Systems thinking helps England plan future health and care workforce

A trailblazing study has informed thinking in England about the future health and care workforce, and the skills needed to keep pace with changing health needs.

As part of the project, the Centre for Workforce Intelligence, an independent think tank created by the government of the United Kingdom, now part of the Department of Health, mapped out necessary skills and competencies for the health and care workforce, investigated roles and responsibilities for different health and care workers, and outlined 6 scenarios for change in future demand.

“Achieving and sustaining universal health coverage requires a health workforce that is fit for purpose. This study highlights an approach to determining the necessary skills for the workforce so it can meet future population health needs,” explains James Buchan, Senior Adviser on Human Resources for Health at WHO Europe.

The research is one of many examples of good practice which will be shared to inspire policy-makers attending the high-level regional meeting Health Systems Respond to Noncommunicable Diseases (NCDs), on 16–18 April 2018, in Sitges, Spain.

Increased demand for health and care workers to support people with NCDs

In England, more than 15 million people live with a long-term health condition, such as high blood pressure, depression, dementia and arthritis, and this figure is expected to increase.

The horizon scanning exercise revealed that demand for health and care workers’ time could grow more than twice as fast as the rate of overall population growth. Additionally, over 80% of the increased demand in the future will be driven by needs associated with long-term conditions and NCDs.

This major shift in health and care needs is related to the future patient demographic, including an increasing ageing population and the number of people who will be living with multiple health conditions.

Demand for caring skills projected to outstrip demand for specialist skills

The research also suggests while demand for all skill types will increase, the need for certain profiles of health and care workers will be quite different in the future.

Matt Edwards, Head of Horizon Scanning and International at the Department of Health, England, who co-led the research, explained that “the demand for caring skills that don’t typically require high levels of registration or training, such as those offered by health-care assistants, junior nurses, nursing associates, support workers and housekeepers, will far outstrip the demand for higher skills which we associate with medical and dental professionals”.

Insights such as these have helped the health and care system in England to gain a better understanding of the skill profile that will be needed in 2035, and to plan accordingly.

More investment, new roles and more training places

The study is part of the evidence base which the English health and care system, led by the Department of Health, has drawn upon to develop new health workforce policies. For example, England has pledged to invest £1.3 billion to expand the mental health workforce to treat an extra 1 million patients by 2020, and to provide services 7 days a week, 24 hours a day.

The country is also looking at creating new roles, such as nursing associates and physician associates, to deliver high-quality care for patients. Additionally, the government intends to provide more places on nursing, midwife and allied health professional degree programmes, and to expand undergraduate training to increase the home-grown medical workforce by 25%.

Setting a global example

The Centre for Workforce Intelligence study has inspired similar health workforce research elsewhere.
Parts of the approach used by the research team were adopted for skills research in Europe, as part of the European Union Joint Action on Health Workforce Planning and Forecasting. Elements of the workforce planning exercise have also been adopted by WHO and the Pan American Health Organization (PAHO) in developing longer-term thinking on the future of the workforce in the Americas.