PILOT STUDY EXPERIENCES IN BELGIUM USING HORIZON SCANNING AND THE DELPHI METHOD AS PART OF A NATIONAL REVIEW OF THE GENERAL PRACTITIONER WORKFORCE
The main objective of the Joint Action Health Workforce Planning and Forecasting (JA EUHWF) is to provide a platform for collaboration and exchange between partners, to better prepare Europe’s future health workforce. This objective is both operationalised and realised through the Joint Action’s pilot study.
For Work Package 6 (WP6), which focuses on horizon scanning and qualitative methodologies in health workforce planning and forecasting, the pilot study was a collaboration between the WP6 leaders, the Centre for Workforce Intelligence (CfWI) and the UK Department of Health; and a WP6 partner, the Belgian Federal Public Service of Health, Food Chain Safety and Environment (FPS) with support from the University of Antwerp and the University Catholique de Louvain.
WHAT WAS PILOTED?
As an earlier output of the Joint Action WP6 produced a description of the qualitative methods used in different national-specific contexts by EU Member States (MS) and WP6 partners (Fellows and Edwards, 2014).
Through conducting this pilot study, the Joint Action demonstrated a “proof of concept” that horizon scanning and the Delphi method were able to be adapted and adopted as part of workforce planning in Belgium.
WHAT WERE THE RESULTS?
Overall the approaches of horizon scanning and Delphi have added value to the General Practitioner (GP) review in Belgium. Specifically new areas of information and data have been revealed:
- The horizon scanning stage has collected a broad range of ideas about the future and how some of the driving forces may impact the GP workforce. These have not been systematically or formally captured before in Belgium as part of workforce planning. This new information has provided a deeper level of understanding of these driving forces and enhanced the robustness of the study. Examples include driving forces such as technology enabled sharing of patient data, changing finances as part of moving towards integrated care and patients monitoring their own health more.
- Use of the Delphi method has built on this further by working with experts to quantify a range of variables that can be used within the Belgian workforce planning model. These variables include expected changes in future demand, FTE patterns, activity rates of GPs and distribution of tasks. These new parameters provide the existing quantitative model with new values that increase the robustness of the overall workforce planning approach in Belgium as well as better inform decision making.
As an overall result, these methods will be used again as part of workforce planning and integrated into the overall approach by Belgium for the future. The findings of the pilot study will go forward into the advice and recommendations for the overall GP review.
The team in Belgium at the Planning Unit commented:
“Anyone can apply these methods with the right support and obtain new useful outputs for workforce planning. We will use these methods again as we have integrated them into our formal workforce planning process”.
Download the report
Pilot study experiences in Belgium using horizon scanning and the Delphi method
PDF to download – Final version June 2016
This report presents the findings of the pilot study in Belgium where horizon scanning and the Delphi method were used as part of a national review of the GP workforce.
RECOMMENDATIONS FOR MEMBER STATES APPLYING HORIZON SCANNING AND THE DELPHI METHOD IN THE FUTURE
In addition to the benefits and lessons learnt collected, the Belgian and UK teams also reflected on advice and recommendations for Member States who might seek to apply these methods in the future.
METHODS – HORIZON SCANNING
The horizon scanning process enables the capture, categorisation and linkage of influential systemic factors and components from subject matter experts.
System factor identification in the horizon scanning phase (CfWI, 2014a)
HORIZON SCANNING IN PRACTICE – SUMMARY OF THE HIGH AND MEDIUM IMPACT FACTORS IDENTIFIED IN BELGIUM FOR THE GP WORKFORCE
Horizon scanning in Belgium classified factors using the TEEPSE framework, other classifications are available at the UK horizon scanning portal and ideas bank (link)
High impact factors identified
- A more capitation oriented payment for integrated care delivery (Economic)
- Changes to more horizontally integrated services e.g. out of hours (Political)
- Introduction of new professions and adaptation of the legal framework (Political)
- Task shifting to more multidisciplinary group practices (Political)
- Changes in health care needs (Social)
- Decreasing activity rate in GPs (working hours + numbers) (Social)
- Task definition of GPs and other health care providers (Social)
Medium impact factors identified
- Electronic sharing patient information (Technological)
- Regional variation in GP distribution (Environmental)
- Vertical integration the relationship between GP and specialist doctors (Political)
- Distribution of GP students between the two language communities (Political)
- Large outflow older GPs (Social)
METHODS – THE DELPHI METHOD
The Delphi method was used to ask questions of experts on the GP workforce, about how certain variables used for workforce modelling might change over the next 20 years out to the year 2035.
The Delphi technique Heuer and Pherson (2011)
DELPHI IN PRACTICE – DELPHI QUESTIONS USED REGARDING THE GP WORKFORCE IN BELGIUM TO THE FRENCH AND DUTCH LANGUAGE SPEAKING COMMUNITIES
- What is the expected change in demand for GPs in the female / male population between now and 2035?
- How many hours does a full time equivalent consist of now, and how do you expect this to change in 2035?
- What is the expected change in activity rate for female / male GPs between now and 2035?
- What is the expected change in distribution of task for a GP between now and 2035?
Below are some of the results where experts considered future population demand change by age band for males and females in different communities. The results highlight the range of values and the inherent uncertainty that workforce planning and modelling needs to take account of when creating future projections.
TOOLKIT FOR HORIZON SCANNING AND DELPHI
Below you can download the horizon scanning template and Delphi template that can be reused as part of workforce planning. These templates are provided as draft examples, they are indicative and must always be customised to the study you are undertaking.
Please contact us should you have questions or need guidance