Using system dynamics to inform future pharmacist student intake in England until 2040
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Using system dynamics to inform future pharmacist student intake in England until 2040 Jack Lawrence, Siôn Cave
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The CfWI presented to the International System Dynamics Society Conference in Delft.
Transcript of Using system dynamics to inform future pharmacist student intake in England until 2040
Using system dynamics to inform future pharmacist student intake in England until 2040
Jack Lawrence, Siôn Cave
• The Centre for Workforce Intelligence was commissioned by the Department of Health to deliver a project that would:
• Review the future supply and demand drivers facing the pharmacist workforce up to 2040.
• Produce a report to inform a review of pharmacist education and training policy.
Future pharmacist workforce projectA strategic review Informing pharmacist student intakes
Workforce planning is ensuring “The right people, with the right skills, in the right places, at the right time”
Future pharmacist workforce projectWorkforce planning
Mpharm course
Future pharmacist workforce projectPharmacy students in England
Pre-registrati
on training
Registered pharmacist
1 year work based training
4 year course
Future pharmacist workforce projectPharmacy students in England
Mpharm course
1999 2009
Pharmacy
schools12 21
Pharmacy
students4,200 9,800
Pre-registrati
on training
Registered pharmacist
1 year work based training
4 year course
Future pharmacist workforce projectA strategic review Informing pharmacist student intakes
• ‘the systematic examination of potential threats, opportunities and likely developments including but not restricted to those at the margins of current thinking and planning’ (Chief Scientific Adviser’s Committee, 2004).
• To identify and produce a broad range of ‘driving forces’ likely to impact on the pharmacist workforce in the future.
• Approximately 50 stakeholders and experts identified the factors influencing the future pharmacist workforce
Future pharmacist workforce projectHorizon scanning Informing pharmacist student intakes
Future pharmacist workforce project
24 stakeholders in a workshop setting developed four challenging but plausible scenarios to 2040 for the pharmacist workforce.
The four scenarios represent a shared assessment by expert stakeholders of the most impactful and least predictable futures facing the pharmacist workforce for which we need to make informed decisions and plan.
The scenarios, are not intended to describe expected, exhaustive or preferred states. They represent a plausible range of ways the future could unfold, and boundaries are set, which can be used to test policy options for robustness.
Scenario generation Informing pharmacist student intakes
Future pharmacist workforce projectWorkforce modellingInforming pharmacist student intakes
Future pharmacist workforce project
University Pre-registration Register
Leave course
Leave system
Leave course
Leave system
Attrition from register
Join pre-registration from OSPAP (non-EEA)
Non EU students
Home/ EU students
Join register from EEA
Rejoin register
Pharmacy workforce supply model stock and flow diagram
Workforce modellingInforming pharmacist student intakes
Future pharmacist workforce project
Pharmacy workforce supply model Vensim diagram
Workforce modellingInforming pharmacist student intakes
Mpharm Coursestart andcontinue
mpharm course
complete studyyear and progress
to next year
completempharmcourse
mpharmleave course
startmpharmcourse
startmpharmenglish
startmpharm eea
completedmpharm leaving
system
able to get onto preregistration and stay
in system
XL percentage of thosewith mpharm degrees that
leave system
XL percentage of mpharmintake that will drop out
XL annual mpharmintake from eea
XL annual mpharm intakefrom england
Pre Registration Training1st Exam Attempt
start pre registrationtraining from outside
of country
XL percentage of preregistration completers
that leave system
England Register
enter england registerfrom outside of
country
registerattrition
XL register intake fromoutside of system
XL initial englandregister
XL annual mpharm intakefrom england age profile
XL annual mpharmintake from eea
age profile
total mpharm coursestudents by age
total mpharm coursestudents
total mpharm coursestudents by years left
total englandregister by agetotal england
register
XL annual pre registrationtraining entries from outside
of system
XL annual pre registrationtraining entries from outside
