24th June 2021

The NHS workforce challenge

The heart of the NHS is its workforce, and it is because of those 1.3 million individuals, that the NHS can deliver such clinical excellence, driving innovation and caring for every patient. Sustaining the scale and wellbeing of that workforce, however, remains one of the greatest challenges it faces.

The NHS People Plan for 2021 recognises the critical role staff play and shows that growth in staff numbers is part of the story, however, the future success of the NHS is as reliant on how it is able to adapt to workforce change, developing new roles and skillsets to meet the growing demand for care from an ageing population and to meet the vision in the NHS Long Term Plan.

Block recognises the overall workforce challenge cannot be broken down into simple constituent parts, it is far more nuanced, with each area dependent upon a web of factors. We do believe however that emphasis on key tenets provides the opportunity for organisations like ours to focus on how we are able to support the workforce challenge. We set out below our view of the key workforce challenges we believe the NHS need to focus upon over the coming years:

• Staff shortages: Significant gaps in staffing remains one of the key workforce challenges for the NHS. The King Fund NHS Workforce Paper estimates this to be approximately 100,000 and projects that without intervention this figure could grow to 250,000 by 2030.
• Changing role requirements: Demographic shifts in society, with patients living longer, with more comorbidities, has led to changing role requirements for the NHS. The challenge of refocussing, to different areas of clinical capability and realigning to different care settings provides significant, planning, design and investment challenges for the NHS.
• Work life balance and staff wellbeing: The challenge of wellbeing within the NHS has provided debate for many years. A lack of flexibility in working models and unsustainable workloads have often been seen as two key factors that have led to a lack of work life balance and in turn led to potential issues with regards to staff retention.
• Lack of integration: The recent government paper Integration and Innovation, highlights the need for collaboration across the health and care ecosystem. A lack of integration has previously led to workforce challenges, which now present a tremendous opportunity for change and improvement.
• Impact of Covid: The impact of COVID-19 on the NHS workforce has been substantial, acting as a catalyst and magnifying the other workforce challenges discussed above.

NHS Implication

The workforce challenge is complex and to solve it will take a considered and balanced approach. Planning guidance following the impact of COVID-19 shows one of the key implications is to ensure organisations strengthen their delivery of local People Plans and develop more inclusive ways of working, enabling staff to carry out their roles in a more effective and safe manner.

Block believes there is no silver bullet to ensure our NHS workforce thrive, but see a set of priorities, that together support the development of a happier, healthier, and more effective workforce:

• Workforce redesign: Key to supporting the workforce is ensuring the design of services are fit for purpose, in the 21^st The Health Foundation Report: Closing the Gap provides insight into how “the right mix of health workers, with the right skills, providing services in the right places, to better respond to changing patient need” is key to future success. Block believe this approach is critical to the enablement of workforce.
• Choice: Enabling staff choice is a key principle within workforce redesign. There are many practical examples of ways NHS organisations provide choice, for example, tools for flexible and remote working, which both facilitate redesign to support more effective care, while also promoting wellbeing and flexibility. The importance of choice was borne out in the recent NHS staff survey results, where 57% of staff were satisfied with the opportunities for flexible working, a figure that has been improving since 2016, but which requires continued focus.
• Skills, training & education: Development of these factors is critical, not only to encourage staff wellbeing, but in preparing the workforce for the required changes in working practice which will come over the next decade.
• Support & engagement for staff: A structured approach to supporting workforce is critical and is something being prioritised by NHS employers in the development of the Health and Wellbeing Framework. Indeed, the broader ability to engage is critical to wellbeing, with staff that have face to face contact with patients or service users being more enthusiastic for their job than staff in non-facing roles, a statistic which has stood for over 5 years.
• Recruitment: Recruitment is an absolute priority for the NHS over the next decade and creating effective models of recruitment will aid pressures on the workforce. Block believes supporting the NHS in how it can interact with prospective employees internationally is one example of the focus that needs to be placed on recruitment. Equally the implication of how the NHS better engages with its more traditional recruitment channels such as universities and colleges, provides great scope to encourage more effective recruitment.
• Retention: Each of the above components contribute to staff retention, however, Block believes retention should also be considered as a specific priority. Opportunities such as leveraging workforce data to improve retention, as well as support for new starters to better engage with staff from the outset are just two examples of developing retention specific approaches to supporting the NHS workforce.

Digital Opportunity

Block believes the delivery of innovate technology will create a digital environment, enabling staff to work more flexibly, bringing choice as to how services are delivered, giving staff the professional flexibility to deliver effective care and personal flexibility to achieve a better work life balance.

Technology alone however will not empower the NHS to support an effective workforce, it is critical that staff are developed digitally as well. The NHS Digital Academy is a great example of how the NHS has taken the opportunity to develop its future digital leaders, putting it in a stronger position to take advantage of technology during the next decade.

Block’s assessment of the importance of the workforce and the challenges they face, has allowed us to consider how our solutions and services can contribute to efforts in supporting the NHS. Our solutions contribute towards enabling and empowering the NHS workforce in the following ways:

• Collaboration: Our solutions prioritise the need for integration, providing technology that works within current ecosystems and ensures that previous investment is utilised. More important is a focus on connecting commonly used collaboration platforms to ensure the technology is transparent to the user, providing a consistent and coherent experience, where users can better engage with patients and each other.
• Mobile clinical workspace: Our innovative desktop provides accessibility and flexibility to the NHS workforce in a secure and performant wrapper. This has empowered NHS staff to be able to work flexibly from both a geographic and organisational perspective, providing enhanced work life balance, as well as improved clinical and operational efficiency.
• Software defined wide area network: Connecting disparate organisations effectively requires technology that can act as the foundation for that connection. Block’s SDWAN solution provides the ability for NHS organisations to deliver a seamless experience to multiple staff groups across a complex array of collaborating organisations.
• Software defined network: Block’s SDA network provides NHS organisations with the foundation upon which to build an infrastructure to support their workforce, giving the functionality to enable staff in a multitude of ways, from location aware functionality to track critical equipment, to the agility and control to make changes at pace to enable service transformation to consistently be delivered, supporting better ways of working.
• Cloud: Our cloud services enable NHS organisations to provide their workforce with access to applications in a highly scalable and secure manner. Giving them the agility to be sure they can make decisions regarding service redesign, that can be delivered at pace.