Deal or no-deal, Brexit or no Brexit, wherever you may stand on this polarising debate, the uncertainty surrounding our relationship with Europe is undeniably having a profound impact on the NHS and our ability to strategically plan ahead for the future. While we are busy stockpiling vital medicines, working out supply chain logistics and finding ways to retain our overseas healthcare staff as part of no-deal contingency planning, trouble is brewing.
It’s with no sense of schadenfreude that I say we are on the brink of a global workforce crisis in healthcare. As the global population grows and ages, we are confronted with the daunting challenge of meeting a deficit of 18million worldwide healthcare workers by 2030 – a staggering 20% of the total capacity to care. In the UK, the NHS may be tasked with filling 190,000 clinical posts – an increase of 15% – over the next eight years. In my opinion, this is the single most important issue the healthcare sector will need to address for the next decade and beyond.
But we are not alone in confronting this harsh reality. As part of my role at KPMG I have worked in 77 countries around the world, and during the last few years I’ve seen concerns around looming staffing shortages escalate considerably. America – the country that spends most on its healthcare – faces a shortfall of one million nurses over the next decade while Japan faces a projected 380,000 shortfall in care workers by 2025 as it struggles to cater for its ageing population. India is currently short of nearly four million healthcare workers while trying to launch universal healthcare. Even Australia, coveted as one of the most attractive health systems around the world, is facing a deficit of 123,000 nurses by 2030.
Back on home shores, I welcomed the recently published NHS Long Term Plan together with the government’s £20billion cash injection, particularly in the midst of uncertainty around Brexit. Successive governments had categorically failed to implement a long-term vision for the NHS and many of the policies proposed in the plan – increased mental health provisions and a greater focus on community care, to name a few - are exactly what the country needs. However, much of this progress is at risk of being undermined by a lack of staff – a notable omission from the plan. The clock is ticking as we await further proposals on the future of the NHS workforce, which we’re told are in the works and due to be published later this year.
Sadly, this is not a new problem. Even before the term ‘Brexit’ had even been conceived, we were already struggling to fill positions across the NHS and becoming over-reliant on recruiting foreign staff – currently at 12% of the NHS workforce, 6% of whom are from EU countries. At a critical moment in time, when we should be strategically thinking about how we can circumnavigate shortages, we are instead fighting fires and taking a rather myopic approach.
British people have so much to be proud of when it comes to our beloved NHS. We have a health system which is considered by many as the role model and blueprint for universal healthcare, with world leading universities providing fantastic education and training for as much as 10% of the health workers around the world. But as comforting and uplifting to the British soul the NHS may be, it would serve us well to remember what the service is actually composed of, and that is, first and foremost, its clinicians and staff. Whilst Brexit certainly demands innovative, agile thinking, we must look beyond current political circumstances into the none-to-distant future. If we want our country’s greatest institution to remain sustainable and survive for decades to come, we should address the gravest of all threats and ensure that the skilled, talented and dedicated workforce that makes the NHS so human, is supported so that the service can continue to grow and flourish.
It’s not necessarily all about finding quick fixes and increasing headcount. We need to develop our thinking about how best to curb demand, improve the productivity of staff, adopt new technologies and ensure that our workforce is more motivated and agile. In my new book, I outline ten solutions to this global workforce crisis which will help our sluggish UK productivity and ensure that health creates even greater national wealth.
Mark Britnell is global chairman and senior partner for healthcare, government and infrastructure at KPMG, and a former NHS director-general for commissioning and system management and chief executive of University Hospitals Birmingham NHS Foundation Trust. His new book Human: Solving the global workforce crisis in healthcare is out now, published by Oxford University Press.