Restoring Healthcare – Understanding the human capacity

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People are healthcare’s most crucial resource. Digital can supply dynamic workforce intelligence, improve wellbeing, and support staff in patient care planning.

Individuals working in healthcare have been recognised for their response to the pandemic with personal sacrifice to help others. But many of the changes are not sustainable. “Thousands of nurses and other staff may leave the NHS in the near future unless they are given the ‘time and space’ to recover from the coronavirus pandemic”.[1]

Whilst we need to address the backlog of work, staff also need time to recover and adapt to new ways of working. Some staff will not be able to return, some will retire, some will look for less intense employment.

Our experience across a variety of sectors and of working in the NHS suggests that digital approaches could help, and that the NHS may want to focus on these areas.

  1. Using digital to understand the talent issues.

“Workforce planning has three stages: identify the people needed to deliver the planned service; assess if there is enough supply to meet this need; if not, agree an action plan to address the gap.”[2]

The usual annual cycle of workforce planning will not be responsive enough in the pandemic recovery period. The first step in workforce planning is to establish the needs of the service, but the service and needs seem to have changed. As we emerge from the pandemic, there are too many unknowns that will be constantly changing, such as:

  • Will shifting health priorities and changes to planned services impact the workforce requirements of the NHS and community health services?
  • How many staff will be off sick due to the physical and mental health impact of the pandemic?
  • Will more staff take career breaks or work reduced hours?
  • Will those staff who returned to work via the “bringing back staff” programme for the pandemic stay?
  • How many staff will leave?
  • How will international recruitment be affected by travel restrictions, new legislation and staff attitudes?
  • Will staff who missed out on a year working abroad all take it next year?
  • Will staff want to move specialties (e.g. will we see an exodus from critical care)?
  • What will be the future risks to staff generally or for specific groups? (e.g. ethnicity related risk in COVID)
  • How can staff with medical conditions or who are at elevated risk from acquired infections be best utilised and not lost from their professions?
  • Increasing complexity of requirements of HR and operational leadership functions to support staff wellbeing.

There are also some knowns:

  • Over 850 UK healthcare staff are thought to have died of COVID between March and December 2020.[3]
  • The NHS is the largest employer in England, with nearly 2 million full-time equivalent (FTE) staffworking in hospital and community services. NHS hospitals, mental health services and community providers are now reporting a shortage of nearly 84,000 FTE staff [4]
  • The need to identify staff with critical care experience highlighted the lack of detailed information to support staff moving between roles.
  • The recruitment to Nightingale Hospitals and need to work at alternative locations highlighted the challenges of moving between provider organisations within the NHS.

This is further amplified by predicted exits – a recently published 2020 NHS staff survey highlighted that “a third of staff are considering leaving their jobs and nearly one in five are thinking of leaving the health service entirely”.[5]

This degree of fluidity and complexity, and the need to have near real-time workforce planning, makes it ideal for data science and AI-based predictive analytic systems.

  2. Improving staff experience by digitisation and personalisation “reducing the frustration”

“An engaged and happy workforce is the key to the NHS thriving”.[6].

If digital innovations are introduced effectively, they should make life easier for staff and therefore increase their effectiveness and quality of care. Examples of the existing digital solutions to common frustrations that I hear from healthcare colleagues include:

  • Seamless communication by introducing omni-channel communication systems (including eliminating bleeps and fax machines!), enabling experiences at work like those in personal and domestic communication.
  • e-rostering that allows staff to express their work time preferences and easily swap shifts.
  • Flexible and annualised job planning to increase resilience, especially in consultant job planning to allow the balance of SPA/DCC time to be changed by season or for other predicted changes in demand.
  • Common HR systems or staff passports[7] across integrated care systems, so staff can work across organisational boundaries without duplication of contracts, training etc.
  • Personalised systems so individuals have their own portal that support their preferred way of working.
  • Integrated systems to allow single data entry for all personal training, appraisal, and validation requirements.
  • Simple appointment and revalidation systems with visibility of processes for the user.
  • Adequate system capacity to prevent watching the spinning wheel of death on the computer screen.

User centred design is key to reducing this staff frustration and begins with understanding the users and challenging assumptions to build products and services that are holistic, sustainable, and fit for purpose. This systemic approach would call for more fundamental changes to processes and systems, designed with an understanding of the full service rather than single interactions. Options may include moving to HR Cloud solutions that could integrate, ideally across the entire NHS. Furthermore, ambitious ideas such as Talent Marketplaces, to enable the NHS as well as its staff to post requirements and easily match with staff skills, preferences and availability may be harder to implement, but will revolutionise talent management across the NHS, potentially giving access to untapped talent pools too.

  3. A truly augmented workforce enabled by data, digital and AI in the provision of care. “Automating processes so staff can spend more time doing higher value tasks”.

Healthcare is a highly professionalised business with many very skilled individuals. But most staff would also tell you that they spend a lot of time doing mundane tasks. Digital systems, tools and AI should automate many of these tasks, enabling staff to work at the top of their skill set, spend more time with patients and enhance quality of care.  A few examples that may have a high impact include:

  • Automation of routine and repetitive tasks e.g. stock checks and reordering, clinical order sets.
  • Rapid but secure sign in across multiple applications.
  • Empowering patients to control their care, both to focus on what matters to them but also enable them to undertake tasks usually undertaken by the service. e.g. booking and rearranging appointments.
  • Auto-populating patient notes and supporting information across applications e.g. when a patient attends ED/GP that are relevant to their acute case.
  • Using data science, AI and predictive capabilities to better capture staff and patient sentiment as well as better match demand and supply across the various care pathways, making the lives of both healthcare commissioners and providers easier.
  • Robotics to replace manual tasks (e.g. pharmacy supply chain) and for precision tasks (e.g. minimally invasive surgery).
  • Continuing and expanding home/remote working developed in the pandemic.

Perhaps in the future, every time someone says we need more staff, we should challenge this by asking what the data tells you about staffing predictions, how can you reduce the everyday frustration for staff and how can you make better use of their time.

We would love to hear your views and solutions.

References

[1] https://www.nursingtimes.net/news/workforce/warning-thousands-of-nhs-staff-will-leave-unless-allowed-covid-19-recovery-24-03-2021

[2] https://www.hsj.co.uk/workforce/workforce-planning-is-complexity-squared/7029646.article Rob Smith March 2021

[3] Shone, E. More than 850 health and social care workers have died of Covid in England and Wales since the pandemic began January 27, 2021, The Scotsman

[4] https://www.kingsfund.org.uk/projects/positions/nhs-workforce

[5] https://www.nhsconfed.org/resources/2021/03/nhs-staff-survey-2020

[6] https://www.lancaster.ac.uk/news/nhs-needs-to-keep-staff-happy-if-it-is-to-thrive-for-another-70-years

[7] . https://www.england.nhs.uk/coronavirus/secondary-care/workforce/digital-staff-passport/

 

Author


Matthew Cooke

Matthew Cooke is Chief Clinical Officer at Capgemini. He spent most of his career working in the NHS as an emergency physician and was the National Clinical Director for Urgent and Emergency Care.

 

 

Aditi Kejriwal

Aditi Kejriwal leads the ‘Employee Experience & HR’ practice for Capgemini in the UK, and she brings extensive experience in experience design, HR, workforce, and change management across multiple sectors including Healthcare and Life Sciences.

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