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Expanding the practice team ‘only way forward’ to address workforce shortages, think tanks warn

by Costanza Pearce
21 March 2019

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The expansion of the primary care team is the ‘only way forward’ to address workforce shortages, according to a new report published today (21 March).
The report, published by The Health Foundation, The King’s Fund and Nuffield Trust, analysed staffing shortages in the health and care workforce and outlined a series of policy recommendations for the upcoming NHS workforce implementation plan.
The recommendations focus on general practice and nursing and include an investment of an additional £900m per year for Health Education England by 2023/24.
The report projects that despite Government efforts to increase GP numbers, they will ‘fall substantially short of demand’ and ‘the only way forward is to make substantial progress towards a new model of general practice with an expanded multidisciplinary team’.
It added: ‘As both growing GP numbers and expanding the wider team carry risks, a mix of the two is important.’
The report welcomed the inclusion of funding for 20,000 additional general practice staff in the new GP contract but called on the workforce implementation plan to address the implementation of the model ‘at pace’.
Anita Charlesworth, director of research and economics at the Health Foundation, said: ‘The workforce is the make or break issue for the health service and unless staffing shortages are substantially reduced the recent NHS long term plan can only be a wish list.
‘It doesn’t have to be this way. Decisive policy change backed by targeted investment could eliminate nursing shortages over the next decade. But if the NHS is to have access to the skilled health workers it needs, the government must stop seeing funding for the workforce as a cost to be minimised and prioritise investment in training more staff.’
A new model
The recruitment of at least 3,000 more pharmacists and 6,000 physiotherapists into general practice over the next ten years could make a ‘major contribution’ towards meeting patient demand, according to the report.
It also recommends ‘significantly increasing the number of administrative and clinical support staff over the next 10 years’ alongside an increased use of new technologies to save GP time.
The report says: ‘Helped by technology, both existing established professionals as well as new staff roles can offer more clinical and administrative support, including as health care assistants, medical assistants, phlebotomists, pharmacy technicians and administrators.
‘While it is not possible to substitute the fundamental role that GPs undertake in primary care, it is possible to substitute some of the tasks they undertake.’
It is hoped ‘ambitious changes to the workforce composition’ will ‘capture’ GP time by delegating tasks to other roles and ‘provide some hope of a sustainable model of primary care’.
GP shortage could triple
The report projects that if urgent measures like these are not embraced in the upcoming NHS workforce plan, GP shortages in England will almost triple to 7,000 by 2023/24 and nurse shortages will double to 70,000.
The report also calls for more opportunities for staff near retirement to work part-time, NHS pay to rise in line with the rest of the economy and £250m a year of the overall £900m set aside to fund technology training for staff.
Candace Imison, director of workforce strategy at the Nuffield Trust, said: ‘The imminent workforce plan needs to mark the moment we stop treating the staffing of health and social care as a second order issue. Our recommendations might seem radical, but the time for tinkering at the margins has passed.
‘I’m especially worried that while medical and technological advances mean staff need to adapt and learn more quickly than ever, we have slashed the funds that support this.’
She added: ‘If any of our lofty aspirations about better outcomes and digital technology are to become a reality, we need to get the budget for developing skills at least back to where it was – and that means a fourfold increase by 2023/24.’