intended benefits from the changes. You should recognise those forces that
support the change or may hamper it.
Goals/Benefits of change – What are the objectives of the proposed changes?
What is prompting the changes?
What are the costs and outcomes under the current models?
What are the intended benefits from the changes?
How will the change be monitored effectively?
Current baseline – What are the current costs and measures of performance?
Drivers/constraints – What context must the new service operate within?
What forces will support the changes, and what resistance is expected?
Appraisal of options – What different scenarios for the changes have been
considered and costed?
Working models – What is the preferred model(s) and why?
Does the preferred model provide the desired benefits more effectively
than others?
Or is it simply more achievable, given the expected constraints?
Is there a clear and shared understanding of the future operating and
working arrangements?
Defining the required workforce
This step involves mapping the new activities and confirming the skills and the
types and numbers of employees required to do them. It is described in more
detail in Section 4.
Activity analysis – What are the key tasks within the new model?
Have the activities been broken down into skills, time, individual or
team?
How have the jobs been defined? Do they include new posts?
Types/Numbers – Can the required numbers of different employees with the
required competences be modelled?
Have the relevant units been confirmed – section, department, team?
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Has an assessment of the size and composition of the team been
made?
Productivity – Can new ways of working be considered and can the costs of
different blends of skill be measured?
Have the implications of increased productivity been considered –
such as technology, patterns of working, service models and
redistribution of tasks?
Have different blends of skill been measured?
Understanding the availability of the workforce
This step is about establishing the current and future availability of the staff
(‘supply of the workforce’). It involves describing the current workforce in the
areas under consideration, including its skills and deployment, and assessing
any problems arising from its age profile or turnover.
The current workforce – What are the characteristics of the current workforce
– numbers, jobs, skills, location, et cetera?
Forecasting the future workforce – What turnover, vacancies and patterns of
recruitment are expected? What factors might affect this – for example,
legislation on working time, demographic changes, or the competition for
skills in the local/national labour market?
Options for changing supply – What initiatives for retention, retraining,
recruitment, redeployment, new methods of working, etc. can realistically be
developed? Have they been analysed and costed?
It might be that the ready availability of employees with particular skills – or,
alternatively, the shortage of such employees – itself influences the changes to
the business and the definition of the required workforce. In such cases, steps
3.2 and 3.3 will need to be revisited. Consideration should be given to the
practicalities and cost of any retraining, redeployment and/or recruitment that
could increase or change the supply of the workforce.
Planning to provide the required workforce
This step involves determining the most effective way of ensuring the
availability of employees required for the business. A plan for providing the
right people, with the right skills in the right place, needs to be drawn up, with
milestones and timescales.
Gap analysis – What key changes are needed to the current workforce?
Priority planning – What are the most significant things to change?
Planning for action – What is the best option? How do education and other
strategies support the main plan? What are the potential problems and how
can they be tackled?
Managing the change – How can you develop a momentum for change, and
how do you sustain it?
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Implementing, monitoring and refreshing the plan
As soon as you begin to implement the plan, you must systematically review
and adjust it.
What are the key milestones of your plan? Have you been clear about
how success will be measured?
How will unintended consequences be measured, so that corrective
action can be taken?
What is the process for revisiting your plan and refreshing any
requirements?
Defining the required workforce
This section expands on step 3 of the Six-Step Methodology. It is an abridged
version of the Collinson Grant Healthcare report, ‘Planning the pathology
workforce’.
The report formed the basis of the Department of Health publication ‘Planning
the pathology workforce – a guide for pathology managers’. The guide was
part of a ‘pathology workforce toolkit’ developed by CG. Some of the
terminology used is, therefore, specific to this sector. But the methodology
should apply to workforce planning in any organisation.
The guide describes a method for analysing the activity of the workforce in
pathology and relating it to the service provided. By modelling different
scenarios for the service, managers can simulate the workforce they will
require. They need to gather data and record them in specially designed
spreadsheets provided by CG. There is a separate guide called How to use the
model that tells them what data to collect, how to collect them and how to
record them in the spreadsheets.
There are five steps in the process to design the required workforce:
Establish a baseline – record the activities of the staff and the amount
of work done
Simulate the optimal workforce – Challenge the assumptions that
underpin the baseline profile of the workforce. Discuss ways of
achieving efficiencies and improving the effectiveness of the
workforce. And model the effects these changes would have
Simulate changes to the service – Starting from this remodelled
profile of the workforce, examine the determinants of change – the
wider factors that may cause volumes of work to change. In other
words, model the future state
Consider further forces for change in the workforce – Refine the
picture of the future state by considering additional influences on the
design of the workforce
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Next steps – Consider how you will influence the supply of skilled and
competent workers. Plan to repeat this analysis at regular intervals
Establish a baseline
The first step is to quantify the inputs and outputs of the pathology service, by
department, as it currently stands. What volume of work does each
department do in a year? How many people are employed? In what band do
people work? And how do they spend their time?