of system age profile
XL initial englandregister ageprofile
XL register intake from outsideof system age profile
total mpharm coursestudents by gender total englandregister bygender
activeenglandregister
XL percentage ofregister that isactive
total active englandregister by age
total active englandregister
total active englandregister by gender
start preregistration
training from withinsystem and abroadapply for
preregistration
unable to getonto pre
registration
Mpharm Graduates WhoWere Turned Away From
Pre Registration
<INITIAL MPHARMBY COMPLETION
YEAR>
by pass preregistration
route
complete preregistration andpre reg by pass
<XL percentage of thosewith mpharm degreesthat leave system>
finish prereg training
finished prereg stay in
system
finished prereg leavesystem
startmpharm non
eea
XL annual mpharmintake from non eea
XL annual mpharmintake from non eea
age profile
Pre Registration Training2nd Exam Attempt
Pre Registration Training3rd Exam Attemptresit exams after
failing 1stattempt resit exams after
failing 2ndattempt
successfullycompleted preregistration
exams
pass1st
attemptpass3rd
attempt
fail 3rdattempt
fail 1stattempt andwithdraws
fail 2ndattempt andwithdraws
XL pre registration 1stexam pass rate XL pre
registration 2ndexam pass rate
XL pre registration3rd exam pass rate
pass2nd
attempt
pre reg fail 1stexam attempt 2nd
rate
<XL preregistration 1st
exam pass rate>
pre reg 2ndexam attempt
3rd rate
<XL preregistration 2ndexam pass rate>
Waiting To J oin SecondPre Reg Cohort
starting prereg firstcohort
XL percentage of preregistration starters
by date of entry
starting prereg second
cohort
total mpharm coursestudents by course
structure
total mpharm coursestudents by years leftand course structure
overall attritionfrom theregisterXL pre registration
fail 1st attempt andchoose to attempt
2nd exam rate
fail 1st attempt andwithdraw fromsystem rate
XL pre registration fail2nd attempt and choose
to attempt 2nd examrate
fail 2nd attempt andwithdraw fromsystem rate
total pre registration
total pre registrationincluding those waiting to
join second cohort bygender and age
total pre registrationby age
total pre registrationby gender
<Pre RegistrationTraining 1st Exam
Attempt>
<Pre RegistrationTraining 2nd Exam
Attempt>
<Pre RegistrationTraining 3rd Exam
Attempt>
<Waiting To J oinSecond Pre Reg
Cohort>
retry to getpre reg place
give up waitingand leave system
initial prereg attempt
1
initial prereg attempt
2
initial prereg attempt
3
total startmpharmcourse
total completempharm course
total applying forpre registration
total applying forpre registration bypre reg application
attempt
total unable to get ontopre registration byapplication attempt
total mpharm graduates whowere turned away from preregistration by application
attempt
total retry to getpre reg place
total englandregister by 10 year
age bandstotal england registerby 10 year age bands
and gender
<XL percentage ofmpharm intake that will
drop out>
<XL percentage of thosewith mpharm degreesthat leave system>
<XL preregistration 3rd
exam pass rate>
XL initial waiting tojoin second pre reg
cohort
<XL initial preregistration training ageprofile pre age shift>
<MONTHSPER YEAR>
total waiting to joinsecond pre reg cohort
sum foriegnjoiners
completempharm stay in
system
total completempharm stay in
system
total preregistration 1stexam attempt
total preregistration 2ndexam attempt
total preregistration 3rdexam attempt
sum passing registerexam and choosing to
stay in systemsum register
leavers
total starting preregistration first
cohort
total startpre
registration
total able to getonto pre
registration
total waiting to joinsecond pre reg cohort by
gender
total pre registration attempt 1and those waiting to join
attempt 1 by gender
total preregistration
attempt 2 and 3 bygender
total pre registrationattempt 1 and those
waiting to join attempt 1
total preregistration
attempt 2 and 3
rejoin theregister
XL rejoining theregister
XL rejoining theregister age profile
XL percentage of failed prereg applicants that leave after
1st or 2nd attempt
By Pass Route RegisterExam Holder
XL percentage of people on bypass route who take an extrayear to pass the register exam
<XL percentage of failed prereg applicants that leave after
1st or 2nd attempt>
XL percentage of peoplewho fail register exam in
by pass route
by pass register routefor people who take a
further year
by pass register routefor people who pass
first year
by pass register routefor people who take afurther year delayed
by pass route register ex
am
pass registerexam on by pass
fail registerexam on by
