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Securing a sustainable and fit-for-purpose UK health and care workforce

Author

Listed:
  • Anderson, Michael
  • O'Neill, Ciaran
  • Macleod Clark, Jill
  • Street, Andrew
  • Woods, Michael
  • Johnston-Webber, Charlotte
  • Charlesworth, Anita
  • Whyte, Moira
  • Foster, Margaret
  • Majeed, Azeem
  • Pitchforth, Emma
  • Mossialos, Elias
  • Asaria, Miqdad
  • McGuire, Alistair
Abstract
Approximately 13% of the total UK workforce is employed in the health and care sector. Despite substantial workforce planning efforts, the effectiveness of this planning has been criticised. Education, training, and workforce plans have typically considered each health-care profession in isolation and have not adequately responded to changing health and care needs. The results are persistent vacancies, poor morale, and low retention. Areas of particular concern highlighted in this Health Policy paper include primary care, mental health, nursing, clinical and non-clinical support, and social care. Responses to workforce shortfalls have included a high reliance on foreign and temporary staff, small-scale changes in skill mix, and enhanced recruitment drives. Impending challenges for the UK health and care workforce include growing multimorbidity, an increasing shortfall in the supply of unpaid carers, and the relative decline of the attractiveness of the National Health Service (NHS) as an employer internationally. We argue that to secure a sustainable and fit-for-purpose health and care workforce, integrated workforce approaches need to be developed alongside reforms to education and training that reflect changes in roles and skill mix, as well as the trend towards multidisciplinary working. Enhancing career development opportunities, promoting staff wellbeing, and tackling discrimination in the NHS are all needed to improve recruitment, retention, and morale of staff. An urgent priority is to offer sufficient aftercare and support to staff who have been exposed to high-risk situations and traumatic experiences during the COVID-19 pandemic. In response to growing calls to recognise and reward health and care staff, growth in pay must at least keep pace with projected rises in average earnings, which in turn will require linking future NHS funding allocations to rises in pay. Through illustrative projections, we show that, to sustain annual growth in the workforce at approximately 2·4%, increases in NHS expenditure of 4% annually in real terms will be required. Above all, a radical long-term strategic vision is needed to ensure that the future NHS workforce is fit for purpose.

Suggested Citation

  • Anderson, Michael & O'Neill, Ciaran & Macleod Clark, Jill & Street, Andrew & Woods, Michael & Johnston-Webber, Charlotte & Charlesworth, Anita & Whyte, Moira & Foster, Margaret & Majeed, Azeem & Pitch, 2021. "Securing a sustainable and fit-for-purpose UK health and care workforce," LSE Research Online Documents on Economics 110809, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:110809
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    File URL: http://eprints.lse.ac.uk/110809/
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    References listed on IDEAS

    as
    1. Courtin, Emilie & Jemiai, Nadia & Mossialos, Elias, 2014. "Mapping support policies for informal carers across the European Union," Health Policy, Elsevier, vol. 118(1), pages 84-94.
    2. Mossialos, Elias & Naci, Huseyin & Courtin, Emilie, 2013. "Expanding the role of community pharmacists: Policymaking in the absence of policy-relevant evidence?," Health Policy, Elsevier, vol. 111(2), pages 135-148.
    3. Niezen, Maartje G.H. & Mathijssen, Jolanda J.P., 2014. "Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain," Health Policy, Elsevier, vol. 117(2), pages 151-169.
    4. Maria Panagioti & Jonathan Stokes & Aneez Esmail & Peter Coventry & Sudeh Cheraghi-Sohi & Rahul Alam & Peter Bower, 2015. "Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-30, August.
    5. Michael Anderson & Alistair McGuire & Elias Mossialos, 2019. "Health and social care," CEP Election Analysis Papers 053, Centre for Economic Performance, LSE.
    6. Mossialos, Elias & Courtin, Emilie & Naci, Huseyin & Benrimoj, Shalom & Bouvy, Marcel & Farris, Karen & Noyce, Peter & Sketris, Ingrid, 2015. "From “retailers” to health care providers: Transforming the role of community pharmacists in chronic disease management," Health Policy, Elsevier, vol. 119(5), pages 628-639.
    7. Tomoko Ono & Gaétan Lafortune & Michael Schoenstein, 2013. "Health Workforce Planning in OECD Countries: A Review of 26 Projection Models from 18 Countries," OECD Health Working Papers 62, OECD Publishing.
    Full references (including those not matched with items on IDEAS)

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    Cited by:

    1. Anderson, Michael & Drummond, Michael & Taylor, David & McGuire, Alistair & Carter, Paul & Mossialos, Elias, 2022. "Promoting innovation while controlling cost: The UK's approach to health technology assessment," Health Policy, Elsevier, vol. 126(3), pages 224-233.
    2. Sutton, Claire & Prowse, Julie & McVey, Lynn & Elshehaly, Mai & Neagu, Daniel & Montague, Jane & Alvarado, Natasha & Tissiman, Chris & O'Connell, Kate & Eyers, Emma & Faisal, Muhammad & Randell, Rebec, 2023. "Strategic workforce planning in health and social care – an international perspective: A scoping review," Health Policy, Elsevier, vol. 132(C).
    3. Litchfield, Ian & Kingston, Beth & Narga, Dee & Turner, Alice, 2022. "The move towards integrated care: Lessons learnt from managing patients with multiple morbidities in the UK," Health Policy, Elsevier, vol. 126(8), pages 777-785.

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    More about this item

    JEL classification:

    • R14 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - Land Use Patterns
    • J01 - Labor and Demographic Economics - - General - - - Labor Economics: General

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