Form a project team
Four key roles are needed for a project team:
Project sponsor – to oversee the whole process. The sponsor’s main
task is to get the commitment of the departments, to make sure the
process is locally owned.
Project manager – to oversee the work of each department in
collating and analysing the data. She or he will take ownership of the
main modelling spreadsheet, analyse the standard reports from it,
debate the optimal structure of the workforce and simulate possible
future states.
Project advisors – to provide objective, independent analysis and
advice. They should be from outside the pathology service. One
advisor should have skills in workforce planning.
Department managers – to collate data and contribute to the debate
on future configurations of the workforce. They will provide specialist
advice on the activity of the staff in their departments and on the
skills and competences needed to do the work.
Project Sponsor
(Director or Associate
Director)
Project Advisors
Project Manager
(Business Manager)
(Workforce Planner,
accredited workforce
representatives)
Department
Managers
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Workforce planning
Define the scope of the project
Departments
The spreadsheets will analyse data for each department that you specify. In
agreeing on the scope of your project, you need to decide which departments
will be included in the analysis.
People
Ideally, you should capture data for all the people who work in the
departments you plan to review. You should include all scientific personnel,
plus medical personnel and those in managerial and administrative jobs.
Gather data
The first major task is to gather data that describe the inputs of the workforce
(time and activities) and the main outputs of the departments (volume of
work).
The CGH model uses the concept of Processes, Activities and Tasks (PATs) to
describe the total effort of the workforce. Data are collected and put into the
spreadsheets provided.
Generating your baseline profile
Once all the data have been gathered, the ‘Current workforce – input’
worksheet (shown below) will reveal how the effort devoted to each task is
spread across departments, jobs or salary grades.
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Christmas trees
Christmas tree representations are designed to give a bird’s-eye view of the
shape of the workforce by band. A number of Christmas trees are available in
the model. They show the profile of the pathology service as a whole. They
convert numbers of employees into ‘Whole Time Equivalents’ (WTEs).
Christmas tree: current
WTEs by Band
Band 9
Band 8D
Band 8C
Band 8B
Biochemistry
Band 8A
Haematology
Band 7
Microbiology
Immunology
Band 6
Histopathology
Band 5
Cytology
Central Sample Reception
Band 4
Other (1)
Other (2)
Band 3
Band 2
Band 1
WTEs
Adjustments to the profile of the workforce will change the shape of the
Christmas tree.
The work of the staff by process
The ‘WTEs by process’ worksheet shows how the workforce spends its time on
the high-level processes. In the example below, by far the most time is spent
on Process 4 – providing the service.
WTEs by process
9
8
7
6
5
WTEs
4
3
2
1
0
Process 1
Process 2
Process 3
Process 4
Process 5
Process 6
Process 7
Process 8
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Simulate the optimal workforce
The data collected in the previous section describe the activities of the current
workforce. But is the profile of activity balanced? Are the right people doing
the right things – and enough of them?
Two main factors must be considered:
The distribution of skills and competences between different bands of
staff – Are the right bands of people doing the work?
The productivity of the workforce – Do people do enough work that
adds value? Do they work efficiently? Are the processes lean? Is the
right number of people dedicated to each activity and task?
The model not only provides a profile of the current workforce, but also allows
a re-profiled workforce to be simulated and indicates the changes in efficiency
that result.
The model also provides a Christmas tree representation for the revised profile
of the workforce. This can be compared with the baseline Christmas tree. As
different scenarios are simulated, the effect of the changes can be seen.
A suggested approach
The project manager and a workforce planner conduct an initial
review of the data and pinpoint the main issues
Update the data in the model to reveal indicative efficiency savings
Discuss the main findings and issues with the project manager,
department managers and project advisors
Agree on an improved profile of the workforce for each department
Update the data in the model again. This is now the ‘go to’ position
for your current volume of work.
Skills and competences – Who should be doing the work?
The first area to examine is the distribution of work into the various bands.
Look at the ‘Revised workforce – input’ worksheet in main_model.xls.
Examine the tasks in turn and think critically about whether they are being
done by people in the most appropriate band.
