Impact of Covid on the economic recovery of our health service
What areas of our health services have been most impacted by the pandemic and how can we ease the burden of pressure for our workforces?
The response to the pandemic was described by MPs as "one of the most important public health failures the UK has ever experienced”. The health and social care sectors entered the pandemic in a weakened state, against a context of funding pressures, staff shortages, and increased demand for services.
Waiting Times & Wait Lists
Latest figures published by NHS England highlight nearly 6 million people are waiting for routine hospital treatment and more than 300,000 are waiting for an operation.
Reports suggest clearing the backlog of cancer treatments could take until 2033 if services operate at 5% above their pre-pandemic levels. The Institute for Public Policy and CF Consultancy have called for government investment in cancer workforces to meet the demand on services.
A&E wait times are at their worst levels since the four-hour target was introduced in 2004, with latest figures showing 1 in 4 patients wait over four hours to be seen.
Ambulance Handovers
In September, The Royal College of Emergency Medicine warned that increased ambulance handover times were threatening the safety of patients. Their survey highlighted that over half of responders were forced to hold patients outside A&E every day, compared to one-fifth in March last year.
999 call handlers received nearly one million calls last month and the average wait was nearly 40 minutes for an ambulance to reach category 2 incidents (which includes heart attacks, road traffic accidents, and seizures).
Military personnel have been deployed to support ambulance services across the UK, but this is not a sustainable long-term solution. Adopting strategies that allow for flexibility will diminish the need for a reactive approach when services are stretched in the future. We must invest in creating resilient systems that protect and develop our workforces to meet the demand on services.
Staff Shortages
In Tackling the National Skills Shortage from Within, we discussed the effects of burnout on healthcare staff, the ageing workforce, and the low attrition rates of student nurses.
Investing in quality training programmes allows us to put in place preventative measures for staff burnout, increase staff retention and close the gap in skills - improving the capability of our workforces and the capacity of our services.
Paramedics
In July, the NHS announced a £55 million fund for ambulance trusts to increase their staffing in preparation for winter. It typically takes on average three to five years to train a fully qualified paramedic, so developing a strategic plan for ongoing workforce growth is essential.
A survey carried out by The Royal College of Emergency Medicine demonstrated emergency responders and call handlers had little to no confidence that their organisation could safely and effectively manage the predicted pressures as we head into winter.
UNISON highlighted the unsustainable demand on ambulance services, calling on employers to support the welfare of their staff, both in control rooms and ambulances. Their report to the Association of Ambulance Chief Executives highlights that investment in workforces is the most viable solution to address ongoing capacity issues.
Nurses & Student Nurses
From 2010 to 2018, the number of full-time nurses barely increased – despite the demand for services growing by a third. Latest figures suggest that 36% of nurses within our current workforce are considering leaving the industry entirely.
Whilst UCAS reported an increase of enrolments on nursing degrees this year, student attrition has been historically low; so we must develop strategies that can improve the opportunities available for student nurses to progress.
Providing student nurses with mentorship from within the health service will improve access to practical on-the-job support, strengthening workforce capacity and capability. Building quality curriculums and training programmes that develop resilient and empowered workers will improve staff retention and student attrition rates, in turn attracting more from the talent pool.
Social Care
The pandemic occurred against a backdrop of issues in social care including funding shortfalls, workforce shortages, and provider instability. Between 2019 and 2020, there were approximately 110,000 vacancies in the sector, a staff turnover rate of 30%, and nearly a quarter of the workforce were on zero-hour contracts.
The Coronavirus Lessons Learned report highlighted the lack of training opportunities as a significant contributor to the sector's ability to manage the demands of the pandemic. Guidance on PPE changed 30 times up to the beginning of August last year. Poor communication of policies, lack of training around infection control, and inadequate supplies of PPE left many staff and patients at risk.
Skills for Care noted the staffing shortfalls in the sector impacting our health service too. Care organisations are unable to work at full capacity and patients are remaining in hospital when they have no care facilities to be discharged to, reducing hospital bed capacity and further delaying treatments.
Tackling chronic staff shortages is essential to easing the burden of pressure on services. Strategies that prioritise workforce development will retain and attract workers; allowing our workforce to develop their skills and progress in their careers, whilst improving the capacity of care available.
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An increase in demand for specialist healthcare services has demonstrated a disparity between the need for specialist support and the lack of trained professionals to provide it.
Figures released this month highlight GP practices are facing record demand, with over 24 million appointments taking place.
With a shortage of specialists to accommodate the increased demand for acute and community care, heavy workloads are affecting staff wellbeing. 92% of trusts told NHS Providers they had concerns about staff wellbeing, stress, and burnout following the pandemic.
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A survey by the World Health Organization showed that the pandemic disrupted mental health services in 93% of countries worldwide. 1.47 million UK residents contacted mental health services in July this year.
The NHS set out objectives for improving mental health services in their Mental Health Five Year Forward View. However, to meet the increased demand, further investment into workforce growth is necessary.
The Royal College of Psychiatrists highlighted that one of the biggest causes of workforce burnout in mental health services was the “lack of professionals to support all the patients who need help”. A quarter of all nursing vacancies are in mental health and one in 10 consultant psychiatrist posts are vacant. For a further 360,000 patients a year to access talking therapies, we must develop and retain a resilient workforce of specialist mental health staff.
Recovering Sustainably
The introduction of the Health & Social Care Levy will provide funding for approximately 9 million treatments, but what other opportunities are there for the sector to recover?
The Department for Health & Social Care has invested in projects like local surgical hubs, new technology to speed up diagnosis, and innovative methods to tackle the waiting lists for appointments, treatments, and surgeries. As such, our workforces will require investment in their learning to meet the evolving needs of their roles.
Investing in People
The introduction of the Apprenticeship Levy in 2017 demonstrated a shift in the quality of apprenticeships; apprentices are recruited based on their soft skills and organisations deliver specialist training designed around their sector.
In collaboration with an approved training provider or by becoming an Employer Training Provider, organisations have utilised the Levy to provide apprenticeship opportunities for their workforces to grow their skills.
Health and social care specialists are the most competent trainers available to develop the skills of the next generation. With dedicated support from specialists familiar with the education and training sector, our health services can develop quality training programmes internally that meet the demands of our workforce.
Enrich the Wellbeing of our Workforce
The Government’s Health is Everyone’s Business highlighted a strong relationship between health and work. Employers who invest in the wellbeing of their employees see a reduction in absences and sickness and an increase in productivity and staff retention.
Equipping leaders with the tools to manage the wellbeing of their workforces is essential in developing resilient, capable services within the sector.
“At THINK, we want to help the health service to build capacity by using workforce development strategies that include the Apprenticeship Levy. We recognise that navigating the skills system at times can be quite daunting for employers”
With guidance around public policies and the advantages of the Apprenticeship Levy, our health services can adopt a new ways to recruit and undertake workforce training.
We are eager to share our practical experience of workforce planning and development so organisations and individuals can build capacity. We want to help employers to understand the benefits and the positive impact which can be achieved on business performance.
At THINK, we’re determined to bridge the skills system with organisations that have a requirement to build capability & capacity.
We know how to build capable workforces and we know the value of investing in skills, but it's health care professionals who are most qualified to grow the skills of their workforce. Our insight equips leaders to plan, implement, and evolve their workforce development programmes with the confidence to adapt as circumstances dictate.
We can recover our health care services sustainably if workforce wellbeing and growth are at the centre of our strategies for success. Health care leaders have the power to transform the skills of their workforce; developing resilient, motivated, and capable workers who provide quality care to patients.