Key
takeaways and actions by host, Professor John Unsworth, Deputy Pro Vice
Chancellor for the Faculty of Health and Life Sciences
Health and
Social Care in the United Kingdom are amongst the world's largest employers
with more than 3.2 million people being employed across both sectors. Despite
considerable efforts, both sectors are experiencing huge workforce problems
with around 9% of posts being vacant across the NHS and even more significant
problems in social care where 152,000 posts are vacant, which is around 10.7%
of the total workforce.
Against this
backdrop, NHS England published its Long-Term Workforce Plan (LTWP) in 2023 setting out a wide range of
interventions to address workforce supply, retention and transformation. At the
first Working Well in Healthcare event, hosted by Northumbria University, Professor Mark Radford, Deputy Chief Nursing Officer for
NHS England and the National Director for Education & Training and the LTWP
outlined how the numbers, should the LTWP by achieved, were truly startling
with a projected 10% of all adults in employment being in employment in the NHS
by 2030. When social care is added in 20% of adults will work in health or
social care by the end of the decade making this a project of biblical
proportions.
Addressing
workforce deficits is only part of the task. Many people refer to healthcare as
being like a leaky bucket, with retention representing a huge problem. While
most would assume that this would happen when professionals first qualify
Professor Debbie Porteous, Emeritus Professor, outlined that the major pinch
point for professionals within healthcare is actually at around two years
post-registration with many people deciding to leave the sector after significant
time within the profession. This combined with projected retirements and
migration to other countries, especially Australia and New Zealand, have
conspired to produce the perfect storm.
During the
event, we explored a range of interventions which can address the retention of
experienced staff. Professor Mark Radford referred to the ‘rookie effect’ which
would be created if we lost experienced staff and replaced them with newly
qualified practitioners overnight. The ‘rookie effect’ can affect safety and
also place an increased burden on the new practitioners who feel less well
supported. Initiatives like the Professional Nurse Advocate programme, the hot debrief
and restorative supervision also assist in supporting staff alongside the use
of emotional intelligence when deploying and potentially redeploying staff to
different clinical areas.
The
Long-Term Workforce Plan in England will require a change in mindset to ensure
delivery. Many issues remain unresolved and with funding not arriving until
2025 for apprenticeships and other delivery, the plan is already on a slippery
slope. Part of the challenge is ensuring sufficient placements and the event
heard about the need to learn from other countries. Professor Laura Serrant urged everyone to look beyond the shores of this island. Just because we have
always done it this way didoes not mean it is the most appropriate way. For
example, many registered nurses worldwide are successfully educated on fewer
practice hours than the UK currently requires. Yet, outcomes are the same or in
some cases better in terms of safety and mortality.
One of the
more significant burning issues is the fall in applicants for nursing, medicine
and allied health courses. The numbers have reduced by 10% from 2022 for
nursing with a 26% fall over the last two years. Whereas for medicine the fall
has been less significant with just over 3,000 fewer applicants. The cost of
living crisis has certainly impacted more mature students entering the
professions. However, since the pandemic, industrial action across nursing and
medicine has also projected a negative image of the professions. Professor
Laura Serrant asked people to consider what they would do and contribute to
supporting individuals to pursue these professions, highlighting that we are
all responsible for promoting the range of exciting roles available in nursing
and beyond. Similarly, Laura asked people to reflect on what their contribution
would be to making society and healthcare more equitable. Training can only go
so far and we all have to work out what our actions will be and how they will
contribute.
There was
evidence that everyone wanted to see the workforce issues resolved while at the
same time being open about challenges and barriers in the spirit of seeking
solutions. Professor Alison Machin, Chair of the Council of Deans for
Health was clear about the need to ensure that we have a robust workforce of
educators both within Universities and in clinical practice. At the same time
encouraging the proliferation of apprenticeships will require a rethink of the
regulatory and other burdens this places on a sector which is already highly
regulated.