You also need to think about ways of making improvements to the profile of
the workforce:
Can skills be transferred from people in higher bands to those in
lower bands?
Can differences in productivity between higher and lower bands be
overcome with better training?
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Would better planning of rotas help to relieve more senior people of
the burden of work that could be done by those in a lower band?
Does everyone work at her or his highest level of skill?
experts concentrate on work that only they can do?
And do
The objective is to pinpoint work that could and/or should be moved to
different bands. The model shows how changing the band of worker affects
the profile of the workforce.
Productivity
Direct work and support work
The PATs list is divided into tasks that are considered direct to the work of a
pathology service, and those that are support tasks:
Direct – describes effort that is applied directly to creating results so
that the service meets its patients’ and customers’ requirements.
Direct work adds value
Support – describes effort that supports the direct work, enabling the
service to continue its day-to-day operations and improve its
performance
The efficiency of a department is measured, in part, by the relationship
between direct and support work.
The model shows the amount of direct work done in each department. The
departments should ideally have a high proportion of direct work – at least
75%. You should therefore investigate the reasons for low proportions of
direct work:
Reduce the amount of support work done by experts to a minimum.
They are expensive, so get the most out of them
Is the amount of support work simply too high? If so, the department
is failing to concentrate on tasks that add value.
Re-evaluate the structure of the workforce in departments that are doing
insufficient direct work. On the ‘Revised workforce – input’ worksheet in
main_model.xls change the number of WTEs to reflect the changes you would
like to make.
Bottlenecks and constraints
One reason for low productivity might be pinch points in the flow of work.
These can be caused by the lack of specific skills, by insufficient resources, or
by ineffective equipment. Are any of the tasks (in the PATs list) associated
with bottlenecks? If so, try to understand the cause.
There are a number of things you can do to relieve bottlenecks, and these can
affect the design and deployment of the workforce:
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Try to minimise the bottleneck’s idle time by smoothing the flow of
work through it as much as possible
Similarly, if the bottleneck is caused by spatial constraints, try to
smooth the flow of work through that part of the laboratory
Ensure that everyone works at her or his highest level of skill and that
experts concentrate on work that only they can do
Try to find ways of increasing capacity (of both people and
equipment) by using spare capacity elsewhere.
The impact of technology
Changes in technology can have a dramatic effect on the workforce. New
technologies can automate a process, thereby reducing the number of people
needed to do it. Alternatively, new technologies can enable people to become
more productive.
If you are planning to introduce new equipment, consider which tasks might be
affected. Using the data in the model (‘Revised workforce – input’), try to
predict the number of WTEs that might be displaced and alter the number of
WTEs accordingly.
Benchmarks for efficiency
The model tells you how much of the work of the staff is on activities that add
value. But it does not tell you whether people work efficiently on those
activities. You might routinely calculate efficiency ratios for your service
(tests per WTE, cost per test, and so on). But these are only of value if you
have a view on whether the results are good or bad. Without benchmarks, you
have no context.
There is no reason why laboratories should not group together to do some
comparative analysis of their findings. However, benchmarking gives you a
relative position. And, by definition, some organisations must be above and
some below the average. There is always scope for further improvement!
The most valuable form of benchmarking you can do, therefore, is to measure
improvements over time. You can do this by repeating this methodology at
regular intervals and comparing your results with previous ones.
Simulate changes to the service
Up to now, the model has been used to establish a desired or optimum profile
of the workforce for the current workload. But the future workload might be
very different. The model can now be used to simulate the effects on the
workforce of changes in workload. But first you need to consider the factors
that might influence the volume of work.
Note that the model assumes a linear relationship between the volume of work
and amount of direct labour required. But volumes change from month to
month, and some types of tests show, for example, seasonal distortions of
volume. The pathology service should reasonably be expected to cope with a
12

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Workforce planning
certain degree of flexing in its workload, without having to resort to changes
in the number of people it employs.
So the relationship between WTEs and volume of work is ‘stepped’ rather than
linear. There is inevitably a point at which no more work can be absorbed
(unless through a compromise on quality and safety) without a step change in
the number of people employed. If you have optimised the workforce to its
leanest point, then the resultant profile will be directly scalable with volumes
of work – because the leanest possible system of work has little or no spare
capacity.
