Tackling the National Skills Shortage from Within
The National Skills Shortage is taking its toll on many sectors; from hospitality, transport, construction, and healthcare. In the past three months, vacancy numbers in the UK have risen to above one million for the first time.
The Bank of England predicted that unemployment rates might reach 5.5% this year, after seeing a year on year decline for the last decade. However, economists have been surprised by a continued decline as society recovers. The government's furlough scheme allowed 4 million workers to remain in their roles during the COVID-19 pandemic so, as the scheme ends and millions of workers return to their roles, why are we seeing such large numbers of vital roles left vacant?
Whether we blame it on staff retention, lack of investment in Health and Social Care, the impacts of Brexit, or Covid-19, we must find solutions to tackle the national skills shortage.
With healthcare waiting lists reaching over 5 million in June, how the government allocates funds from their rise in National Insurance contributions will determine the speed of recovery. This influx of funding will scratch the surface of the problem but a detailed model by the Health Foundation suggests a further £17bn is needed to make the necessary improvements.
Considerations Affecting the Crisis
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Before the pandemic, healthcare services were struggling to recruit and retain their workforces. There were more than 41,000 registered nursing posts reported vacant in the NHS in 2018. Now, many overworked and exhausted workers are considering leaving the industry entirely. The psychological impact on healthcare workers throughout the pandemic has left many suffering from burnout.
“‘We must recover our people before we recover our services’ (Greenberg, 2021) “
Particular attention has been placed on the varying pressures healthcare staff have been subjected to during the pandemic. Positioning our frontline healthcare staff at the centre of our recovery measures will allow us to rebuild a healthy, happy, and supported workforce. This must include a solid management structure, with wellbeing strategies for our workers at the forefront of our recovery plans.
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The aging population is a notable concern for the future of the healthcare system. With many workers reaching retirement age, the younger generations have not gained the skills or qualifications to take up the vacant roles. Therefore, we cannot afford the younger members of our workforce to leave the industry because their workload is overwhelming.
It isn’t just our workforce that is aging; Our aging population requires more continuous care for their health and wellbeing. This increases the demand for health and social care services. In 2019, The Health Foundation reported staffing to be the biggest issue facing the adult social care industry and the pandemic has since provoked an unprecedented strain.
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Demand for services has been particularly strained in the past 18 months; with unprecedented wait times for a variety of services.
1.46 million UK adults contacted mental health services in June this year, and over 350,000 referrals to services were made that month. The NHS Long Term Plan identified mental health as an area of priority, but figures demonstrate the number of mental health nurses has risen by only 0.5%. With a limited talent pool, the industry needs to widen its lens to employ a capable workforce and tackle the increased service demand.
It isn’t just the mental health sector feeling the strain of the staffing shortage. The latest publication of NHS Vacancy statistics demonstrates a similar trend to previous years; with more demand for acute and specialist care across all regions in the UK, the number of open vacancies in these sectors continues to rise. London and the Midlands have also seen a growing demand for community care over the past four years.
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The overall number of EU nationals working within the UK has declined during the pandemic. The 2016 referendum saw a notable decline in EU and non-EU nurses registering to practice within the UK and a restrictive immigration policy prevented many international nurses and doctors from moving to the UK to practice altogether.
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Before 2017, applicants to healthcare qualifications could apply for an NHS Bursary. However, enrolments on nursing qualifications fell by 18% in 2018, after the Bursary was withdrawn, and has continued to decline since. Across the UK, 24% of those starting a nursing degree either didn’t graduate or failed to do so within the expected timeframe.
If degrees are becoming too expensive for student nurses and attrition rates are high across the sector, there must be an alternative, more cost-effective solution to recruiting and training.
Combating the Crisis
How can we finally break this cycle of strain on our healthcare system? What investment can be made to ease the burden on services, for both staff and patients?
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Utilising agency and temporary staff has been a strategy employed to fill the gaps in healthcare workforces. However, the cost implications highlighted by the NHS in 2018 demonstrate the lack of long-term feasibility. Agency staff cost much more, not just in wages but in time dedicated to training in-house and then refilling the role when they leave again.
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Improving staff retention within the healthcare sector was cited by The Health Foundation in 2017 as the most effective method for reducing vacancies and improving the stability of workforces.
Ideally, staff retention strategies focus on improving the working environment, workforce wellbeing, and providing development opportunities. Growth and development opportunities are at the forefront of prospective employees' requirements for a role too.
