Summary
- Centralized healthcare challenges: The UK’s National Health Service (NHS) provides free healthcare but faces significant issues, including workforce shortages, long wait times, and financial strain due to rising costs in both staff banks and agency reliance.
- International recruitment as a solution: Despite recruiting 50,000 nurses in five years, UK vacancies remain high. International recruitment is critical to filling these gaps, but local talent shortages persist due to low pay and reduced financial support for nursing students.
- Collaborative partnerships for progress: Panelists emphasized the need for partnerships and shared goals between bank and agency staff to address workforce and financial challenges, while also encouraging learning from international healthcare systems to find sustainable solutions.
Table of Contents
In this insightful Roundtable event, April Hansen, Group President of Workforce Solutions at Aya Healthcare, hosted a discussion with two panelists from ID Medical. David Newton, Managing Director, and Trushar “TJ” Patel, Head of Permanent and International Recruitment, shared their valuable perspectives on the differences and similarities between the UK and US healthcare markets. They drew on their extensive experiences to highlight key challenges and potential solutions in both systems.
State of the UK Healthcare Market
David began with an overview of the UK healthcare market, shedding light on the pros and cons of centralized healthcare. The National Health Service (NHS) is a centrally funded system that provides free healthcare to all UK residents, a concept highly valued by Britons. Despite its noble mission, the NHS faces significant challenges, including a substantial gap between supply and demand, leading to long wait times and overburdened staff.
Financial Sustainability and Workforce Challenges
Hospitals are continuously trying to cut costs while managing increasing pressures on their services. The system’s aging infrastructure and lack of new hospital construction exacerbate these issues, leading to overcrowded hospitals and delayed patient care. April drew parallels between the UK and US healthcare systems, noting common challenges such as workforce vacancies, low morale and budget overruns. The discussion highlighted the importance of learning from each other’s experiences to address these shared problems effectively.
Staff Banking and Agency Usage
David then described the concept of staff banking in the UK, a government-driven solution in which internal resource pools are used to reduce reliance on external agencies. Although agency usage was initially intended to handle short-term absences, such as sicknesses, holidays and maternity leave coverage, it went on to become a long-term solution due to widespread vacancies. This has led to high agency spending, scrutinized by the government and media. Staff banks were introduced to control costs, but the reality has been different.
David summed it up like this, “The original destination was to reduce costs. Costs have gone up massively for [staff] bank. And we’re spending more on our workforce than we ever have. Bank spend is much bigger than agency spend in the UK market, not as the result of increased volume but just as a result of increased unit cost.”
When asked what it will take to overcome the vilification of agencies to improve the healthcare system, David emphasized the power of partnerships. He noted that disparaging parties and playing the “blame game” rarely yields positive results. Instead, establishing common objectives and collaborative roadmaps can help address the complexities of the healthcare system. David cited the harmonization of bank and agency staff as an example of a collaborative approach that is yielding better value and efficiency.
International Recruitment
From here, TJ discussed the critical role of international recruitment in addressing the UK’s healthcare workforce shortages. Despite significant recruitment efforts, it is estimated that there are currently approximately 125,000 vacancies across the UK, translating to a 9% vacancy rate. This shortage is expected to grow to 250k-300k vacancies in the next seven years.
The UK government has implemented various initiatives to address these challenges, from increasing training and educational routes into the nursing profession, to improving retention through flexible schedules and childcare support. But the biggest and most profound impact has come from policies supporting international recruitment.
Through these efforts, the government managed to recruit 50,000 nurses over a five-year period. But even so, the total number of nurse vacancies has not changed by a significant amount.
Addressing Local Talent Shortages
The panel also explored the reasons behind local talent shortages in the UK, identifying low pay as a primary factor. Industrial action by healthcare professionals has highlighted the need for better pay and working conditions. Until 2017, the UK government provided full financial support to nursing students through bursaries. The removal of these bursaries in 2017 led to a predictable decline in applicants, exacerbating the workforce shortage.
Efforts to reintroduce financial support had limited success in reversing this trend. In the 2023-2024 academic year, there were around 4,600 fewer nursing school applicants—a 20% decrease compared to the surge in applications post-COVID in 2021.
Last year, the UK launched the NHS Long-term Workforce Plan, aiming to double the number of medical school placements for doctors from 7,500 to 15,000 annually by 2031. Additionally, the plan seeks to nearly double the number of nursing placements. It addresses crucial issues such as the delivery of community care, with a specific focus on mental health. The UK has backed this plan with £2 billion ($3 billion USD).
Conclusion: A Call for Long-Term Solutions
In their concluding remarks, both David and TJ called for a long-term view of healthcare challenges. They emphasized the need for collaborative approaches, both nationally and internationally, to address workforce shortages and financial sustainability. This panel provided a comprehensive overview of the challenges faced by the UK healthcare system and offered valuable insights for the US market. By understanding these issues and adopting best practices from across the pond, healthcare leaders can better navigate the complexities of modern healthcare and work towards more sustainable and effective solutions.