Securing a sustainable and fit-for-purpose UK health and care workforce.
Securing a sustainable and fit-for-purpose UK health and care workforce.
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获得可持续和适合的英国健康和护理人员。
DOI：
10.1016/s0140-6736(21)00231-2
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发表时间：
2021-05-22
期刊：
影响因子：
168.9
通讯作者：
McGuire, Alistair
中科院分区：
文献类型：
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作者：
Anderson, Michael;O'Neill, Ciaran;Clark, Jill Macleod;Street, Andrew;Woods, Michael;Johnston-Webber, Charlotte;Charlesworth, Anita;Whyte, Moira;Foster, Margaret;Majeed, Azeem;Pitchforth, Emma;Mossialos, Elias;Asaria, Miqdad;McGuire, Alistair
大约13%的英国劳动力受雇于卫生和护理部门。尽管作出了大量的劳动力规划努力，但这种规划的有效性受到了批评。教育、培训和劳动力计划通常孤立地考虑每一个卫生保健专业，没有充分应对不断变化的卫生和保健需求。其结果是持续的空缺，士气低落，低保留。这份卫生政策文件强调的特别关注领域包括初级保健、精神健康、护理、临床和非临床支助以及社会保健。应对劳动力短缺的措施包括高度依赖外国和临时工作人员，对技能组合进行小规模调整，以及加强征聘工作。英国卫生和护理劳动力面临的挑战包括越来越多的人，无偿护理人员的供应日益短缺，以及国民保健服务（NHS）作为国际雇主的吸引力相对下降。我们认为，为了确保一个可持续的和适合目的的卫生和护理劳动力，综合劳动力的方法需要开发的同时，改革教育和培训，反映在角色和技能组合的变化，以及多学科工作的趋势。增加职业发展机会，促进工作人员的福祉，并解决歧视的国民保健服务都需要改善招聘，保留和工作人员的士气。当务之急是为在COVID-19疫情期间暴露于高风险情况和创伤经历的员工提供足够的善后护理和支持。为了回应越来越多的要求承认和奖励卫生和护理人员的呼声，薪酬的增长必须至少与平均收入的预期增长保持同步，这反过来又需要将未来的NHS资金分配与薪酬增长挂钩。通过说明性的预测，我们表明，要维持劳动力的年增长率约为2.4%，将需要每年增加4%的国民保健服务支出的真实的条款。最重要的是，需要一个激进的长期战略愿景，以确保未来的国民保健服务的劳动力是适合的目的。
Approximately 13% of the total UK workforce is employed in the health and care sector. Despite substantial workforce planning efforts, the effectiveness of this planning has been criticised. Education, training, and workforce plans have typically considered each health-care profession in isolation and have not adequately responded to changing health and care needs. The results are persistent vacancies, poor morale, and low retention. Areas of particular concern highlighted in this Health Policy paper include primary care, mental health, nursing, clinical and non-clinical support, and social care. Responses to workforce shortfalls have included a high reliance on foreign and temporary staff, small-scale changes in skill mix, and enhanced recruitment drives. Impending challenges for the UK health and care workforce include growing multimorbidity, an increasing shortfall in the supply of unpaid carers, and the relative decline of the attractiveness of the National Health Service (NHS) as an employer internationally. We argue that to secure a sustainable and fit-for-purpose health and care workforce, integrated workforce approaches need to be developed alongside reforms to education and training that reflect changes in roles and skill mix, as well as the trend towards multidisciplinary working. Enhancing career development opportunities, promoting staff wellbeing, and tackling discrimination in the NHS are all needed to improve recruitment, retention, and morale of staff. An urgent priority is to offer sufficient aftercare and support to staff who have been exposed to high-risk situations and traumatic experiences during the COVID-19 pandemic. In response to growing calls to recognise and reward health and care staff, growth in pay must at least keep pace with projected rises in average earnings, which in turn will require linking future NHS funding allocations to rises in pay. Through illustrative projections, we show that, to sustain annual growth in the workforce at approximately 2·4%, increases in NHS expenditure of 4% annually in real terms will be required. Above all, a radical long-term strategic vision is needed to ensure that the future NHS workforce is fit for purpose.