28 research outputs found
The Allied Health Professional Workforce: Evidence and Impact
Health workforce issues have been on the top of the policy agenda across the globe in recent years. Any dialogue with health policy makers about the health workforce is likely to engender the following key questions:
- How do we plan how many health workers to educate, and employ?
- How can we improve recruitment, retention and return?
- Which incentives are effective in motivating staff?
- How can we determine and deploy the most effective skill mix of staff?
- How do we improve productivity?
These health workforce challenges were summarised by WHO in the 2006 World Health Report, which presented an estimate that there was a world-wide shortage of almost 4.3 million health care workers, and that 57 countries, mostly in sub-Saharan Africa, had critical shortages. Sub-Saharan Africa had only 4% of health workers but 25% of the global burden of disease (GBD); in contrast the Americas had 37% of health workers but only 10% of GBD (WHR 2006). One critical dimension of shortages- is that there is uneven distribution of health workers to meet demand, by country, by region, by sector and by occupational mix.
Against this backdrop of global shortages, and in the context of cost containment measures in many countries, developed and developing, it is critical that the allied health professional (AHP) workforce receives sufficient policy attention to enable it to make an optimal contribution to meeting health needs. At the moment, this is not happening fully in many countries and contexts. In part this is because the AHP workforce is often a newer element in the health system, and may not have developed the policy influencing mechanisms that are used by more established- and larger in number professions such as medicine and nursing. In part it can also be because some policy makers do not understand fully just what a contribution is being made, and could be made, by the AHP workforce.
This paper summarises the recent evidence base on the contribution of the AHP workforce to health service delivery, and highlights current AHP workforce priorities.sch_nurunpub4303unpu
Globalisation and healthcare labour markets: a case study from the United Kingdom
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International recruitment of physiotherapists: a report for the Chartered Society for Physiotherapy.
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Determining skill mix in the health workforce: Guidelines for managers and health professionals
Discussion Paper 3. Department of Organization of Health Services DeliveryGenevaMost health systems are coming under increasing scrutiny with a view to cost containment, often as a direct or indirect result of health sector reform. Health care is
labour intensive, and the level and mix of staff deployed is a central element in determining the cost of care and the quality of care. It is important that managers and
health professionals in any health care organization strive to identify the most effective mix of staff achievable within available resources and organizational priorities.
This report builds on the work already undertaken for WHO in this area, which developed a typology of approaches to skill mix (Buchan, Ball & O'May, 1996; see also
Buchan, 1999). It examines the context in which decisions on skill mix are made,drawing from country case studies, and provides practical guidelines for health
professionals and managers.sch_nurpub513pu
Safe staffing levels - a national imperative. The UK nursing Labour Market Review 2013
LondonThis report is the 2013 annual review of the UK nursing labour market commissioned by the Royal College of Nursing. Events over the last twelve months point to the urgent need to address both the national security of the supply of nurses, and the local ability to determine evidence-based nurse staffing levels.div_PaSThe Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS
Foundation Trust Public Inquiry: executive summary. London: Stationery Office (Chair: R Francis).
www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf
2 Royal College of Nursing (2013) Mid Staffordshire NHS Foundation Trust Public Inquiry Report: Response of
the Royal College of Nursing. RCN, London
http://www.rcn.org.uk/__data/assets/pdf_file/0010/530956/004476.pdf
3 See e.g. Healthcare Improvement Scotland (2013) Announced Inspection Report - care for older people in
acute hospitals, Aberdeen Royal Infirmary, NHS Grampian. Healthcare Improvement Scotland, Edinburgh
www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/opah_grampian/aberde
en_royal_infirmary_jun13.aspx
4 Scottish Government (2012) News Releases. Nurse staffing levels. 26th November. Scottish Government,
Edinburgh. http://www.scotland.gov.uk/News/Releases/2012/11/staff261112
5 Buckland L (2013) 67 million boost to NHS staff to avert age crisis. Scotland on Sunday, August 11, p6.
6 Royal College of Nursing, Wales (2013) RCN in Wales responds to Health Minister's 10 million nurse
recruitment announcement.
www.rcn.org.uk/newsevents/news/article/wales/rcn_in_wales_responds_to_health_ministers_10_million_nu
rse_recruitment_funding
7 DHSSPS (2013) Health Minister and RCN agree on nursing priorities for Workforce Plans.
www.northernireland.gov.uk/news-dhssps-080713-health-minister-and
8 Department of Health (2013) The Cavendish Review. Review of healthcare assistants and support workers in
NHS and social care. Department of Health, London.
