Awaiting the long-awaited NHS workforce plan
NHS staff and patients are anticipating the publication of the government’s NHS workforce plan this week. Workforce shortages of >100 000 are limiting service delivery. A plan that can help the health service meet demand is critical to the sustainability of the current model of the NHS.
The workforce plan will set out how the government intends to increase the numbers of health professionals working in the NHS through training and recruitment, though a healthcare workforce supply plan in silo will be limited as a solution.
What would a holistic workforce plan look like?
1) Lag time planning
It will take time to get more health professionals through training. While adjusting training requirements to enable more service provision through studying and training years has been put forward as a workaround, in some press coverage, the prime minister has suggested that the plan’s effects may not be felt for “five, 10 or 15 years”. During this time working conditions could deteriorate, spiralling to attrition and deteriorating capacity and care.
2) Working conditions
Demand outweighing resource is the biggest factor contributing to challenging working conditions in the NHS. More qualified healthcare workers coming on stream may take years and meanwhile, the evolving healthcare needs of the population will lead to increasing demand. Working conditions including but not limited to preventing uncapped demand on shift, work and health support for the workforce and fair pay would contribute to making it more sustainable for healthcare workers to stay in their posts.
3) Social care
Even if the healthcare workforce crisis was solved, the challenges faced by the social care workforce (where there are currently more vacancies than in the NHS) would continue to impact healthcare delivery and healthcare working conditions as the systems are symbiotic. Social care capacity affects flow through healthcare, and demographic change means the population’s social care needs continue to increase. The government’s plan should consider the social care workforce in parallel to the healthcare workforce.
4) Data
Historically, it has been difficult to track intention and progress in workforce numbers as pledges can be ambiguous. E.g. in some publications ‘doctors working in general practice’ can mean foundation doctors or GP trainees - who have a different pace and level of autonomy to fully qualified GPs, and may not be retained by the general practice workforce at the end of their training. Data on headcount is not as useful as full time equivalent staff: many healthcare staff cannot afford the personal and financial cost of working for the NHS full time, so reduce their full time equivalent percentage and take on another role alongside their NHS role. As well as collecting this data, clearer publicly accessible data on leavers, reason for leaving and whether this is mobility or attrition will help understand what is actually happening to the workforce and why. In terms of qualitative data, exit interviews at a local level could be a rich source of soft intelligence regarding working conditions on the ground.
5) Technology
There are more and more opportunities to use technology to support service delivery, beginning with the operational and logistical aspects of delivering care. Technology can help increase capacity and reduce demand on staff, and can perform better than humans on some operational tasks. Using technology to automate the administrative burden on healthcare workers will allow them to focus on what they do best- the human aspects of care. R+D on what works for healthcare workers, the benefits, the downsides and how to implement this safely for staff and patients is a critical part of future-proofing the workforce.