pass
total by passpre registration
route total by passregister route take
extra year
total by passregister route dont
take extra year
total by pass registerroute take extra year
after delay
total sitting by passroute exam for the
final time
total pass last attempt atby pass route register
exam
total fail last attempt atby pass route register
exam
flag onetimestep
afteraging
<TIMESTEP>
<12MONTHS>
<Time>
number of people wholeave the register in a
year
<100PERCENT>
number of people wholeave the register in a
month
<MONTHSPER YEAR>
<TIMESTEP>
sum holding for secondpre reg by pass attempt
total preregistration bygender and age
total pre registration includingthose waiting to join second
cohort by gender
total pre registration includingthose waiting to join second
cohort by age
total pre registration includingthose waiting to join second
cohort
<XL pre registration maximum position
s>
maximum prereg places
<XL flaglimit pre
registration places>
percentage ratioof english register
age bands
<100PERCENT>
test 1
<TIMESTEP>
test 1 0
<TIMESTEP>
test 1 00
<TIMESTEP>
XL percentage ofwithdrawls from pre
registration
<100PERCENT>
leave preregistration without
qualifying
<XL percentage ofwithdrawls from pre
registration>
<100PERCENT>
<Time><INITIALTIME>
<simulationyear> <STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
Future pharmacist workforce project
Pharmacy workforce supply model Vensim diagram
Workforce modellingInforming pharmacist student intakes
Mpharm Coursestart andcontinue
mpharm course
complete studyyear and progress
to next year
completempharmcourse
mpharmleave course
startmpharmcourse
startmpharmenglish
startmpharm eea
completedmpharm leaving
system
able to get onto preregistration and stay
in system
XL percentage of thosewith mpharm degrees that
leave system
mpharmcourse delay
XL percentage of mpharmintake that will drop out
XL annual mpharmintake from eea
XL annual mpharm intakefrom england
100 PERCENT
<100 PERCENT>
Pre Registration Training1st Exam Attempt
start pre registrationtraining from outside
of country
XL percentage of preregistration completers
that leave system
<100PERCENT>
England Register
enter england registerfrom outside of
country
registerattrition
XL register intake fromoutside of system
XL initial englandregister
XL annual mpharm intakefrom england age profile
XL annual mpharmintake from eea
age profile
total mpharm coursestudents by age
total mpharm coursestudents
total mpharm coursestudents by years left
total englandregister by agetotal england
register
agingmphar
mcourse
flagagingtrigger
aging preregistration training1st exam
<flagaging
trigger>
aging england register
<flagaging
trigger>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIME STEP>
<Time>
XL annual pre registrationtraining entries from outside
of system
XL annual pre registrationtraining entries from outside
of system age profile
<100PERCENT>
XL initial englandregister ageprofile
<100PERCENT>
XL register intake from outsideof system age profile
<100 PERCENT>
total mpharm coursestudents by gender total englandregister bygender
1 YEAR
<1 YEAR>
<1 YEAR>
activeenglandregister
XL percentage ofregister that isactive
<100PERCENT>
MONTHS PASSEDBEFORE START OFACADEMIC YEAR
flag startacademic
year<Time>12 MONTHS
<12 MONTHS>
<flag start academic year>
<flag startacademic
year>
total active englandregister by age
total active englandregister
total active englandregister by gender
start preregistration
training from withinsystem and abroad
<100PERCENT>
<100PERCENT>
apply forpre
registration
unable to getonto pre
registration
<percentage completempharm and leave systemincluding pre registration
limits>
<100 PERCENT>
Mpharm Graduates WhoWere Turned Away From
Pre Registration
<INITIAL MPHARMBY COMPLETION
YEAR>
by pass preregistration
route
complete preregistration andpre reg by pass
<XL percentage of thosewith mpharm degreesthat leave system>
<100 PERCENT>
finish prereg training
finished prereg stay in
system
finished prereg leavesystem
startmpharm non
eea
XL annual mpharmintake from non eea
XL annual mpharmintake from non eea
age profile
<TIMESTEP>
<1 YEAR>
<mpharmcourse delay>
<100 PERCENT>
<flagstart
academic year>
XL mpharm 4year course
delay
XL mpharm 5year course
delay
flag bypass pre
registrationtraining <100 PERCENT>
Pre Registration Training2nd Exam Attempt
Pre Registration Training3rd Exam Attemptresit exams after
failing 1stattempt resit exams after
failing 2ndattempt
successfullycompleted preregistration
exams
pass1st
attemptpass3rd
attempt
fail 3rdattempt
fail 1stattempt andwithdraws
