Plans to address challenges faced by the Welsh health and social care workforce must be ‘accelerated’ to improve working conditions, according to a government minister.
A report published by the Welsh Government highlights the ‘unprecedented high levels of demand for a sustained period of time’ for the NHS and commits the government to producing a national nurse retention strategy by April.
Writing in the National Implementation Plan: Addressing NHS Wales Workforce Challenges, Eluned Morgan, minister for health and social services in the Welsh government, said: ‘These workforce issues are threaded through every discussion I have with NHS Wales staff and leaders and have been front and centre in recent months.
‘The message is clear – we must accelerate our action underpinned by strong, collective and compassionate leadership if we are to improve retention and recruitment and provide our workforce with the working environment and conditions that they need to be able to care effectively for the people of Wales.’
The plan outlines a series of practical actions to accelerate a strategy published in 2020 setting out a 10-year vision for the health and social care workforce, commissioned by the Welsh government.
This includes a commitment to the production of a nurse retention plan to address high levels of turnover among NHS nurses.
The plan will draw from the findings of an RCN report on nurse retention published in October last year, however, the Welsh Government will have until next month to publish their own plan as part of the ongoing strategic workforce plan.
It will be overseen by a Strategic Workforce Implementation Board chaired by Judith Paget, director general of health and social care in the Welsh government and chief executive of NHS Wales.
The board will help make ‘tough decisions’ about where to focus ‘limited resources’ in the face of a ‘global healthcare workforce crisis’, as declared by the World Health Organisation (WHO), which estimates a projected shortfall of 10 million health workers by 2030.
Ms Morgan said: ‘NHS Wales is experiencing health and social care workforce challenges replicated globally.’
Referring to the WHO’s Time to Act report, published in September 2022 highlighting the multiple workforce crises faced across the continent, she added: ‘Exacerbated by the COVID-19 pandemic and the economic situation, the report lays bare chronic staff shortages magnified by recruitment and retention issues due to stress, fatigue, burnout, unattractive working conditions and poor professional development opportunities.’
The board will bring together key partners to share knowledge and expertise.
However, Ms Morgan warned that there are ‘no quick fixes’, adding: ‘We will look at all innovative approaches to change not only our ways of working but also our ways of thinking to create a sustainable NHS workforce for the future.
‘We must respond quickly and decisively to tackle the challenges facing our workforce in NHS Wales.’
The board will give regular updates to the minister on its progress.
Actions for the second phase of the strategy are currently being developed through consultations with stakeholders and partners, and a review of the evidence post-pandemic.
It will respond to key clinical priorities for Wales including supporting a cancer implementation plan, urgent and emergency care, access to primary care, and mental health and well-being.
Actions set out in the report include filling the workforce gaps; retaining the workforce by supporting their health and well-being; and planning for the future.
The report said: ‘We need to think and act differently to take forward a range of approaches to deliver additional workforce capacity.’
This includes deploying the existing and future workforce ‘more effectively’ and using technology to ‘deploy people more flexibly’.
A redesign of the current system is planned, using digital solutions to ‘release time to care’.
The report said: ‘We will see increased levels of care taking place directly in the community which is more personalised, and technology-enabled. There will be a greater focus on population health, prevention and reducing health inequalities. Earlier diagnosis alongside new and integrated models of care, and better use of technology offer the potential to significantly improve the health of Wales and the care given to our population.’
This includes new medical and technological advances to improve early diagnosis throughout bowel cancer screening programmes, enabling people to take a test in their own homes.
Twenty million pounds has also been invested in the NHS Wales app and website to give people ‘on demand’ access to their GP records.
Currently, more than 105,000 staff are directly employed by NHS Wales organisations, which has seen an increase in its total pay bill by 53 per cent since 2015-16, to £5,028bn.
The Welsh government has prioritised investment in the education and training of the future workforce over the past eight years, resulting in the highest-ever number of people entering education programmes.
This year (2023-24) is the ninth consecutive year where funding to support health professional education and training in Wales will increase, with £281.98m planned to be invested – an eight per cent increase from 2022-23.
The report said: ‘As a result of that sustained investment, we are now seeing these increases flowing through into increases in the number of people graduating from these courses ready to take up roles within the health and social care system in Wales.’
The report identifies the need to consider the ways the future workforce of the NHS wishes to work, with a significant percentage of healthcare graduates wanting to work part-time hours.
The report said: ‘We need to support all staff with flexible work options that build around their other commitments or life events, for example, staff who have caring responsibilities or those considering retirement. We must provide competitive total reward packages to enable people to develop their skills and careers in a fulfilling and meaningful way.’
However, the report recognised that the cost-of-living crisis and a competitive labour market have ‘resulted in a less attractive employment offer which has impacted our ability to attract people to work in the NHS in Wales’.
It is looking to find new innovative ways to attract people to health and social care, which includes the launch of an interactive ‘Careesville’ site to provide an online tool for people to explore the range of careers in the sector.
By April this year, Health Education and Improvement Wales (HEIW) plans to have launched a new campaign for NHS Wales to support national and overseas recruitment.
Funding of £730,000 has also been provided to HEIW to fund an innovative three-year pilot to help recruit registered nurses to work in care homes.
The report stated that work is already underway to reduce agency use and spending.
Around six per cent of the total NHS Wales bill, totalling £318m was spent on agency workers this year.