www.gov.uk/government/uploads/system/uploads/attachment_data/file/212732/Cavendish_Review_ACCESS
IBLE_-_FINAL_VERSION_16-7-13.pdf
9 NHS England (2013) Review into the quality of care and treatment provided by 14 hospital trusts in England:
overview report. NHS England, London.
www.nhs.uk/NHSEngland/bruce-keogh-review/Documents/outcomes/keogh-review-final-report.pdf
10 National Advisory Group on the Safety of Patients in England (2013) A promise to learn- a commitment to
act: Improving the Safety of Patients in England. NHS England, London
www.gov.uk/government/uploads/system/uploads/attachment_data/file/226703/Berwick_Report.pdf
11 Imison C, Bohmer R (2013) NHS and social care workforce: Meeting our needs now and in the future? King's
Fund, London
www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/perspectives-nhs-social-care-workforcejul13.
pdf
12 Centre for Workforce Intelligence (2013) Future nursing workforce projections - starting the discussion,
London: CfWI. www.cfwi.org.uk/publications/future-nursing-workforce-projectionsstarting%
20the%20discussion
13 Buchan J Seccombe I (2011) A decisive decade. The 2011 UK nursing labour market review. Royal College of
Nursing, London. www.rcn.org.uk/__data/assets/pdf_file/0006/405483/LMR2011_FINAL.pdf
14 RCN Scotland (2013) Student numbers maintained, but looming shortage of nurses, warns RCN. RCN
Edinburgh, 25 February.
www.rcn.org.uk/newsevents/news/article/scotland/student_numbers_maintained,_but_looming_shortage_of
_nurses,_warns_rcn
15 Department of Health (2013) Delivering high quality, effective, compassionate care: Developing the right
people with the right skills and the right values. A mandate from the Government to Health Education England:
April 2013 to March 2015. Department of Health, London
http://hee.nhs.uk/wp-content/blogs.dir/321/files/2013/05/29257_2900971_Delivering_Accessible.pdf
16 National Audit Office (2013). Managing the transition to the reformed health system. NAO, London.
www.nao.org.uk/report/managing-the-transition-to-the-reformed-health-system/
17 Timmins N (2013) The four UK health systems: Learning from each other. King's Fund, London
www.kingsfund.org.uk/sites/files/kf/field/field_publication_summary/four-uk-health-systems-jun13.pdf
18 Audit Scotland (2012) NHS financial performance 2011/12. Audit Scotland, Edinburgh
www.audit-scotland.gov.uk/docs/health/2012/nr_121025_nhs_finances.pdf
19 National Audit Office (2012) Progress in making NHS efficiency savings. NAO London.
34
www.nao.org.uk/report/progress-in-making-nhs-efficiency-savings/
20 Jones N, Charlesworth A (2013) The anatomy of health spending 2011/12. Nuffield Trust, London.
www.nuffieldtrust.org.uk/publications/anatomy-health-spending-201112-review-nhs-expenditure-and-labourproductivity
21 Roberts A, Marshall L, Charlesworth A (2012) A decade of austerity? Nuffield Trust, London
www.nuffieldtrust.org.uk/sites/files/nuffield/121203_a_decade_of_austerity_full_report_1.pdf
22 Duffin C (2013) Stop start recruitment of nurses is damaging morale and patient care. Nursing Standard
27(48) p5
23 Department of Health (2013) National health visitor plan: progress and future implementation. DH London.
www.gov.uk/government/publications/health-visitor-vision
24 NHS Employers (2013) NHS Staff Council. NHS Working Longer Review: Audit of existing research. NHS Staff
Council/ University of Bath
25 Nursing Times News (2013) Retirement age health visitors offered sweeteners to stay in work. Nursing Times
27 (44), July 3
26 Sprinks J (2013) Minister tells trusts to cut spending on agency staff and equipment. Nursing Standard 27
(50), p10.
27 UCAS annual datasets (subject dataset v2.0, JACS3 subject line B7 Nursing)
28 NHS Education for Scotland, 2011, Untangling a complex issue: Nursing & Midwifery Student Recruitment
and Retention Delivery Group Annual report 2010-11
www.nes.scot.nhs.uk/media/536359/delivery_group_-_annual_report_2010-11_final.pdf
29 Nursing Times, 27 September 2011, Huge fall in numbers dropping out of nursing courses
30 http://hee.nhs.uk/2013/05/09/top-nurses-to-oversee-pilots-on-pre-degree-care-experience/
31 Centre for Workforce Intelligence (2013) Horizon scanning - A strategic review of the future healthcare
workforce: Informing the nursing workforce
www.cfwi.org.uk/publications/horizon-scanning-a-strategic-review-of-the-future-healthcare-workforceinforming-
the-nursing-workforce
32 Queens Nursing Institute (2013) District Nurse Education 2012/13. QNI London
www.qni.org.uk/campaigns/report_on_district_nurse_education
33 RCN Policy Unit (2012) The Community Nursing Workforce in England. RCN, London
34 Department of Health (2013) Care in local communities - district nurse vision and model. DH London.
www.gov.uk/government/uploads/system/uploads/attachment_data/file/213363/vision-district-nursing-
04012013.pdf
35 Nursing Times (2013) Retirement age health visitors offered sweeteners to stay in work. Nursing Times, 27
(44) July 3rd.
