Concerns about the health and social care workforce are at an all-time high due, in part, to the impact of austerity, Brexit and the lessons learned from the Mid Staffordshire hospital scandal.
There has been a 96% drop in the number of EU nurses registering to work in the UK. Nursing and Midwifery Council (NMC) figures published in June showed a marked decline from a high of 1,304 in July 2016, to 344 in September, and then just 46 EU nurse registrants in April 2017.
Any indication that the UK is becoming a less attractive place to work is naturally a cause for alarm, especially as social care and health services will continue to depend on workers from outside the UK in the short to medium term. Actions by the government to reassure European Economic Area citizens and by the regulator to improve its processes are welcome, although much still needs to be done.
One example is the Cavendish Coalition, a group of 35 health and social care organisations that came together in the wake of the referendum result to address the workforce implications of Brexit.
A number of organisations are also working together to respond to the concerns of the workforce and to keep more of them working within the NHS and social care. While much attention has focused on the impact of seven years of pay restraint, other areas need to be addressed, including funding of postgraduate education, access to affordable accommodation, the poorer experience of BME colleagues, greater flexibility, and better use of technology.
Retaining talented staff is therefore crucial in the immediate term, but we must look at what we need to do to attract people to the healthcare sector in the longer term. NHS Employers’ own work in this area is stepping up, with a briefing document launched at its annual workforce summit, held in Liverpool in June, covering ways to bring in, and then consequently keep, local talent over the longer term.
There are plenty of instances of good practice from employers taking steps in this area, which we highlight.
South Tees hospitals NHS foundation trust works with Jobcentre Plus to offer a 12-week pre-employment scheme, which provides certain mental health service users with opportunities to get back into work through structured learning and vocational experience.
Meanwhile, Chelsea and Westminster hospital NHS foundation trust and Imperial College London medical school offer a scheme called MedEx summer school, which provides four-day work experience to year 12 students. It’s aimed specifically at students from underprivileged backgrounds who show talent for and interest in medicine.
Public Health England (PHE) uses the Project Search initiative, with a programme supporting young people with learning disabilities or who are on the autistic spectrum through a 10-month rotating work experience scheme, alongside specially tailored coaching and on-the-job training.
NHS Employers itself also has a number of programmes designed to help employers look differently at attracting and retaining a talented and diverse workforce, including practical support and information on apprenticeships, support to engage with young people via its ThinkFuture campaign, and briefings to encourage and support practices such as improving access to employment for people with mental illness.
The greater part of our workforce is sourced from the UK, and there is more we can and will do in that area. We need, however, to combine our focus on increasing domestic efforts with ensuring that the country develops a post-Brexit immigration system that won’t be detrimental to health and care.
There are many challenges facing the NHS, and more broadly, health and social care, regarding the availability of our workforce. We will continue to challenge the government to support better supply and retention, but we must also challenge ourselves to improve access to employment and to retain the people we already have through better quality workplaces and work.
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