fail 2ndattempt andwithdraws
XL pre registration 1stexam pass rate XL pre
registration 2ndexam pass rate
XL pre registration3rd exam pass rate
pass2nd
attempt
<100 PERCENT>
<100 PERCENT>
<100 PERCENT>
<100PERCENT><100 PERCENT>
<100 PERCENT>
pre reg fail 1stexam attempt 2nd
rate
<XL preregistration 1st
exam pass rate>
pre reg 2ndexam attempt
3rd rate
<XL preregistration 2ndexam pass rate>
<flag aging trigger> <flag a
ging trigger>
aging preregistration training2nd exam
aging preregistration training3rd exam
MONTHS PASSEDBEFORE J ULY
<12 MONTHS><Time>
flag july
Waiting To J oin SecondPre Reg Cohort
starting prereg firstcohort
XL percentage of preregistration starters
by date of entry
<100 PERCENT>
starting prereg second
cohort
flagoctober<12 MONTHS>
<Time>
MONTHSPASSEDBEFORE
OCTOBER
<flag startacademic
year>
<flag startacademic
year>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<flagjuly>
<flagoctober>
<TIMESTEP>
<flagjuly>
<flagoctober>
<flagjuly>
<flagoctober>
<flagjuly>
<flagoctober>
mpharm coursedelay by course
type
total mpharm coursestudents by course
structure
total mpharm coursestudents by years leftand course structure
<flag bypass pre
registrationtraining>
overall attritionfrom theregister
<100 PERCENT>
<simulationyear>XL YEAR 5 YEAR
DEGREE COURSEINTRODUCED
XL pre registrationfail 1st attempt andchoose to attempt
2nd exam rate
fail 1st attempt andwithdraw fromsystem rate
<100 PERCENT>
XL pre registration fail2nd attempt and choose
to attempt 2nd examrate
fail 2nd attempt andwithdraw fromsystem rate
<100 PERCENT>
total pre registration
total pre registrationincluding those waiting to
join second cohort bygender and age
total pre registrationby age
total pre registrationby gender
<Pre RegistrationTraining 1st Exam
Attempt>
<Pre RegistrationTraining 2nd Exam
Attempt>
<Pre RegistrationTraining 3rd Exam
Attempt>
<Waiting To J oinSecond Pre Reg
Cohort>
agingwaiting to
joinsecondpre regcohort
<flagaging
trigger>
agingmpharmgraduateswho were
turned awayfrom pre reg
<flag aging trigger>
retry to getpre reg place
<flag startacademic
year>
<TIMESTEP>
give up waitingand leave system
<TIMESTEP>
XL initial preregistration training
attempt 1XL initial pre
registration trainingage profile pre age
shift XL initial preregistration trainingage profile post age
shift
<XL initial preregistration training ageprofile pre age shift>
<XL initial preregistration trainingage profile post age
shift>
XL initial preregistration training
attempt 2
XL initial preregistration training
attempt 3
initial prereg attempt
1
<100 PERCENT>
<100PERCENT>
initial prereg attempt
2
<100 PERCENT>
initial prereg attempt
3
<register attrition rateincluding scenario and
retirement and maximumage adjustments averaged
across all sectors>
total startmpharmcourse
<TIMESTEP>
<flag startacademic
year>
total completempharm course
<flag startacademic
year>
<TIMESTEP>
<flag startacademicyear>
<TIMESTEP>
total applying forpre registration
total applying forpre registration bypre reg application
attempt
total unable to get ontopre registration byapplication attempt
<TIMESTEP>
<flag startacademic
year>
total mpharm graduates whowere turned away from preregistration by application
attempt
total retry to getpre reg place
total englandregister by 10 year
age bandstotal england registerby 10 year age bands
and gender
<100PERCENT>
<flag startacademic
year> <XL percentage ofmpharm intake that will
drop out>
<100PERCENT>
<XL percentage of thosewith mpharm degreesthat leave system>
<flag startacademic
year>
<TIMESTEP>
<flagjuly>
<flagoctober>
<TIMESTEP>
<TIMESTEP>
<flagjuly>
<flagoctober>
<flagjuly>
<flagoctober> <TIMESTEP>
<flagjuly>
<flagoctober>
<XL preregistration 3rd
exam pass rate>
XL initial waiting tojoin second pre reg
cohort
<XL initial preregistration training ageprofile pre age shift>
<100PERCENT>
<percentage change toannual mpharm intake due
to scenario by year>
<percentage change toannual mpharm intake
from eea by year>
<percentage change toannual mpharm intakefrom england by year>
<percentage change toannual mpharm intakefrom non eea by year>
<percentage change toannual mpharm intake due
to scenario by year>
<percentage change toannual mpharm intake due
to scenario by year>
<MONTHSPER YEAR>
total waiting to joinsecond pre reg cohort
sum foriegnjoiners
completempharm stay in
system
<100PERCENT>
total completempharm stay in
system
<flag startacademic
year>
<TIMESTEP>
total preregistration 1stexam attempt
total preregistration 2ndexam attempt
total preregistration 3rdexam attempt
sum passing registerexam and choosing to
stay in system
<TIMESTEP>
