In a report published yesterday, the World Health Organisation (WHO) warns of a projected global shortage of healthcare workers of 12.9 million – today the figure is 7.2 million. Implications of this massive and growing shortfall in the numbers of skilled health professionals on global health are stark.
In our UK context, we are playing our part in adding to that shortfall. The current media and political frenzy highlights failures in the current ‘demand and supply’ NHS workforce planning. This leads to cyclic boom and bust in commissioning numbers of student education and training places in UK universities with short-term NHS financial efficiency savings leading to cuts in the number of health professionals being trained, which then leads to shortages in sufficient numbers of health professionals to meet UK needs.
This is currently being evidenced by NHS shortages of A & E doctors, a crisis in the recruitment of hospital nurses from overseas to fill the reported 15% vacancy rates (which risks denuding other countries of their nursing workforce) and through calls for urgent increases in the number of district nurses, midwives and allied health professionals to meet NHS service needs.
Given such shortages in UK and global healthcare, is ‘workforce planning’ an oxymoron? Trying to predict the ‘right numbers’ of health professionals needed to deliver healthcare in the UK and match that to available funding for education and training is, to say the least challenging – I do not envy those tasked with this flawed process. The employer-led planning process broadly assumes that those studying as health professionals in specific localities in the UK will subsequently gain employment in the NHS in those localities, or at least (it is hoped) working within UK healthcare.
Those new graduates who do not gain employment in NHS in UK are currently viewed by commissioners as ‘wastage’. Very high applications to UK universities to study health professional courses (from both UK and overseas students), increasing numbers of healthcare students and qualified health professionals gaining experience of studying and working overseas, and with a growing shortage predicted in the global healthcare workforce, point to a need for re-examination of workforce planning as part of a wider review of the funding of UK university education and training.
UK universities are already extensively engaged in global healthcare education, training and research. While the NHS contracts held by UK universities and the strong partnership working for the UK workforce are important, many universities are working with Departments of Health across the globe supporting the education and training of their workforces. The WHO report identifies Asia and Sub-Saharan Africa as areas where shortages will be most acute. At Leeds Metropolitan University we have been delivering ‘in-country’ healthcare education in Zambia for nearly 10 years. More recently we have extended delivery of health professional education in The Gambia, Ghana, Mauritius and Malaysia. When asked whether my Faculty works with the Department of Health, I answer – ‘which Department of Health ?’
Matching the opportunities for education and training of the healthcare workforce with funding is difficult. The hugely moving scenes of the injured and sick following the devastation in the Philippines and of those in war-torn Syria, remind us of our global social responsibility for a global healthcare workforce and we must ensure that the current shortages in qualified health workers do not fall even further as WHO is predicting.