CfWI Annual conference 2013 - Sir Andrew Cash Presentation
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This document discusses issues and ideas regarding the healthcare workforce in 2023. It notes that the workforce will likely be similar but older and more stressed if changes are not made. Opportunities exist to tackle longstanding problems with the current pressure acting as a catalyst for change. The healthcare environment will see an aging population with more long-term conditions. Patients will expect more involvement in their care through technology. The workforce will need to be more integrated across health and social care and have new generalist and advanced skills to meet these changing needs. Effective workforce planning involving multiple stakeholders is needed to reshape roles and the delivery of care for patients.
CfWI Annual conference 2013 - Sir Andrew Cash Presentation
- 1. Healthcare workforce in 2023ideas and issues CfWI produces quality intelligence to inform better workforce planning, that improves people’s lives
- 2. The shape of things to come • The risk is the workforce in healthcare in ten years time will be much the same as it is now, only older and more stressed. • The opportunity is that the current pressure on the service will be a catalyst for tackling long standing problems. • There are no simple solutions to these challenges and they cannot be solved in Whitehall or Quarry House
- 3. So what is changing…. • As identified by the Wanless Review and CfWI Horizon Scanning: • Patients changing (more elderly with longer years of unhealthy life) • Long term conditions increasing • Many with more than one condition (dementia/Parkinson's/range of physical) • Six out of ten over 65’s affected by 2020 • Changing expectations of patients, especially younger and affluent sections • No "decision about me without me" • Seek advice on internet • Wish to be actively involved in care - no more "doctor knows best"
- 4. So picture this in 2023…. • • • • • • • Risk stratified population Profiling your likely disease portfolio Hospitals of the future 24/7 working Integrated Health and Social Care Health, Higher Education and Industry Technology and self care
- 5. From a CEO of a Regional Hospital • • • • • Quality Patient experience Staff engagement Spending public money wisely Research, innovation and education
- 6. We have the technology • What can be done is changing faster than we can keep pace with • Genetic Science - the meaning of life • Bio-engineering (the rebuilding of life) • Application of digital technologies to medical use (self monitoring) • Some technologies already adopted (telehealth and robotic surgery) • Diagnostics will move centre stage • In healthcare science "There are things we know, things we do not know and things beyond knowing..."
- 7. Outside of NHS control? • Fundamental factors affecting health outside NHS control • Public health trends going in divergent directions (obesity/smoking) • Inequalities remain severe and diverse healthcare needs growing • Public health risk (e.g. pandemic) • Will there remain a consensus for an NHS style system?
- 8. Issues for medical staff • Have legacy of expansion of medical training (rolling forward) • Consultant role-delivery or coordination • Educational issues (Shape of Training Review once in a decade chance?) • Need for greater generalist skills-reverse trend to specialisation • More flexible employment model • Reshape how care is delivered to be more around patient need e.g. (24/7)
- 9. Nursing • Debate on staffing ratios • Resolve issue of identity (one workforce or two) • Changing relationship with patient (more of broker/ally) CfWI • Major changes in nurse training model (return to apprenticeship?) • Advanced practitioners
- 10. Support and technical workforce • Bands 1-4 untapped resource (only gets 5% of training budget) • Build on successful developments on advanced practitioners • Integration with social care -various models raise key issues • Pay and employment model needs to change
- 11. New approach to workforce planning (1) • In search of holy grail of effective workforce planning we have created new model: • Three pillars from 2012 • Health Education England • Local Education and Training Boards (must be led by employers) • Informed by our own workforce planning gurus (CfWI) • Have concentrated on alignment issues (timescales/relationships) • Employers increasing capacity and skills
- 12. New approach to workforce planning (2) • HEE also looking at funding for training and how to support role redesign • Workforce plans - move from predictions to forecasting • We need to move focus to changing practice • NHS Employers has developed views on some key areas • How do we move things forward • Learning to share/"Share and Learn" • Looking at experience in new entrants and in other sectors
- 13. Keeping what works • NHS workforce has strengths (dedication, knowledge, teamwork) • Most of the workforce we will have in 2023 are already in place • Build on what we have • But “modernising the NHS goes beyond simply creating new roles. It needs to start from the needs of patient and public rather than starting from traditional roles and professions” (HR in NHS Plan 2002)
- 14. Making it happen 2023…. • A more generic technology aware workforce • Patient pathway and outcome focused across boundaries • Community based • Advanced and specialist roles • Role redesign on wider scale than in past • Employers need to dedicate time to workforce planning
- 15. Sir Andrew Cash OBE Chief Executive Sheffield Teaching Hospitals NHS Foundation Trust