sum registerleavers
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME><Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
<Time>
<INITIALTIME>
total starting preregistration first
cohort
<flag startacademic
year>
<TIMESTEP>
total startpre
registration
<flag startacademic
year>
<TIMESTEP>
total able to getonto pre
registration
<flag startacademic
year>
<TIMESTEP>
total waiting to joinsecond pre reg cohort by
gender
total pre registration attempt 1and those waiting to join
attempt 1 by gender
total preregistration
attempt 2 and 3 bygender
total pre registrationattempt 1 and those
waiting to join attempt 1
total preregistration
attempt 2 and 3
rejoin theregister
XL rejoining theregister
XL rejoining theregister age profile
<100PERCENT><MONTHS
PER YEAR>
XL percentage of failed prereg applicants that leave after
1st or 2nd attempt
<100PERCENT><flagstart
academicyear>
By Pass Route RegisterExam Holder
XL percentage of people on bypass route who take an extrayear to pass the register exam
<flagstart
academic year>
<XL percentage of failed prereg applicants that leave after
1st or 2nd attempt>
XL percentage of peoplewho fail register exam in
by pass route
by pass register routefor people who take a
further year
by pass register routefor people who pass
first year
by pass register routefor people who take afurther year delayed
by pass route register ex
am
<Time> <INITIALTIME>
<TIMESTEP>
pass registerexam on by pass
fail registerexam on by
pass<100PERCENT>
total by passpre registration
route total by passregister route take
extra year
total by passregister route dont
take extra year
total by pass registerroute take extra year
after delay
total sitting by passroute exam for the
final time
total pass last attempt atby pass route register
exam
total fail last attempt atby pass route register
exam
<TIMESTEP>
<TIMESTEP>
<TIMESTEP>
<TIMESTEP> <TIMESTEP>
<TIMESTEP>
aging bypass routeregisterexamholder
<flagaging
trigger>
<100PERCENT>
<100PERCENT>
<TIMESTEP>
flag onetimestep
afteraging
<TIMESTEP>
<12MONTHS>
<Time>
number of people wholeave the register in a
year
<100PERCENT>
number of people wholeave the register in a
month
<MONTHSPER YEAR>
<TIMESTEP>
sum holding for secondpre reg by pass attempt
total preregistration bygender and age
total pre registration includingthose waiting to join second
cohort by gender
total pre registration includingthose waiting to join second
cohort by age
total pre registration includingthose waiting to join second
cohort
<XL pre registration maximum position
s>
maximum prereg places
<XL flaglimit pre
registration places>
percentage ratioof english register
age bands
<100PERCENT>
test 1
<TIMESTEP>
test 1 0
<TIMESTEP>
test 1 00
<TIMESTEP>
XL percentage ofwithdrawls from pre
registration
<100PERCENT>
leave preregistration without
qualifying
<XL percentage ofwithdrawls from pre
registration>
<100PERCENT>
<Time><INITIALTIME>
<simulationyear> <STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
<simulationyear>
<STARTYEAR>
Future pharmacist workforce project
Uncertainty analysis for supply and demand for the total number of pharmacists
Workforce modellingInforming pharmacist student intakes
Supply
Demand
Future pharmacist workforce projectKey findings on supply and demand forecasts
•The CfWI forecast of future supply of pharmacists is likely to be an underestimate if the current trends continue.
•The possible range of oversupply by 2040 across the plausible possible futures is between 11,000 and 19,000.
Workforce modellingInforming pharmacist student intakes
•Intervention may be needed to bring supply and demand of pharmacists into balance.
Future pharmacist workforce project
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2020 2030 2040
Scenario 3
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2020 2030 2040
Scenario 4
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2020 2030 2040
Scenario 1
30,000
40,000
50,000
60,000
70,000
80,000
90,000
2010 2015 2020 2025 2030 2035 2040
Scenario 2
Num
ber o
f phar
mac
ists
(full tim
e eq
uiv
alen
t)
Year
A staged change: the number of students entering MPharm courses from 2015/16 to 2019/20 is reduced by 5, 10 and 15% with a 3 per cent yearly increase between 2020/21 and 2030/31.
Policy analysisInforming pharmacist student intakes
The CfWI recommended a staged approach to balancing supply and demand if intervening at the point of entry to university.
Policy analysisInforming pharmacist student intakes
Using system dynamics to inform future pharmacist student intake in England until 2040
Jack Lawrence, Siôn Cave