36 http://frontlinefirst.rcn.org.uk/sites/frontlinefirst/index.php/blog/entry/scotlands-families-deserve-healthvisitors
37 Sprinks J (2013) Drafting in of Danish health visitors is just a short term fix, says Unison. Nursing Standard 27
(51), p9
38 House of Commons, Health Committee (2007) Workforce Planning: Fourth Report of Session 2006-07
Volume I Report, together with formal minutes. Health Committee, London: The Stationery Office Limited
www.publications.parliament.uk/pa/cm200607/cmselect/cmhealth/171/171i.pdf
R C N L A B O U R M A R K E T R E V I E W
The RCN represents nurses and nursing,
promotes excellence in practice and
shapes health policies
September 2013
RCN Online
www.rcn.org.uk
RCN Direct
www.rcn.org.uk/direct
0345 772 6100
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Physician Assistants in NHS Scotland: Reviewing the Issues. Report for the Scottish Executive Health Department.
EdinburghThis paper was commissioned by the Scottish Executive Health Department (SEHD). It provides background information on the role of physician assistants (PAs), and on their deployment in the United States and in England. The SEHD is planning to recruit and deploy a small number of US educated PAs in the NHS in Scotland in 2006.
The primary focus of the paper is to identify lessons for consideration during planning and implementation of the planned pilot-. This paper highlights key lessons from
the literature, and from key informants, on the employment of PAs.
Readers who wish a comprehensive assessment and description of the development of the PA role in the USA, should consult the American Academy of Physician Assistants (AAPA) website (www.aapa.org) and also the core book by Hooker and
Cawley (2003).
Given constraints of time and resources the focus of the review was on identifying key messages for Scotland; it was not structured as a systematic review (no systematic
review of physicians assistants was identified during the search). The review was supported by follow up contact with key individuals and representatives of organisations in the US and with UK organisations working with PAs. The purpose was to identify the issues that need be considered in the lead up to the recruitment and deployment of PAs in the NHS in Scotland.
The remainder of the paper is in two sections: Section 2 reports key findings from the literature review; and Section 3 reports of follow up findings, and focuses on key
messages for Scotland.sch_nurpub504pu
Beyond hierarchy? An assessment of the early phase of implementation of the Beyond Hierarchy Initiative at North Staffordshire NHS Trust
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The right profile? a review of approaches to determining personnel mix in healthcare
Edinburghsch_nurpub953pu
Review of Models of Employment for Nursing Roles which Bridge Practice and Education:A Report for NHS Education for Scotland
This review was conducted for NHS Education for Scotland. It investigates the literature pertaining to different models of contractual employment for nurses that 'bridge' practice and education in order to identify the evidence base and current practice in other countries. The specific context for the review was the development of clinical education career pathways in Scotland as part of Modernising Nursing Careers (MNC) initiative. The objectives were to review the literature on evaluation, and on reported strengths and weakness of different models of employment/deployment of nurses in practice/education roles, to provide a typology of the key characteristics of these different roles - where possible to include job
descriptions, types of contractual employment (e.g. fixed term, open ended, joint appointment, sessional etc.); employment status; work location(s) etc. and to highlight examples of such roles in different health systems.
Areas explored in the review included models of employment, career structure, and role content of nurses in these roles. In practice the review of published material highlighted that the literature did not enable all the
objectives to be met in detail- in particular there is little published evidence on types of employment contracts etc. This may be because much of the publicly available literature is written from an educational delivery perspective rather than from a workforce/HR perspective. Supplemental information on this issue was obtained from contacts in other countries- notably Canada and New
Zealand- to provide relevant background information.
The Practice Education Facilitator (PEF) is one recent NHS Scotland role which aims to support mentors and mentorship in the clinical areas, helping develop and promote those areas as learning environments (NES, 2007). The
PEF is just one type of role that bridges between practice and education. The types and roles of personnel used to bridge the 'practice-education gap', or 'practice-theory gap', their places of practice, and conditions of employment
vary widely throughout the world. This review examines some of these roles, with the objective of examining strengths and weaknesses associated with different models of employment/deployment, with a view to informing NHS
Education for Scotland (NES).sch_nurpub502pu