Workforce issues
Tackling workforce challenges in the NHS
Dr. Steve Fox argues that the healthcare sector must consider how insourced staff can be used appropriately to embed long-term resilience in the NHS workforce.
With an increased demand for healthcare during the pandemic exacerbating existing pressures on health services, the NHS has been left with a backlog of patients,1
as well as workforce
and capacity challenges that policymakers and healthcare leaders are still attempting to grapple with. According to the Health and Social Care Select Committee’s damning assessment of the landscape of the UK’s healthcare workforce, the health and social care sectors are facing the greatest workforce crisis in their history, with research by the Nuffield Trust finding that the NHS in England is 12,000 hospital doctors and more than 50,000 nurses and midwives shy of what it currently requires.2 Indeed, further assessments suggest that
England alone will need 475,000 additional jobs in the healthcare workforce by the 2030s.2
While
pay has been recognised as a barrier to both recruitment and retention within the health and social care workforce, it is also important to look at other factors that have resulted in shortages in almost every healthcare profession in the country.2
The unfortunate reality is
that the pandemic created a culture of long working hours with restricted breaks due to contamination and risk of spreading the virus3
In
the early days of COVID-19, the world saw many healthcare staff living alone for months at a time to protect their loved ones, adding further to the emotional strain of working in the sector. Workforce morale is also at a considerable
low, with the Committee’s report highlighting the that the NHS lost two million full-time equivalent days to sickness in August 2021, including more than 560,000 days to mental health issues including anxiety, stress, and depression.2
The
result is that many in an exhausted workforce are leaving for other better paid sectors such as hospitality2
and the NHS has seen an increase in
resignations.4 This has subsequently created a cyclical
challenge whereby the exit of these individuals from the workforce further increases the pressure on their former colleagues, who in turn feel equally over-burdened and wish to leave the workforce. Without the provision
of the necessary resources to support these individuals, it is difficult to envision an end to this enduring cycle. While the Government has committed extra to develop the social care workforce
funds5
(including through training opportunities and new career pathways), the publication of its long-term plan for the NHS workforce has been delayed. This has left the sector without the leadership it desperately needs to find long- term solutions to these challenges and, given the time-lags associated with training qualified healthcare professionals, this crisis is only set to further intensify. Considering this time-lag in training and in the absence of this steer from the Department for Health and Social Care, it is important that the sector considers alternative avenues of support in finding a solution to this crisis, including that offered by insourcing professionals.
What is insourcing? Insourcing is prevalent in the UK and Ireland and involves a managed service of the appropriate full team of clinicians to deliver surgery and clinics within the hospital’s estate; the service should be viewed as “additive” to the local health economy, rather than as a replacement. The service can increase the capacity of
traditional healthcare providers by providing the critical staff needed to help decompress the healthcare system and help to create
efficiency gains while supporting the delivery of positive patient outcomes. Offering a lifeline to the healthcare workforce before, during, and beyond the pandemic, insourced healthcare staff continue to provide an invaluable support network for the NHS. Indeed, at a time when staff are continuing to contract COVID-19 themselves and having to take time off of work at short notice, insourcing staff are also providing vital last-minute support which enables health providers to continue delivering patient care. At present, NHS leaders are essentially
firefighters, wrestling with issues around the backlog and long waiting lists and, as a result, Trusts simply do not have the resources to focus on the positive development of the workforce. This is despite the widely accepted benefits that programmes such as widening staff training and assessing the benefits of new technology can have to develop the workforce of the future and consequently improve health services. Until challenges such as the backlog have begun to be tackled – and the fires have been ‘put out’– Integrated Care Systems (ICSs) will be unable to consider wider opportunities of training or innovation among their workforces, limiting the potential of the employee body. It is in these circumstances that private insourcing providers can play their greatest role. By promoting the long-term benefits
of training staff and supporting innovative technologies to help the NHS deliver faster and
February 2023 I
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