Developing the quality of your current workforce starts with their fundamental needs; Maslow suggests that you cannot thrive when overworked and exhausted. A chronic workload will only lead individuals to make mistakes, forget things and ultimately affect the quality of patient care. Errors in the workplace also negatively impact work satisfaction in your workforce.
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Equipping health care workforces with the relevant tools to manage stress and burnout is essential to retaining and attracting staff and improving patient care.
Creating relevant policies and procedures that ensure your workforce is supported starts with developing compassionate leaders. (O’Doherty, 2021) Effective leadership has a significant impact on attrition rates and staff burnout. Empowering our management teams to have honest and open conversations with their workforce can encourage an environment of trust, opportunities for early intervention and will have an overall positive impact on staff resilience and mental health.
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There has been a significant and continuous lack of investment into professional development for healthcare staff. The NHS receives a third of the funds they did in 2015 towards workforce development. Research in 2018 highlighted training funds were £2bn less than they would have been in 2006.
Training activities and Continuous Professional Development for team members allow our workforce to develop the relevant knowledge and skills. Subsequently, creating a learning environment where our workforce is motivated, listened to, and supported to grow will attract others to a career in the sector.
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Why is a career in the healthcare industry less appealing to the younger generations?
Community outreach is vital to attract younger generations to a career in healthcare, but spreading the word is not enough. The healthcare sector must accommodate the needs of this potential workforce.
The most highly desired attributes of a career for Millenials and Gen Z’s include;
Supportive Leadership
Interesting Work that allows them to make a Positive Impact
Opportunities to Develop New Skills
Help Solve Social and Environmental Challenges
Autonomy over Tasks
Flexible Work Options
Utilising Technology in their Roles
Ideally, a workplace should be an environment that welcomes creative thought, initiative, encourages work/life balance, and ensures workloads are manageable. Management should provide opportunities for growth and training, as well as ensuring their workforce is valued. This produces well-motivated workers and improves the quality of care and services.
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The introduction of the Apprenticeship Levy in 2017 allowed employers to utilise their Levy allowance for dedicated training. However, the complicated rules have left many businesses failing to use their allocated funds. In 2019, £400m in expired funds were returned to the government, with over a third of employers being unaware of the scheme completely.
Apprenticeships have improved in quality since the beginning of the Levy, with more uptake in higher level qualifications. Apprentices are recruited based on their soft skills rather than experience, allowing employers access to a diverse talent pool. This gives organisations the opportunity to develop technical skills and knowledge in line with the role’s requirements, whilst also gaining fresh insight from a developing workforce.
But, sectors that require specialist skills have struggled to find the right training providers to develop their workforces. So, how can healthcare employers make use of the Levy scheme to invest in their workforce and attract new talent to the sector if the most qualified experts are still in the industry?
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Organisations like Rolls Royce and The Royal Navy have taken their training provision in-house, designing their own programmes around the specialist skills each sector requires. Employers who become Approved Training Providers have greater freedom to develop their workforce to their brand standards, controlling what is delivered, whilst investing their levy allowance back into their workforce development budgets.
Casting a wider net, local healthcare providers can attract a diverse range of talent by taking their training provision in-house. Without the heavy burden on fees for students, apprenticeships are a more attainable, reliable route for qualifications and experience in the sector. Employers create a teaching environment within their workplace, which provides new and existing talent with opportunities to learn within their role and develop resilience to sector specific challenges.
Seek Specialist Support
In-house industry training provides opportunities to learn the organisation from within, specific to each sector and designed by those in it. However, creating specialist skills programmes brings new legal requirements, additional administration, and an understanding of Apprenticeship Standards, funding, Ofsted, and more.
Resources are already stretched in the industry, leaving little time to make sense of new policies and procedures. However, another route has been carved out by specialists from the apprenticeship sector...
Companies have had valuable support from industry experts like us at Think, to successfully develop their in-house training provision. We are at the forefront of Apprenticeship Levy planning and implementation, facilitating companies as they invest in their people.
We are specialists in workforce development, policy planning and organisational improvement and able to provide valuable insight in to the design, planning and implementation of development programmes. Working with businesses, local authorities, and the education sector, experts like us will support healthcare organisations as they transition to in-house training provision. This will enable employers to structure the growth of their workforce, improve levels of patient care and promote a desirable working environment for future talent.