Agenda item

Report of the Strategic Director, Care, Wellbeing and Learning

The OSC considered a report and received a presentation advising of the regional and local issues in respect of the Health and Social Care Workforce (many of which reflect the national workforce picture), and to advise the OSC of some of the initiatives that are being implemented, to address workforce recruitment and retention issues.

The national picture in respect of the health and social care workforce has been raised in profile over recent years and months, particularly in respect of issues which have attracted national media attention, such as winter pressures in the NHS and A&E waiting times, and collapse of some care sector businesses and some providers “handing back” social care contracts to Local Authorities.

Members of the OSC are well sighted on some of the specific issues that have faced Gateshead, in respect of GP recruitment and retention (leading to some surgery closures); challenges in recruiting to specialist medical functions (such as the stroke pathway); and issues of recruitment and retention within the social care provider market. The report and presentation, seeks to set some further context to the issues, and also to outline some of the innovative approaches  that are developing in Gateshead and with regional partners.

The workforce in the context of the Gateshead/Newcastle population were outlined as follows:-

Population Demographics (total population estimate 498,070)

Workforce Demographics; NHS Secondary Care (total workforce estimate 996)

·         Social Care Workforce Demographics (total workforce estimate 17,600)

·         81% Female, 19% Male

·         Average Age: 44 (all job roles, both genders)

·         Retirement Profile: 25% (aged 55+)

·         Current data set (NMDS-SC) is limited in terms of reliable date for private/voluntary sectors and carer registration

Current combined state

·         NHS Combined Workforce: 18,715 (estimate)

·         30% retirement profile

·         Social Care Workforce: 17,600 (estimate)

·         25% retirement profile

·         Total Population: 498,070

·         20% retired (65+)

The OSC were advised that the current service delivery models are struggling to meet the demographic challenge of people living longer, often with complex

co-morbidities, and the increasing demands on the health and social care system. 

The workforce currently encompasses four generations – Baby Boomers and Generations X,Y and Z all of whom having differing expectations of their working life. As the report and data demonstrate, as well as the well documented current workforce issues within health and social care, there are particular “pinch points” in respect of the age profile of the workforce, which mean that it appropriate action is not taken now, the system will be facing even greater pressures, especially in relation to retirement projections across both the health and social care.

The OSC were advised that it is recognised nationally that we are experiencing a multi-factorial workforce crisis, caused by challenges in recruitment, retention, lack of specialist skills, affordability, and a preference for shorter worktime commitments. There are a number of factors which create additional pressures within the workforce system. Within social care for example, it is known that the role of home care worker is not necessarily an attractive one.

In Cumbria and the North East, Health Education England, Foundation Trusts, CCGs and Local Authority social care are working hard to tackle these issues, but much of the current workforce planning is uncoordinated and based around professional siloes.

Workforce development funding has reduced significantly, with central funding allocated non-recurrently and to various agencies resulting in an uncoordinated and patchwork approach to investment. There has also been impact as a result of some national decisions, such as the end of nursing bursaries. In February 2017, the Royal College of Nursing reported a 23% reduction in applications for Nursing Degrees, which they associated with the decision to scrap the bursary.

In May 2017 the Kings Fund analysed the potential impact of Brexit on the Health and Social Care workforce nationally. Approximately 60,000 of the 1.2 million NHS workforce are from other EU countries, including more than10,000 doctors and more than 20,000 nurses and health visitors (figures exclude those working in Primary Care or contracted out services). In adult social care, 90,000 of the 1.3 million workers employed by local authority and independent sector employers come from elsewhere in the EU. The Kings Fund research identified that the number of EU nationals registering as nurses in the UK had fallen by 96% since the referendum, with juts 46 EU nurses registering with the Nursery and Midwifery Council in April 2017. There had also been a fall in the number of EU nationals taking jobs in the social care sector.

The Committee were advised that Gateshead has an opportunity through the combined Cumbria and North East system arrangements, to develop a coordinated strategy to meet these challenges, ensuring that future workforce is planned on a whole systems basis, allowing for greater innovation and new models of care.

The presentation that the OSC received set out some of the new approaches that are taking place across health and social care, to try and address the short, medium and long term recruitment and retention of health and social care staff. Within these approaches are some key overarching themes, such as:

a) understanding barriers to recruitment and retention

b) understanding perverse incentives which may adversely impact on positive    recruitment and retention

c) considering the appropriate skill mix of teams, and upskilling allied professionals to work across traditional boundaries

d) developing longer term career pathways and apprenticeship routes

e) developing models of reward and investment

In terms of strategic aims, there are a number of key aims that are being developed locally and regionally:

·         Focus on enablement, asset based approaches, and prevention, to address demand for health and social care services

·         Delivery of care within communities and neighbourhoods, streamlining pathways and optimising the use of shared resources

·         Developing career pathways into health and social care for the workforce of the future