Government 'Must Act' to Address Health Staff Shortages 

Peter Russell

February 11, 2021

The COVID-19 pandemic has reinforced the urgent need to confront the problem of health service staffing shortages, a global health expert has argued. Mark Britnell, a senior partner at the professional services firm KPMG, said governments and planners needed to recognise that health and wealth are inseparable.

Mark Britnell/KPMG

The former chief executive of University Hospitals Birmingham, and former director-general at the Department of Health, said: "The most pressing health problem facing the world is the COVID-19 pandemic, but the most pressing problem for the healthcare system is its workforce."

Healthcare was forecast to be the largest employer globally by 2022. However, "with the collapse of the hospitality sector and the collapse of the retail sector, health now is already the biggest employer in the world".

With the World Health Organisation estimating that the planet would be short of 18 million healthcare workers by 2030 he said: "We face a future of too much work with too few workers. We know the position sadly in the United Kingdom."

Mr Britnell, who has experience of healthcare systems in 77 countries, was a guest speaker on day one of the Royal College of GPs' 'A Fresh Approach to General Practice' virtual conference.

Pandemic Management and Economic Recovery 'Go Hand in Hand'

"Many countries have a national industrial strategy, and then a national health strategy, and they're entirely separated.

"Many of you, like me, believe that health is wealth and clearly this pandemic has brutally taught most countries the lesson that actually you can have good pandemic management, and economic recovery, and they go hand in hand."

While not saying that "health is like a factory", "I believe health care has all of the ingredients we need to make our country more productive".

Bringing About Change

Mr Britnell set out a number of ways for boosting the health workforce and relieving pressure on existing staff.

"No country will meet its health challenges, unless it embraces progressive immigration," he argued. "Quite simply put, the workforce in health care is the second most mobile globally, after financial services. And we need to make sure that Britain is open and has progressive immigration policies" and a healthcare workforce "to reflect our population demographics".

Higher productivity in healthcare could be gained from "switching, where clinically appropriate, from face-to-face to virtual consultations", and adopting robotics, machine learning, and artificial intelligence.

Pressure on the health system could be reduced by treating patients as partners and following Germany in its move towards funding care in the community. "Mobilising and explicitly paying for carers in communities, I believe, results in better quality care, higher patient satisfaction, less hospital admissions – and in fact it costs less overall," he said.

"I believe this is part of the solution to the social care problem in the United Kingdom."

Mr Britnell said that governments should act to help reverse record levels of joblessness caused by the pandemic by making healthcare a career opportunity.

"I think it's important for us to reach out to the underemployed, the unemployed, the socially disadvantaged, to make sure they have career paths now in what is the largest employment industry on the planet. 

"The new GP 5-year framework, or contract, is offering to provide some funding to recruit up to 20,000 non-GP roles in primary care, including clinical pharmacists, social prescribing link workers, physician associates, and also first contact physiotherapists," he said. "If you think about releasing professionals to play at the top of their game…there is a 20% to 23% productivity gain there."
 

A New Approach to Managing Health Workers

It was vital that no government or health system should neglect the human aspect. "There needs to be much more flexibility in terms of self-rostering and the ability for human beings to balance work and life. Organisations that refuse to really think about this, deeply and sensibly, are simply turning off the tap to future employees. It's nuts, it's crazy."

The quality of line management, not pay and conditions, was the number one reason why people were likely to leave an organisation. "Much more needs to be done about that now of course, as we come out of, hopefully, the pandemic," he said.

Because of the pressures on healthcare workers from dealing with COVID-19, "the mental health burden not only on the population but our staff as well, will be enormous".

"We have to start to care more for our staff; we have to love our staff more; and we have to think about how we support our staff. 

"We should have been doing this years ago".

Summarising, Mr Britnell said: "We have to mobilise all the assets in society, including patients, and communities, as well as professionals" and "government strategies need to think about productivity and the health and wealth agendas [that] are increasingly becoming intertwined, more so now than ever post COVID and during COVID.

"No government, especially at the moment in the United Kingdom, or [in] the NHS plans that I've seen over the last 10 or so years, have actually joined all these forces together. 

"I'm not saying it's easy, it's not easy, but I am saying it's absolutely necessary."
 

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