The last 18 months has been an extremely challenging time for our workforce - this includes health, social care, the voluntary sector, unpaid carers and the education sector. With the sustained efforts in responding to the pandemic, the rollout of the vaccination programme, and the focus on service recovery, many of our staff are feeling burnt-out, suffering stress, long-COVID or are just weary. Whilst there have been a range of offers put in place to support the workforce, through the Mental Health and Wellbeing Hub and the enhanced occupational health pilots, this still needs to be our number one priority and ensure that recovery of our staff and their health and wellbeing is at the heart of all our plans.
Recruitment and retention challenges are being felt in many areas, including nursing and midwifery with vacancy rates currently around 11.8% and in adult social care with staff turnover rates around 31.2%, with the greatest gap being amongst registered nurses within social care. Pressures are also being felt in many other areas across the health and care system, particularly in primary care and the ambulance service.
In addition, a proportion of our current workforce either returned to practice or delayed retirement to support our response to the pandemic. There is a risk that many of these will now choose to leave our health and care system and with the increased pressure on our entire workforce there is a risk of further loss.
We need to ensure that we work together to look at alternative workforce models: collaborative, and innovative recruitment initiatives to attract people to the sector and new ways of working to mitigate our recruitment risks, but also to ensure we look after our existing workforce and support them to stay within our health and care system.
Many of the challenges facing the social care workforce have been long understood and the role of the care system (and the challenges it faced) in supporting the most vulnerable during the pandemic has again shone a light on these. Recruitment and retention of staff to adult social care, both in domiciliary and in residential care, is a huge issue which has been exacerbated by Brexit which has reduced the available labour market for the sector.
There are many factors which contribute to this growing issue, including the way in which care is commissioned across many independent providers, the inequity of opportunity for career progression compares to staff in the health sector and the low wages which have persisted for many years meaning many staff are choosing to leave and take up higher paid work elsewhere with more flexibility.
A shift in activity from purely health-based care has meant more care being delivered in social care settings by upskilling the workforce and the sector is requiring roles with skills similar to those in health, but without the ability to match pay on offer elsewhere. Some of these factors are difficult to overcome in the short-term and will take further investment and change in government policy. However, there are things that we can do collectively to ensure this sector can attract people to social care by providing ‘good jobs’ which seeks to provide greater career opportunities and professional ‘status’ opportunities for flexible working, access to health and wellbeing support and the opportunity to work across the range of roles available within the local authority care sector.
Opportunities exist to strengthen the out of hospital care provided to our communities through primary, social and community health care services. Further workforce transformation of the primary care networks (PCNs) needs to be done alongside community health services to ensure that effective multi-disciplinary teams (MTDs) within our communities maximise the available workforce including new roles being provided through the Alternative Roles Reimbursement Scheme to create bespoke MTDs – currently we are seeing unintended consequences through this funding scheme which has led to staff moving from one sector to another, therefore impacting on other parts of the health and care system and is particularly being felt within community health services and community pharmacy. We aim to develop a more strategic approach to maximising the opportunities for transformation and integration through joint workforce planning.
The COVID-19 pandemic has resulted in a significant backlog in service provision throughout the health and care system. This at a time when we are seeing increase in need, especially for access to GPs, Accident and Emergency Departments and the Yorkshire Ambulance Service. Colleagues are working to develop the most appropriate services to meet the needs of the population in the safest and most efficient way. There are opportunities to adapt clinical pathways through workforce transformation and adopting digital innovations that we are constantly exploring. This recovery is just as relevant in social care and the VCSE communities, where our workforce is striving to support all those in need in our communities and to support the population to ‘stay well’, whilst they are waiting for their treatment.
We also need to consider the economic effects of COVID-19 and the impact this may have on our colleagues whose households may be impacted in these difficult times and the additional anxiety this will bring. We also need to think how the health and care sector can contribute to the social and economic recovery, ensuring that as we plan our future workforce requirements, we maximise the potential of our anchor institutions to support growth and job opportunities within our local communities.
We have a real opportunity to work with the West Yorkshire Combined Authority and the education sector to ensure we develop training and education packages to support people who want to learn in different ways and who might be accessing education or training later in life.
The NHS Long Term Plan in 2019 and additional reviews such as the Diagnostics Renewal and Recovery Report by Sir Mike Richards in October 2020, set out a range of challenges for the NHS and partners to seek to address which will require increased and more specific workforce developments. We are clear that more integrated care will mean working across all care settings and meeting the needs of our population by delivering new initiatives, such as community diagnostics hubs. All of these challenges will necessitate a ‘fit for purpose’ workforce.