Addressing Our Ageing Population - An Employers’ role in growing workforce skills
The UK’s ageing population is growing; by 2030, those over 65 are expected to make up to 24% of our population. As our population lives longer, our NHS must learn how to best adapt to the changing needs of its workforce and its patients.
For the past decade, workforce growth has been unable to meet the rise in demand for health and social care services. The NHS Long Term Plan set out an ambitious 10 years of phased improvements for NHS services. Covid-19 has accelerated the need for digitalisation and integrated care approaches, but applied pressure onto the NHS workforce and services. So, how can NHS Employers best meet the changing needs of its workforce as we plan for our ageing population?
Caring for Our Ageing Population
Our ageing population requires more integrated, long-term health and social care, which can be achieved by building robust primary care settings with multi-skilled practitioners. The NHS has committed to redesigning care in our communities, where services collaborate and communicate with each other; moving away from each encounter with the health service being a disconnected episode of care.
The NHS Long Term Plan aims to redesign outpatient services by scaling up video consultations, reducing the need for a third of face-to-face hospital visits by 2023. Rising wait times on urgent and emergency care services have been an ongoing challenge for the NHS, and so a care model which moves towards early intervention, easier access to support and information, and a community-focused approach will take the burden away from our emergency services
Building Skills for Primary and Community Care
In the last decade, funding for hospitals has been growing twice as fast as for GP practices; and yet, a year’s worth of GP care for one patient costs less than 2 visits to A&E. NHS providers have begun reversing this decline, with a £12 billion investment in General Practice delivered a year ahead of schedule. As models of care shift to a collaborative community approach, primary care settings will benefit from widening their strategies for staff recruitment, training, and retention.
Trusts that invest in opportunities for clinical practitioners to train across disciplines will allow services to distribute skills dependent on demand needs. The creation of new roles, such as Nursing Associates, and programmes, such as Nurse First, offer healthcare assistants and graduates further routes into registered nursing roles.
To build robust community care services fit for the future, NHS trusts must look at different options to collaborate with community partners. General practices like The Modality Partnership have engaged with voluntary, community, and social enterprises across North and West Yorkshire to bring care to the centre of communities. Their pop up clinics engaged at-risk groups, who typically do not access NHS services early enough to treat health conditions.
Digitalisation of Health Care
Digital transformation throughout the NHS has connected systems and services, simplifying patients’ access to care. During the pandemic, the development of the NHS Datastore enabled the health service to route ventilators and PPE where it was most urgently needed. It also enabled 99% of GP practices the capacity to provide video and online consultations, avoiding 2.9 million unnecessary visits to hospital in the last year.
The NHS AI Lab invests in the development of AI-driven technologies for health and care. So far, we have seen the automation of early lung cancer detection, applications of genomics, and deep learning software to improve breast cancer screening. Clinical applications of innovative technologies require skills that keep up; leaders who are capable of implementing and leading change and adaptable workforces able to access learning and support that meets job demand.
Preparing for the Next Generation of Workers
The UK is now seeing a four-generational workforce emerge and the workplace must cater to the needs of each generation. 47% of the NHS workforce is over 45 years old; in just two decades, almost half of our workforce will be retiring. How can healthcare employers attract and prepare Gen-Z’s for a career in health care.
Programs like NHS Cadets, launched in 2020, offer teenagers the chance to volunteer at vaccination centres, complete first aid training, and support the elderly in the community. Commitments like this to inspire and train the next generation of health workers will support NHS employers to attract new talent to the sector, whilst providing young people more accessible pathways to a career in health and care.
NHS employers play a vital role in creating an attractive culture of work and learning, but further collaboration between schools, colleges, universities, and local authorities could pave the way for young adults to gain first hand experience of working in healthcare.
Building Quality Clinical Leadership
Quality management of services and staff underpins the success of many ‘well led’ NHS organisations. Amanda Pritchard, NHS Chief Executive, highlighted that “we need more people, working differently, in a compassionate and inclusive culture where leaders at all levels inspire, empower and enable them to deliver high quality care in the most effective and efficient way.”
As the focus shifts to building multidisciplinary teams, NHS Employers must ensure their leaders and managers are equipped for this change and capable of fostering a sense of shared purpose amongst their teams. The 'Developing People, Improving Care’ framework aims to improve leadership and skills across the health and care systems. By developing compassionate leaders, capable of managing talent, the NHS can improve the quality of work and care across services.
Management practices vary considerably across the health care landscape, and such variation cannot be resolved with a one size fits all approach. Local leaders should be supported to develop robust strategies which are tailored to individual service needs and context.
The creation of pathways such as the Professional Nurse Advocate are designed to build the skills and competency of nurses to lead team development. Programmes like this build confident clinical leaders who foster a culture of learning within their teams.
Creating a Culture of Learning within the NHS
By creating a culture where leaders and frontline staff are encouraged to learn, grow, and enjoy their work, NHS Employers will attract and retain a loyal, talented workforce. Additional funding, made available by a new Health and Social Care Levy and rise in dividend tax, will allow healthcare employers further opportunities to invest in training and development.
Clinical apprenticeships may support employers to build a multi-disciplined workforce. However, hiring and training apprentices can prove unfeasible for some contexts; managing programmes in a clinical setting requires quality systems and processes, leaders capable of navigating the apprenticeship landscape and a supportive environment for apprentices to apply their learning.
Healthcare employers can collaborate further, working with other stakeholders to carve our development programmes designed around their skills, staff, and services. Working with schools, universities, local authorities, training providers, and experts in workforce development, employers have the power to champion real change within the health service - tackling staff retention and improving workforce capacity and resilience.
By exploring all avenues of education and training on offer, employers can make informed decisions about their workforce planning. Where hurdles arise around funding and regulations, employers can access support to make sense of the education landscape, as well as advocate for change by lobbying policymakers. The Health Foundation’s recent analysis of NHS leadership highlighted that policymakers play a pivotal role in ensuring local services have the resources to tackle training and development needs.
Our next article will explore the impact decision-makers have on bolstering our healthcare workforce as we face the challenges of an ageing population, an overhaul of models of care, and a shortage of skills.
Data taken from NHS England, the ONS, and The Health Foundation