As a new government takes the reins at No. 10, the pressure is on for them to deliver on their election promise and build an NHS that is “fit for the future”. Addressing the workforce crisis that continues to grip the health service – both in terms of recruitment and retention – is a critical first step. But there is an underlying workforce issue which policy leaders and NHS executives will also have to contend with.
I call it the staffing “tug of war”. Both clinicians and managers want the same thing: more flexible, sustainable staffing that supports work-life balance while keeping services safely staffed. But the outdated systems upon which NHS workforce planning currently relies make it difficult to deliver this for one group without negatively impacting the other.
Opposite sides of the coin
Managers are working tirelessly to create sustainable rotas and keep services safely staffed across under-resourced trusts: in September last year, the NHS had 121,000 full-time equivalent vacancies. Workforce teams often have to fill vacant shifts at the last-minute to ensure staffing levels match patient demand, whilst drawing from a shrinking pool of available clinicians and grappling with clunky, outdated digital systems to manage this complex task. All of this leaves little room for providing the flexibility they really want to offer to staff as standard, without compounding the already rising administrative burden they have to tackle and exacerbating the shift vacancies they need to fill.
On the other side, you have clinicians. According to the latest NHS Staff Survey, as many as 29% of NHS staff often think about leaving. But from my conversations with colleagues, I know that the majority of these clinicians do not actually want to give up their roles. What they desperately need is greater flexibility and the ability to balance their work alongside external commitments, such as childcare or further study, to make their careers more sustainable and to protect their wellbeing. However, granting this flexibility, without the efficient systems or data oversight to coordinate this sustainably at scale, just isn’t possible if organisations are to meet patient demand efficiently and cost-effectively.
It can too often feel as though the needs of managers and clinicians are incompatible – leading to a “tug of war” in which efforts to meet the needs of either group unwittingly hamper progress for the other. But this does not have to be the case. What’s needed is a fresh approach that targets the challenges on both sides simultaneously, and works to find a middle ground.
Laying down the rope
It starts with acknowledging that managers and clinicians want the same things – rota planners want to meet the needs of clinicians and grant them genuine flexibility – but the same core pressures are creating problems for both groups. Inflexible, inefficient workforce systems are over-complicating managers’ workloads and making it virtually impossible for them to plan staffing reliably in line with service demand while unlocking flexibility for clinicians. These siloed systems do not provide the workforce oversight or coordination needed to sustainably factor flexibility into rotas or plan further ahead.
With both sides facing the same underlying issues, it follows that we should be able to tackle them with the same solution.
Technology has a role to play. But simply digitising workforce systems is not enough. We need more streamlined, human-centred, data-led systems that genuinely help to reduce the administrative burden on managers and make it easier for them to coordinate staffing in response to demand, while enabling flexibility for clinicians.
For example, having one system that allows clinicians to view and manage their individual and team rotas, submit annual leave requests and file exception reports all in one place can provide greater flexibility and control and make it easier for them to plan their working lives around their personal commitments. At the same time, this approach streamlines a wealth of staffing processes for managers, ensuring that all activities can be easily monitored and tracked, and removing the hassle of switching between different systems to coordinate rotas and keep services safely staffed. Most current digital systems in use across the NHS simply can’t facilitate this.
With the right tools, both managers’ and clinicians’ needs can be met, fostering a healthier, more sustainable workforce that can meet fluctuating service demand while protecting staff wellbeing.
Harnessing technology in the right way to build a holistic solution
We already have the technology to make this a reality. What we need is the understanding and commitment from innovators and healthcare organisations to develop and implement solutions which have been designed with both managers and clinicians in mind, to facilitate smarter rostering and temporary staffing.
This means smart rostering tools that can bring together all relevant workforce and service information in one place, supporting managers to more quickly and easily design rotas which reflect employees’ personal preferences – while meeting patient demand. And digital staff banks which can coordinate a vast network of available clinicians that can be easily drawn from to fill vacant shifts, reducing reliance on external agencies, while offering clinicians the additional flexibility to work the shifts that suit them.
Implementing smarter, interoperable systems will also generate a wealth of valuable data, which can be utilised to drive further workforce improvements and predict future staffing needs. By prioritising consciously designed, interoperable digital systems that can share this data with the other systems already in use across the NHS, we can unlock workforce insights for staffing teams, resulting in improvements for managers, clinicians, and their patients too.
The NHS may be in a staffing tug of war but there’s a way we can lay down the rope and achieve a genuine solution for both sides. We should be harnessing smart digital solutions that tackle the crisis holistically, supporting workforce teams to more efficiently – and safely – staff services in line with demand, while giving clinicians the flexibility and control they desperately need. It’s time to end our divisive outlook on the staffing crisis and take a unified approach that can benefit all.