Healthcare workforce in 2023: ideas and issues

1. Healthcare
workforce in 2023ideas and issues
CfWI produces quality intelligence to inform better workforce
planning, that improves people’s lives

2. The shape of things to come
• The risk is the workforce in healthcare in ten years
time will be much the same as it is now, only older
and more stressed.
• The opportunity is that the current pressure on the
service will be a catalyst for tackling long standing
problems.
• There are no simple solutions to these challenges
and they cannot be solved in Whitehall or Quarry
House

3. So what is changing….
• As identified by the Wanless Review and CfWI Horizon
Scanning:
• Patients changing (more elderly with longer years of
unhealthy life)
• Long term conditions increasing
• Many with more than one condition
(dementia/Parkinson's/range of physical)
• Six out of ten over 65’s affected by 2020
• Changing expectations of patients, especially younger and
affluent sections
• No "decision about me without me"
• Seek advice on internet
• Wish to be actively involved in care - no more "doctor knows
best"

4. So picture this in 2023….
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Risk stratified population
Profiling your likely disease portfolio
Hospitals of the future
24/7 working
Integrated Health and Social Care
Health, Higher Education and Industry
Technology and self care

5. From a CEO of a Regional
Hospital
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Quality
Patient experience
Staff engagement
Spending public money wisely
Research, innovation and education

6. We have the technology
• What can be done is changing faster than we can keep pace
with
• Genetic Science - the meaning of life
• Bio-engineering (the rebuilding of life)
• Application of digital technologies to medical use (self
monitoring)
• Some technologies already adopted (telehealth and robotic
surgery)
• Diagnostics will move centre stage
• In healthcare science "There are things we know, things we
do not know and things beyond knowing..."

7. Outside of NHS control?
• Fundamental factors affecting health outside NHS
control
• Public health trends going in divergent directions
(obesity/smoking)
• Inequalities remain severe and diverse healthcare
needs growing
• Public health risk (e.g. pandemic)
• Will there remain a consensus for an NHS style
system?

8. Issues for medical staff
• Have legacy of expansion of medical training
(rolling forward)
• Consultant role-delivery or coordination
• Educational issues (Shape of Training Review once in a decade chance?)
• Need for greater generalist skills-reverse trend to
specialisation
• More flexible employment model
• Reshape how care is delivered to be more around
patient need e.g. (24/7)

9. Nursing
• Debate on staffing ratios
• Resolve issue of identity (one workforce or two)
• Changing relationship with patient (more of
broker/ally) CfWI
• Major changes in nurse training model (return to
apprenticeship?)
• Advanced practitioners

10. Support and technical workforce
• Bands 1-4 untapped resource (only gets 5% of
training budget)
• Build on successful developments on advanced
practitioners
• Integration with social care -various models raise
key issues
• Pay and employment model needs to change

11. New approach to workforce planning
(1)
• In search of holy grail of effective workforce planning we
have created new model:
• Three pillars from 2012
• Health Education England
• Local Education and Training Boards (must be led by
employers)
• Informed by our own workforce planning gurus (CfWI)
• Have concentrated on alignment issues
(timescales/relationships)
• Employers increasing capacity and skills

12. New approach to workforce planning
(2)
• HEE also looking at funding for training and how to
support role redesign
• Workforce plans - move from predictions to forecasting
• We need to move focus to changing practice
• NHS Employers has developed views on some key
areas
• How do we move things forward
• Learning to share/"Share and Learn"
• Looking at experience in new entrants and in other
sectors

13. Keeping what works
• NHS workforce has strengths
(dedication, knowledge, teamwork)
• Most of the workforce we will have in 2023 are
already in place
• Build on what we have
• But “modernising the NHS goes beyond simply
creating new roles. It needs to start from the needs
of patient and public rather than starting from
traditional roles and professions” (HR in NHS Plan
2002)

14. Making it happen 2023….
• A more generic technology aware workforce
• Patient pathway and outcome focused across
boundaries
• Community based
• Advanced and specialist roles
• Role redesign on wider scale than in past
• Employers need to dedicate time to workforce
planning

15. Sir Andrew Cash OBE
Chief Executive
Sheffield Teaching Hospitals NHS Foundation Trust