Patient Centred Workforce Redesign – why the time may be right

The Head of Quality Improvement for NHS England (London) has stated that over qualified staff are often involved in very basic roles in the NHS.

Roger Durack was speaking at the Londonwide LMCs conference and suggested that the most rudimentary care tasks are often delivered by staff who are higher qualified than necessary.

“We have a specialist workforce delivering skills that only require a basic competency. We are not by any means diminishing the need for professional qualifications. But do we need someone with a degree to cut toenails?”

This is obviously extremely worrying at a time when resources in the healthcare system are stretched to breaking point.

In response to this issue, Durack suggested that a different approach to workforce design could make a significant impact.

Dr Asiya Yunus, a Londonwide LMCs medical director, was also involved in the presentation with Durack.

The presentation was based on “A Patient Centred Approach to Workforce Planning”, originally authored by Carol Brooks and Tineke Bosma, intended to deliver a design that requires GPs to “focus on the demand for skill, rather than the supply of professionals”.

Central to the idea is splitting patient services into basic, intermediate and specialist categories, in order to ensure that appropriate staff members are assigned to the correct tasks.

Durack demonstrated that based on these definitions the current staff members delivering each task are often “higher qualified” than necessary.

The healthcare expert believes that it should be incumbent on practices to work with patients closely in order to identify the services that they require.

Identifying care pathway and patient groups should be considered particularly important, according to Durack.

“Think about the competency levels you need in your workforce to deliver the services patients need,” Durack mused.

While Yunus believes that “redeployment and retraining are important to narrowing the gap between the current workforce and what is required to meet patient need.”

She added that approaching workforce design in this way could “offer some solutions” in the current climate of the NHS.

“This strategy has been shown to influence and make an impact in the community,” Yunus asserted.

One such example of this is physiotherapy and occupational therapy services being realigned at the Sheffield Teaching Hospitals Trust.

The organisation has introduced more assistance, while workforce has also been redesigned in order to improve patient outcomes.

Yunus concluded with regard to this initiative that it “is about getting the right person doing the right job.”

In order to improve the healthcare system, Durack believes that GPs should become more intimately involved with educational planning in order to ensure that needs are appropriately met in the future.

Those speaking at the conference suggested that this will become increasingly important as the impact of a greater population and its consequent demographics become evident.


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