Expert View with Professor Ceri Phillips

Swansea University’s Head of the College of Human and Health Sciences and Professor of Health Economics at Swansea Centre for Health Economics.

ARCH provides the context and environment to develop a collaborative, integrated skills development strategy that will generate an appropriately specialised, multidisciplinary, skilled, motivated and inspired workforce.
The workforce is the primary driver of current and future health and social care costs, with at least 70% of expenditure of health boards consumed by wage and salary payments. In considering future workforce requirements within health and social care, it has to be remembered that professionals have traditionally been trained and developed to work in a system that is primarily based on hospital-based care, whereas the majority of current and future demands for health and social care arise from an increasingly elderly population with multi-morbidities whose needs require multi-skilled staff working in an integrated environment across professional and organisational boundaries and across different settings. The demographic challenge is one of a number that confronts the shape of the future workforce in health and social care.

  • Nurse recruitment represents a significant challenge for health boards and commissioners of educational provision and there is little evidence that this will change significantly in the short-medium term.
  • The supply of GPs also represents a significant challenge in seeking to re-focus care away from the hospital and move towards a system of delivery nearer to the patient in primary and community care.
  • Conversely, the supply of hospital doctors appears to be relatively healthy, but there are noticeable shortages in certain specialities, where needs appear to be greatest, such as paediatrics, emergency medicine, psychiatry and elderly care.

Such challenges highlight the need for a fundamental change in the approaches to training and development, with greater emphasis on team development, based on a wider range of skills to meet increasingly complex patient needs, but at the same time ensuring that basic care requirements of the population are addressed, using generalist and specialist provision, as near to patients’ locations, so as to avoid the situations clearly evident in today’s context of unnecessary hospital referrals and admissions, thereby scuppering the drive to re-focus care provision. Further, the need for thinking around waste reduction, improvement methodologies and lean manufacturing approaches should be brought to bear on workforce planning and change the number and type of staff required for the future health and social care workforce.

ARCH is committed to developing the skills, knowledge and talent of a healthcare delivery workforce fit for the future. The introduction of a Talent Bank, the commitment to world-class education and training and the utilisation and development of information and technology will be key components in ARCH contributing to changing the nature of the workforce in health and social care. The establishment and development of ARCH provides an environment whereby professionals, scientists, managers and policy makers can interact with information and technological developments to enhance the speed and quality of care afforded to patients in the future. The whole system approach that ARCH employs will serve to ensure that the patient experience at all stages is maximised.