2023 Global Health Care Outlook

How some organizations intend to respond to future staffing challenges

By Sara Siegel, Deloitte Global Health Care Sector Leader, Deloitte UK

The world recently entered the fourth year of COVID-19. While most of us have learned to live with the virus, it continues to affect health care organizations around the world. Deloitte Global’s 2023 Global Health Care Sector Outlook explores the impact the pandemic has had, and continues to have, on care delivery, health equity, virtual health, digital transformation, sustainability, and the workforce.

In the United Kingdom, where I live, more than 42,000 workers left the National Health Service (NHS) during the last two quarters of 2022.¹ That number is higher than any quarter over the past decade. About 45% of those health care workers said they felt unwell due to work-related stress, and nearly one-third said they often think about leaving their job, according to a report from the House of Commons.² Many non-emergency surgeries that were put off during the pandemic still have not been rescheduled.³

Over the past 20 years, much of my work has been focused on the NHS—the UK’s publicly funded health care system that provides about 90% of all medical services.⁴ More recently, I have been overseeing our work with other European health care practices, and my role recently expanded to include the global health care sector.

The world will need 80 million health workers to meet the demands of the global population by the end of the decade—double the number of health workers that existed in 2013. But without intervention, we could be short 18 million, mostly in lower-income countries. Nurses make up half of that gap.⁵ Yet even as demand for clinicians grows, many doctors and nurses are looking to reduce their work hours. Some intend to leave the profession altogether, according to our Global Health Care Outlook.

My colleague Eileen Radis recently described the challenges of burnout among nurses in the US, and offered some creative solutions to address it (see To offset nurse burnout, one health system gets creative). But clinician burnout is not limited to the US. Health care organizations and governments around the world are facing shortages and burnout among clinical staff.

Australia is expected to face a shortage of more than 10,600 general practitioners by 2031–2032.⁶
A shortage of registered nurses in Europe was recently described as “a ticking time bomb” that could cause some health systems to collapse.⁷
In South Korea, a shortage of physicians has caused some hospitals to limit service hours.⁸
Eighty-three countries—across sub-Saharan Africa, Southeast Asia, South Asia, and Oceana—currently fail to meet the most basic standards of 23 skilled health professionals per 10,000 people.⁹

Five strategies to help counter worker shortages

Health care organizations around the world are responding to workforce shortages, burnout, and retention. The COVID-19 pandemic might have forever changed the way health care is provided. Here are a few of the strategies that are being considered, according to our report:

Increased flexibility: With the changing workplace demands, some health care organizations are trying to create more appealing and sustainable work environments by focusing on workplace culture and communications, as well as prioritizing mental health services for employees and patients alike.
New credentialing requirements: The NHS is looking to reconfigure pathways so that more people can work at the top of their license or training. Some hospitals and health systems in the US are considering whether licensed vocational nurses (LVNs) or licensed practical nurses (LPNs) can be used for some duties previously assigned to registered nurses. However, this could have a negative impact on skilled nursing facilities and home health agencies that rely on LVNs and LPNs for their staffing needs.
Streamlined documentation: Clinical staff are often required to complete a wide range of administrative, non-value and low-value tasks. Some health organizations have turned to technology to automate certain tasks. But that strategy likely won’t be effective if it fails to give clinicians more time to focus on patients and their care. Health care workers might gather hundreds of data points during patient intake. However, many of them are may not be needed. A health IT company recently identified 87 common elements that need to be collected during a patient intake. Reducing the number of data points collected reduced documentation time by about 30%, and the number of clicks needed to complete an admission fell by nearly one-third (see Giving physicians more time for patient care).
Remote patient monitoring: Digital remote monitoring tools can help clinical staff manage patients virtually. It is generally referred to as a ‘control tower’ in the UK. This can give clinicians the ability to oversee a larger number of patients. In Switzerland, providers are experimenting with hospital at home. Patients who would have required hospitalization can receive round-the-clock monitoring and supervision through wearable sensors and devices. Doctors can communicate via telemedicine technology and specializing nursing staff can provide in-person visits as needed. This model can help improve outcomes and reduce the cost of long hospital stays.
Pay and benefits: Pay is a big issue in the UK because our rate of inflation is higher than in the US at present. Some health care organizations have been able to increase pay for some workers. Others offer student loan repayments, same day pay, schedule flexibility, childcare stipends, and down-payment assistance for workers who are buying homes.¹⁰

CONCLUSION

The COVID-19 pandemic changed global health care, from accelerating the adoption of new technology and care delivery models to increasing the focus on sustainability and resiliency. It also accentuated existing workforce challenges. Health care organizations around the world may be starting to reimagine the workforce of the future as old models and hierarchies may not be meeting the needs of patients. Licensed health care professionals likely need more support from both automation and other clinicians— from nurses to pharmacists. These new models could help to make health care more sustainable and effective for the workforce and produce better outcomes for patients. Rising investments to address worker shortages and attrition could indicate a growing recognition of challenges that providers and other industry participants face. Globally, billions of dollars from both the public and the private sectors are being devoted to the issue.

Endnotes:

¹ Record levels of NHS staff resign, The Independent, January 13, 2023

² Workforce burnout and resilience in the NHS, House of Commons, June 8, 2021

³ Cancelled elective operations, NHS, February 2022

⁴National Health Service statistics and figures, Statista Research, August 30, 2022

⁵ The global health care worker shortage, Project Hope, April 6, 2022

⁶ Australian Medical Association report projects staggering GP shortage, Australian Medical Association, November 25, 2022

⁷The registered nurse shortage in Europe is a ticking time bomb , Health Europa, November 10, 2022

⁸ Chronic doctor shortage pushes South Korea's hospitals to shut off services, Asia News Network, October 26, 2022

⁹ The global health care worker shortage, Project Hope, April 6, 2022

¹⁰ Developing an effective value proposition, Gist Healthcare, July 29, 2022