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System-wide workforce planning for sustainable healthcare

Fiona Grove
By Fiona Grove, NHS Arden & GEM CSU
8 March 2023

Skills shortages and a growing demand for services, combined with external factors such as the cost of living and climate change pressures, create a challenging environment for Integrated care boards (ICBs) looking to provide collaborative services to support their communities. But ICBs also have access to a large, talented workforce which can unlock opportunities to improve health and social care. Before systems can really make effective use of these skills and resources to meet both immediate demands and future priorities, they first need to understand the size, shape and capabilities of their combined workforce.

Know your workforce

Since Integrated care systems (ICSs) were first created, we’ve been working with constituent organisations to help them understand the make-up of their workforce across the system. This is no small task as the amount and quality of employee data varies by partner. Although it can often be easier to access NHS data, thanks to the Electronic staff record (ESR) and the national workforce Minimum data set (wMDS), local authorities use many different HR systems, and the picture becomes more complex still when incorporating private and voluntary sector data. But workforce data sharing can and is being done in some areas, with scope to share learning across the country.

Access to employee data means ICBs can start to benefit from tailored dashboards enabling them to view data according to different requirements, such as sickness absence levels, skills and seniority in different areas, age and diversity breakdowns, or resources by organisation type. These views give ICBs insights into how they might respond to service pressures based on available resources, as well as highlighting opportunities to proactively address issues which may be affecting staff retention or productivity. Whether it’s employee-focused initiatives such as taking action to improve staff health and wellbeing to bring down sickness levels, or understanding whether the right staff are available to maintain a particular service, knowing what you have and where provides a strong starting point.

As data builds over time, trends emerge, giving ICBs the opportunity to ask intelligent questions and take targeted action. For example, a high turnover of staff aged 25-35 could be linked to childcare pressures and flexible working. Understanding this enables systems to identify and implement policies to address these issues. Going a step further, ICBs can use this data to model future scenarios, such as predicting what their workforce will look like in five years’ time if staff opt to retire at the first opportunity, and then consider what initiatives may be needed to address the potential impact.

Supporting service delivery and transformation

Workforce insights enable ICBs to plan their resources to meet current service needs as well as anticipating future pressures and supporting service redesign. This is particularly helpful in helping systems to address health inequalities and embrace new ways of working while retaining valued staff. As systems develop a deeper understanding of population needs, it is becoming easier to identify where additional support is needed and what interventions will have the greatest impact. For example, population health data pinpoints opportunities to provide tailored support to specific patient cohorts or communities, often requiring a specific set of skills. Similarly, as we start to understand and benefit from new technologies such as AI assisted diagnostics and widespread telemedicine, workforce data shows us which staff might need upskilling to take on new roles, or where we have skills that could be more effectively deployed elsewhere. At a time when staff recruitment and retention is so challenging, there is real value in being able to spot opportunities to reallocate and develop existing teams as needs change.

Career development pathways

Information sharing and resource reallocation is not without its challenges of course. Staff across different parts of a health system may be paid differently, receive different benefits and have variable access to career development opportunities. Despite this, in Arden & GEM’s experience to date, system partners have been largely willing to share workforce data (with appropriate information governance and data sharing agreements in place), recognising the wider benefits to the health and care delivery.

Increasingly, we are seeing an appetite for more rotational roles and apprenticeships to give people broader exposure to different parts of a system under a lead provider model. This not only helps employees develop a more rounded understanding of the different parts of health and social care and how they link together, but also creates opportunities to recruit based on care pathways where individuals may work in different parts of the system but all function as part of one multidisciplinary team. Stroke pathways have been supported in this way for some time and we are now seeing this expand into areas such as haematology and some cancer care across systems. That may mean we have to become more accustomed to individuals moving between organisations, but there’s a greater likelihood valued staff will stay within the system and the investment in their training and development will continue to support local community care.

Longer term, integrating system-wide workforce data alongside financial planning will give ICBs greater strategic insight to plan and deliver the best possible care within the financial and staff resources available, particularly as organisations become more accustomed to collaborative working across health and social care. This increasingly advanced data access and analysis provides vital opportunities to facilitate better, more sustainable care and create new career opportunities for staff. But it all starts with a clear understanding of your system’s current workforce.

By Fiona Grove, Head of workforce planning and consultancy, NHS Arden & GEM Commissioning Support Unit

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