Planning the service
Your plan for the workforce should be integrated with plans for the pathology
service, which, in turn, should be integrated with plans for healthcare services
and changes to pathways of care. You should attempt to quantify the volume
of work you may do in the future as a result of such changes. Consider the
following forces for change in particular:
Local priorities set by your host trust and/or commissioned by local
Primary Care Trusts
National priorities as directed by the Department of Health
Changes to the Quality and Outcomes Framework for General
Practitioners
Movement of services out of secondary care and into primary care
settings
Plans for reconfiguration of pathology services
Improvements in the appropriateness of testing. Volumes may
increase for tests that are currently under-requested. Conversely,
volumes may decrease for tests that are currently over-requested.
Updating the model
You can use the model to simulate different future states. The guide describes
how to change the volume of work and view the effect these changes have on
the profile of the workforce. You can compare these outputs with the outputs
for your current profile. This will show the changes you need to make if you
have accurately predicted the future state.
The impact of technology
As discussed above, the introduction of new technology might result in tests
being processed differently. You can use the model to move the volumes
between the four types of test (routine automated to complex manual). The
outputs from the model show the effect on the profile of the workforce of these
changes.
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Christmas trees
The ‘Ch Tree 3’ worksheet in main model.xls contains a Christmas tree
representation for your revised profile of the workforce, incorporating the
revised volumes of work. Compare this with the baseline Christmas tree (‘Ch
Tree’ worksheet) to see the gap between where you are now and where you
think you should be. Refer to this Christmas tree as you simulate different
scenarios to see the effect of the changes you make. Use it as a ‘sense check’
to make sure the profile you are simulating looks right.
Consider further forces for change in the workforce
Until now, you have concentrated on remodelling your workforce to get the
right number of people doing the work (re-profiling across bands), and to get
them doing the right work (maximising direct work to eliminate work that
does not add value). You may also have made some predictions of volumes
and seen how the demand for workforce changes accordingly.
However, there are a number of other factors that need to be taken into
account. Consider each in turn and decide whether any of your predictions for
the workforce need to be tempered.
The impact of legislation
Changes in employment legislation can affect the structure of the workforce.
The European Working Time Directive (EWTD), for instance, has a profound
effect on the planning of rotas. Consider the changes that must be made to
your profile of workforce demand as a consequence.
Demographics of the workforce
The age profile of the current workforce might not be stable – the average age
might be steadily increasing, for instance. The retirement of senior and
experienced personnel can reduce the efficiency and effectiveness of the
workforce if there are insufficient people coming up through the ranks, or
available in the labour market to replace them.
Some tasks require the application of considerable professional judgement.
Such skills tend to spring from experience rather than from qualifications.
Look at the age profile of your workforce. Consider the likelihood of
demographic change in the workforce and the effect this could have on the
overall experience of the staff. Will the future workforce be able to work as
efficiently as the current one (all other things being equal) if this experience
decreases?
Next steps
This guide aims to help you quantify the demand for skills and the number of
people needed in your future workforce. So what next?
Workforce supply
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Having specified what you will need, you must consider how to influence the
supply of appropriately skilled people to meet the demand. You should
consider:
whether perceived shortfalls in skills could be plugged by developing
current personnel. What training will be needed? Who could provide
it? And at what cost?
the range of skills needed for the future. Do current courses in higher
education need to change?
how you should influence your Strategic Health Authority in the
commissioning of education (strategic workforce planning)
how you might better retain the staff and plan for succession.
Issues about workforce supply are dealt with in more detail in sections 3.4 and
3.5 above.
Repeating the exercise
By repeating this exercise at appropriate intervals (say every 6 or 12 months)
you can gauge how your workforce is developing. Does it appear more
efficient (more direct work, less support work)? Is the mix of skills optimised
(people doing work appropriate to their bands)? Have you stripped out overcapacity and replenished areas of under-capacity?
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– planning the pathology workforce – flowchart
Collinson Grant
INPUTS TO
THE MODEL
STEPS
ANALYSIS
STANDARD REPORTS
FROM THE MODEL
Current volume of
tests by
department
Baseline profile of the service
by department
T
L
The time of the
staff apportioned to
tasks
R
WTEs by grade and
the mean WTE cost
by band
E
1. Establish a baseline
Productivity
Change the number
and mix of staff for
each task
Optimised workforce numbers needed at each
band, their activities and cost.
Based on scope of current
service.
O
M
M
O
Change the mix of
bands for each task
P
Skills and
competences
D
U
E
2. Simulate the
optimal workforce
Planning the service
C
3. Simulate changes
to the service
Change the volume
of tests to reflect
service plan
Future workforce - numbers
needed at each band, their
activities and cost. Based on
scope of future service.
4. Further drivers of
change
- The impact of legislation
- Demographics of the workforce
- Retention and turnover
5. Next steps
- Manage supply
- Repeat the process
Appendix

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