Time to Change

Although the majority (57 per cent) of surveyed clinicians remain satisfied with their job, satisfaction has decreased since 2017 and clinicians expressed predominantly negative sentiment when asked to describe working in the UK healthcare system today.

The top drivers of job satisfaction were ‘sense of fulfilment/making a difference’, ‘work/life balance’ and ‘ability to use my skills in my daily work’. As might be expected, pay was the main reason for job dissatisfaction across all staff groups and the main area where staff consider that better conditions would improve their health and wellbeing.

Driven by increasing workloads and pressure, work has had a negative impact on clinical staff wellbeing. Our survey found that 46 per cent of clinical staff were experiencing a negative impact on their physical health and 57 per cent a negative impact on their mental health.

Further, we asked our survey respondents how their feelings on job satisfaction/dissatisfaction affected their views on career intentions. The most common thought (53 per cent of all respondents and 59 per cent of doctors) was to move to part-time work. Crucially, 31 per cent of AHPs, 35 per cent of doctors and 50 per cent of nurses and midwives had considered leaving their profession and changing their career. Doctors were the most likely to consider moving overseas (44 per cent). Nurses and midwives as a group were the least likely to leave their jobs to emigrate, but they were more likely to change their career. AHPs were most likely to consider leaving their current job for full-time employment elsewhere in the healthcare sector in the UK.

Our research suggests that there are various actions that ICSs and healthcare organisations can take to improve the capacity and capability of the NHS workforce. This includes: improving the routes into a clinical career, increasing the efficiency and effectiveness of recruitment, developing effective retention strategies and scaling the adoption of technology to augment the clinical workforce.

• Redefine the sources of recruitment into nursing and allied health professionals training (domestic training, international recruitment and return to practice).
• Increase capacity of medical schools and speciality training experience.
• Reduce attrition and modernise the undergraduate training experience.
• Collaborate to improve the education experience and develop competency-based skills.

• Prepare and support staff through seamless end-to-end recruitment, onboarding and induction.
• Provide regular appraisals and increase opportunities for professional development.
• Support the career ambitions of clinicians including extending scope of practice.

• Improve retention through the development of a listening culture that engenders trust.
• Support the health and wellbeing of staff.
• Provide both financial and non-financial benefits and rewards.
• Improve work-life balance including flexible rostering, self rostering and better deployment of temporary staff.

• Adopt innovations and new ways of working that release time to care.
• Support clinicians to adopt digital technologies to alleviate workload pressures.

The challenges facing the healthcare workforce are not unique to the UK, but the sheer scale of the challenges in the UK makes it difficult for policy makers and healthcare leaders to identify and implement solutions. The growing mismatch between continuing demand for healthcare and shrinking capacity of the workforce to meet that demand, means that many clinicians find themselves on a never ending treadmill. Continuing to deliver care in ways that they have always used but finding it physically, emotionally and psychologically draining. It also means that the NHS continues to operate as a sickness service rather than a proactive, predictive, personalised and preventative (4P) health and wellness service. Today, rising levels of job dissatisfaction, industrial action and long waiting times create a compelling case for change that can no longer be ignored. Our research has identified the features of today’s ways of working that should be retained, actions that could re-engage the workforce, and the ways of working that need to be reimagined.

Digital transformation and the adoption of AI technologies are crucial enablers of the future of work in healthcare. The increasing capacity and capabilities of today’s AI technologies, coupled with the pace of adoption and development, suggest real promise and potential.

The current level of staff shortages in healthcare creates an opportunity to utilise new technologies to enhance existing roles and create new ones that enable clinicians to use the full range of their skills and abilities, and broaden their scope of practice. It is also an opportunity to recruit new types of staff with new skillsets (for example, in analytics, bioinformatics, and behavioural science skills) which are all required in a digitally proficient health system.

Creating a diverse, multi-professional workforce that is trained and deployed across permeable boundaries will alleviate pressures on the current workforce, while enriching careers for clinicians and increasing the attractiveness of caring professions.

• Collaboration and coordination between healthcare professionals, researchers, policy makers and technology experts to effectively integrate AI and automation in healthcare<./li>
• Agree a shared vision, data-sharing agreements, and ethical frameworks to guide the use of AI in workforce development and deployment is a fundamental requirement for the future of health.

• Obtain high quality real-world workforce data to generate accurate and meaningful insights.
• Adhere to standardised data collection methods, interoperable data systems, and transparency in data sharing practices to ensure high-quality data for AI applications.
• Secure, transparent data management and governance.

• Ensure that AI models are transparent, explainable and reliable to gain the trust of HR, OD and clinicians. Involve clinicians in the development and validation of AI models to ensure their relevance and accuracy.
• Establish robust regulations that support innovation.

• Develop AI tools that help healthcare providers optimise resource allocation and improve efficiency by automating routine tasks, reducing administrative burden, and identifying high-risk patients who require more intensive care or active treatments.
• Reflect the impact of AI and automation in workforce planning and budgets.

• Support a shift in the culture and mindset of healthcare organisations to embrace innovation and change.
• Invest in change and the development of effective implementation strategies.
• Train staff to provide the skills needed to embrace AI and identify the solutions that will best improve their workflow.