On 1 December Public Policy Projects (PPP) launched its State of the Nation report, Workforce and Talent Development: More Time to Care.  

Despite accounting for 8.6 per cent of the working age population, health and social care is severely under-staffed. According to the BMJ, one in 10 NHS posts are vacant in England alone – amounting to more than 100,000 full-time equivalent vacancies. Similarly, according to Skills for Care there was a vacancy rate of 7.3 per cent in August 2021, with 105,000 vacancies being advertised on a typical day in 2020/2021. 

The report, chaired by Professor Mike Bewick, Former Deputy Medical Director at NHS England, considers three key themes in workforce planning; recruitment and diversity, development and innovation and wellbeing and retention.  

To form a set of practical recommendations for each theme, the report consulted with a range of stakeholders from Health Education England, NHS Trusts, social care providers, the private sector and the not-for-profit sector.  

Parliament recently rejected an amendment to the Health and Care Bill that would have mandated ministerial transparency over NHS staffing shortages – this has been widely criticised by health experts. More time to care calls upon the government to commit to publishing regular projections of the demands for health and social care staff alongside a plan for how that demand will be met.  

In addition to meeting demands, the report argues that the NHS and social care must better represent the communities they support. A significant difficulty in broadening access to medical training is the idea that medical careers must begin at a young age. New medical schools and new routes such as apprenticeships can provide opportunities for educational institutions to develop links with local schools and encourage greater ambition across students from different ages and different backgrounds. 

More Time to Care also highlights the critical importance of placing patient-centric workforce planning at the heart of the integrated care agenda. Bringing the NHS and social care workforces together is key to providing a high-quality, integrated health and care service, with shared programmes of recruitment, training and retention to build system-wide resilience.   

Joint training programmes will help ensure digital readiness among staff at all levels is a key priority for workforce development. Current workforce strategies are not fit for purpose for the digital age – according to HIMSS Analytics in June 2021, only six hospitals in England had reached a “high level of digital maturity”. The report also stresses that digital implementation must maintain or improve the quality of learning and widen access, ensuring they support rather than disadvantage groups of students such as those with fewer financial resources or students with disabilities. 

Taking steps to support the mental wellbeing of staff  

The pandemic has amplified longstanding pressures on the health and care workforce, with fatigue and burnout increasing as a result – adding to increasingly poor levels of staff retention across the sector. This report highlights the Reflective Spaces programme run by Doctors in Distress, a charity committed to influencing cultural change in the NHS by providing spaces for healthcare workers to come together to talk about the emotional impact of their work.  

Commenting on the report, Doctors in Distress Chief Executive, Ann Paul, said: “There is a critical need for leadership to take a decisive step in the culture change necessary to make a significant difference for the future, while at the same time encouraging medical students to care of their own wellbeing as a matter of course since Doctors in Distress is running several programmes for medical students.  

We hope that this will also encourage students into medical schools – the phrase ‘turning on the tap’ is apposite. The final area of real concern to us and which the report highlights so well is the plight of foundation doctors.  The NHS simply cannot afford to lose doctors at any point, but the drain on Foundation Year doctors is a major issue.” 

The report argues that reaching out for help in the early stages of clinical training is a sign of strength and a mark of professionalism. PPP is calling for a shift in clinical culture to encourage trainees to ask for help. The idea that a deterioration in mental wellbeing is a sign of weakness, particularly among doctors, needs to be banished. Professor Mike Bewick said: “The recent pandemic has laid bare the fragility of our health and social care workforce. Future planning must address both capacity and wellbeing as equal priorities to retain as well as attracting new workers.” 

The role of volunteers  

The report recommends that the NHS should maintain and expand a national register of retired clinical professionals and those who have left the profession mid-career who are willing to return to work at times of high pressure. This would make it easier for them to come forward at short notice.  

Building on the momentum from volunteering during the pandemic, the report also recommends that the NHS should collaborate with voluntary sector organisations to build a significant cadre of volunteers to support staff while improving the patient experience. These volunteer posts should always be complementary to, not instead of, paid staff members. 

Director of Services and Deputy CEO at Royal Voluntary Service, Sam Ward, said: “Having seen first-hand the difference that volunteers can make to our communities and the NHS, particularly during in a health crisis, it is vital that we build on the momentum of volunteering during the pandemic. Volunteering brings out the best in our communities and needs to be supported and developed to become a more extensive and permanent resource for the NHS.” 

A call for reform 

PPP’s latest report on workforce planning calls for comprehensive reform to the way the workforce is planned, developed and supported. Both the NHS and social care continue to face staff shortages that prevent the workforce from meeting patient needs. With NHS staff facing an enormous backlog of care and the Covid booster push creating a diversion of staff, it is more important than ever that the workforce is adequately staffed to face upcoming pressures.  

For more information on PPP’s report: Workforce and Talent Development: More Time to Care, please write to carl.hodgkinson@publicpolicyprojects.com.