This section contains:
Aims
Develop staffing models that:
- are flexible
- can meet current and future demands
- prioritise workforce health and wellbeing
- recognise and reward staff
- value all staff equally
- train staff in transferable skills.
Context
A significant increase in staffing is needed due to increased levels of demand for care. This issue is compounded by the continued impact of COVID-19.
Integrated care systems (ICSs) need to prioritise measures to improve staff health and wellbeing. Many frontline staff report an increase in their own healthcare needs, including mental health issues. Sickness rates have risen throughout the sector.
Implementing these changes will have a positive effect on people who use services too. A happy, healthy workforce is more able to provide excellent care.
Issues around staff retention also need to be addressed. Common reasons for leaving the sector include pay rates, pension issues, flexibility of working and career progression.
Ongoing training and support for existing staff is essential. Retaining trained and competent staff is a good investment compared to recruiting new people. This is because existing staff can support:
- ongoing training
- development of other team members
- development of operational models.
Their knowledge of the organisation is invaluable too.
Overall system design is also important. Staffing decisions should be based on people's needs, not service demands. This means the person who provides care should always be the right person for the task. They should have the correct skills and training to deliver the best possible care.
For more information see:
- NHS England : Our NHS people promise
- Parliamentary committee: Workforce: recruitment, training and retention in health and social care
- Health Foundation: Health and social care workforce analysis
Key suggestions
- Build and incentivise a fully flexible and sustainable workforce. Use a system-wide approach with the right number of people and the right skills mix to deliver care as needed across the ICS.
- Offer innovative and flexible staff rostering. Examples include, self-rostering, annualised jobs plans, combined rotas and surge staffing.
- Enable staff to develop transferable skills so they can move between organisations.
- Support staff health and wellbeing, for example provide 'safe' areas for staff to use on shift and clear routes for feedback.
- Upskill community and acute teams to work smoothly across organisations where necessary.
- Provide frailty in-reach teams and specialised care for older people in emergency departments seven days a week. Collect frailty and dependency data from those patients that have not been diagnosed before.
- Give the right clinical validation and support to NHS 111 and NHS 999 to help safely reduce avoidable hospital admissions.
Examples of good practice and innovation
Advanced paramedic practitioners
Some ambulance services have invested in training and education to create advanced paramedic practitioners. Their enhanced skill set enables them to provide advanced on-site care and prevent avoidable hospital admissions.
Advanced paramedic practitioners also provide remote support to other ambulance crews from the control room. In some areas, they can work in partnership with other services, rotating between support for GP practices, GP out-of-hours services, urgent care services and minor injury units.
See case studies from London Ambulance Service and the Welsh Ambulance Service in the Association of Ambulance Chief Executive's repository.
Multidisciplinary teams (MDTs)
Incentivise services to share staff from across the system as part of multidisciplinary teams (MDTs). Participation in MDTs broadens and develops skills, as staff from different disciplines learn from working closely with each other. This way of working was more prevalent during the pandemic but has largely reverted in recent months.