If the LTWP
is a success the UK will become less reliant on internationally educated nurses
over time. Professor Serrant believed that we will always have places for internationally
educated nurses and that since its inception the NHS has always relied on
overseas recruits. However, it is my belief that as we become less reliant it
is imperative that we have a phased plan to reduce recruitment. Many countries
work on oversupply so it is only fair that we signal less reliance. The
starting point needs to be an end of recruitment from red list countries
(countries where the ratio of nurses per 1,000 of the population is low).
One of the
key messages from the event was that everyone from healthcare assistants to
nationally policy leads has a part to play in ensuring we can effectively
address the workforce issues and support, nurture and retain the current
workforce. As Professor Serrant outlined ask yourself in the ‘eye of the storm’
while things are a bit quieter what you should do and be doing to safeguard the
health of the nation both now and in the future.
The Working Well in Healthcare Event:
The Changes, Challenges and Opportunities for Developing your Workforce was the first in a series of events
aimed at fostering collaboration across the healthcare sector to overcome the
challenges it faces. To register your interest for the next event please click here.
To find our
more about the workforce development and training offering at Northumbria
University click here.
Our
action: Northumbria University – tackling issues head on
Northumbria
University is one of the largest centres for healthcare professional education
in the North of England, offering a range of specialist degree and CPD programmes across many
areas of nursing, midwifery, operating department practice, physiotherapy and
occupational therapy.
The University is
dedicated to delivering high quality learning
and development opportunities through experiential teaching using
simulation-based education and innovative virtual reality technology to enhance
practical learning, much of which was showcased at the event. It also
prioritises providing first-class pastoral support for students. More than 6,000 students have graduated from our
Nursing, Midwifery and Health courses in the last four academic years, over 100
newly registered nurses have entered the regional workforce through our
18-month degree apprentice programme since 2020 and the University’s recent
announcement about its new Centre for Health and Social Equity (CHASE) will further increase capacity for the
University to train the workforce of the future.
CHASE, which will be a
flagship centre of excellence for research and training to meet the needs of
stakeholders and communities in Newcastle, across the region, nationally and
beyond. The University is already proactively driving forward educational
growth and system support focused on delivery of the NHS Long Term Workforce
Plan through initiatives such as; increasing
nursing and Advanced Health Practitioner (AHP) places; developing new
apprenticeships and direct entry; working to improve the continuation and
progression to employment; and working on Advanced Clinical Practitioner
pathways and Primary Care programmes. One of the aims of CHASE
is to further enhance this work.
About our
host: Professor John Unsworth OBE, Deputy Pro Vice Chancellor for the Faculty
of Health and Life Sciences
John Unsworth has worked in Higher Education since 2007 and has held
posts at the Higher Education Academy, University of Sunderland and at
previously at Northumbria University. John’s research relates to patient safety
and workforce development around competence.
John has a background in primary and community care having been a Nurse
Director in a geographically large Primary Care Trust in England. From 2001 to
2007 John was professional lead for nursing, allied health and adult social
care / social work within Northumberland NHS Care Trust. Until 2018 he was
Board Nurse on NHS Northumberland Clinical Commissioning Group. During the
pandemic he has worked for NHS Test and Trace and a Clinical Contact Caseworker
and is now delivering Covid-19 vaccines in Primary Care.
He has also worked in consultancy and a number of specialist nursing
roles over the past 30 years. In 2013 John was made a National Teaching Fellow
in recognition of his work around simulation education and student assessment
in 2013. He became a Principal Fellow of the Higher Education Academy in 2016.
John has worked internationally to develop practice and higher education
teachers in Thailand, China, Hungary, Ghana, Vietnam, Bahrain, Ukraine and in
Grenada (West Indies).
John is a Fellow of the European Academy of Nursing Science and a Fellow
of the Faculty of Nursing of the Royal College of Surgeons, Ireland.
John was awarded made an Officer of the Order of the British Empire
(OBE) in the 2022 Queen's Birthday Honours list for services to community
nursing and community nurse education.
John is a Global Nursing Leadership Institute Scholar with the
International Council of Nurses and has a lead role in influencing UK policy as
Chair of the Queen’s Nursing Institute.
