RCP Cymru Wales has published its response to the joint draft health and social care workforce strategy from Health Education and Improvement Wales (HEIW) and Social Care Wales, calling for an ambitious, patient centred and clinically led approach, accompanied by a clear action plan.
HEIW and SCW should work with the Welsh government and NHS Wales to:
- implement an ambitious patient-centred and clinically led national workforce and training strategy
- build strong medical teams and encourage a sense of belonging and identity at hospitals
- take a nationally coordinated and strategic approach to workforce planning and data collection
- guarantee protected time for research, education, quality improvement and leadership schemes
- invest in national programmes such as the chief registrar scheme and flexible portfolio training
- develop rural and remote medicine as a training pathway in which Wales is a world leader
- increase the supply of doctors across all parts of the medical workforce
- increase the number of medical student and postgraduate training posts in Wales
- increase the number of medical school places offered to Welsh-domiciled students
- make staff health and wellbeing a national priority
- appoint wellbeing staff to improve induction and support trainees as they move around Wales
- plan fair and flexible rotas and take the pressure off trainee doctors to organise their own cover
- establish a junior doctor forum in every hospital with access to staff support
- support specialty doctors working in non-training jobs to develop their careers
- fill rota gaps by investing unspent trainee money in innovative clinical fellowships
- develop and invest in structured CESR courses with mentoring and support for specialty doctors
- invest in and regulate new healthcare roles such as physician associates (PAs)
- give overseas doctors the chance to train in the NHS using the Medical Training Initiative.
This workforce strategy for health and social care is certainly a step in the right direction: it clearly recognises that the NHS in Wales must adapt to being a modern employer, as shown by its commitment to improving skill mix, embracing new roles and promoting new and more flexible ways of working. But the workforce shortages across our health service are stark, and if we don’t fix the supply challenges, the plan will fail to address the very real pressures facing the NHS and our social care services.
We strongly welcome the strategy’s commitment to placing the health and wellbeing of our workforce at the heart of the strategy. As implementation plans are created and enacted we expect these to be clinically-led, patient centred and designed using co-production principles. Health boards and NHS organisations in Wales must ensure that change is genuinely led by patients and clinicians, and not presented as a ‘done deal’ at a late stage in the planning process. There is a real risk that without the genuine involvement of patients and clinicians, any proposed changes will lack ownership, credibility and are unlikely to result in lasting change.
The issue of accountability is also important. Clinicians and healthcare professionals need to know who will be held to account for delivering this strategy and meeting its milestones.
It is also imperative that this workforce strategy is clearly integrated with the proposed Welsh government national clinical plan which is due to be published later in 2019. Delivering patient-centred health and social care services is entirely dependent on a valued, motivated and well-staffed workforce.