In the United Kingdom, there is one doctor for every 356 patients. It is worrying compared to the related countries with an average of one doctor for every 277 patients (National Health Executive, 2019). The total number of full-time equivalent staff is at 1.2 million. About 1.1 million healthcare workers work as adult social caregivers. 46,000 professionals work with independent health care organizations. The available data shows that there exists a severe workforce shortage in the UK. In the year 2-17/2018, the National Health Service spent about 5.5 billion Euros employing temporary staff to cover the shortage (Kings Fund, 2018). The purpose of this study is to highlight and provide an in-depth analysis of the challenges of the National Health Service in the selection and recruitment of human resources and suggest applicable policies to overcome these challenges.
Challenges
In addressing the challenge faced, it is essential to look into some of the theories that have been used in the situational analysis. This study will utilize Wilton’s theory of constraint. According to Wilton’s theory of constraint, there are four levels of examining constraints. These four levels include international constraints, national constraints, external organizational constraints, and internal-organizational constraints.
International Constraints
- Brexit employment legislation
Through International recruitment, the UK is allowed to engage workforce from outside the country to supplement the already existing workforce. According to van Schalkwyk et al. (2020), Brexit has made the UK unattractive for foreign workers. The policy pushed by Brexit seeks to limit the immigration rate of individuals into the UK. The policy has raised concern among NHS employees. The argument brought forth by the NHS is that a flexible migration policy allows foreign healthcare workers into the UK and enables UK doctors to work within the EU (King’s fund, 2018). Immigration restrictions lead to a shortage of much-needed qualified and skilled staff and thus pauses a significant challenge to the recruitment and selection process. The Brexit legislation hits hard on the National Health Service because of its over-reliance on international recruitment to supplement the existing healthcare force (Charlesworth, 2021).
- COVID-19 Challenge
The Covid 19 pandemic is one of the global issues that have significantly constrained the recruitment of the healthcare sector. It has brought with it the need for more nurses. In addition, we have lost a large number of healthcare professionals to the disease itself. The loss of staff is estimated to be at 40% (Charlesworth, 2021; Hardie et al., 2021).
National Constraints
- Under-staffing
Across England, there is a shortage of 100,000 workers. One out of eight nursing posts is vacant in the UK. This shortage is directly caused by the increase in nurses leaving employment even at a young age. Another underlying cause for the deficit in available nurses is the decrease in nurses applying for a nursing course. A good number has also been used but have been declined from joining institutions to do nursing courses. Another significant group can join institutions but later drop out due to a lack of tuition fees (Kings Fund, 2018). Charlesworth (2021) puts it in a much more candid way. The NHS struggles with understaffing due to its failure to train enough staff to recruit into the healthcare system.
According to Buchan et al. (2019), NHS reports show that 1 out of 9 staff leaves the NHS every year. Some of the cited causes for this dramatic exodus include lack of a proper work-life balance, payment, morale, and overall job prospects. The work-life balance comprises about 17% of the reasons why individuals leave the workforce. It is, therefore, needful that healthcare institutions within the UK come up with means of retaining employees to win the crew. This challenge links with underfundingwhere the UK public health sector has been struggling with under-funding and increasing the aged population (Latham, 2021).
Organizational Constraints
- Increase in Service Demand
The increase in age increases the burden for care on chronic illnesses and comorbidity illnesses (Latham, 2021). According to the National Health Executive briefing report issued in (2019), there has been a 5.4% rise in emergency admission in the year 2018/2019, leading to the need for an increase of healthcare workforce recruitment.
- Legal issues to recruitment
Another major constraint against recruitment procedures is that most healthcare organizations cannot directly employ professionals and thus have to make local arrangements that only assert temporal employment.
Solutions
- Improving work plan
In the Kings’ fund (2018) report, poor workforce planning is sighted as one of the challenges faced during the recruitment and selection process. It has also been argued in the House of Commons that the number one reason for recruitment and selection challenges is the lack of a proper work plan (Charlesworth, 2021). Without a work plan, it is impossible to get anything done. In the article written by Latham (2021), the UK health sector is struggling with underfunding. In making a work plan, the government and responsible bodies should work on increasing the health budget. NHS -England has already started talks about increasing the annual budget by 3.4% annually for five years. After expanding the budget, the NHS can now focus on getting the needed human resource, which is the number one challenge in recruitment and selection. Increasing the funding directly affects the increasing workforce.
King’s fund (2018) suggests that increasing the workforce will need an intentional increase in students joining tertiary institutions to train for healthcare-related courses. Support education funding can be done by providing partial scholarships that would supplement the education process. In support of availing funds for educating healthcare workers, Charles worth argues that it is much more expensive not to train enough workforce than to train enough healthcare professionals. In support of the increase in healthcare educated staff, institutions can offer scholarships to qualified students.
- Improving workforce retention
The workforce leaving their stations brings about most of the recruitment challenges faced by NHS. The retention process can be made easy through the NHS, making the procedure for re-entering the workforce much more accessible. In trying to improve worker retention, different strategies can be employed.
The first strategy that can be applied in actualizing workforce retention is creating a positive environment during the recruiting process. Building a positive climate starts with making the workforce have a good experience during the recruitment process. The second strategy to apply in workforce retention is the provision of education and continual learning after recruitment. Continual education allows staff to learn and develop new skills they were not able to do before. Apart from sharpening the skills of the workforce, it provides motivation, which is necessary for job satisfaction. In addition, building on already existing education gives the feel of growth. This strategy is helpful in workforce retention within the healthcare sector.
The third strategy that can be effective in retaining the workforce is improving workforce engagement and providing employees with competitive compensation. Providing compensation allows for job satisfaction that may prevent early retirement.
- Increase International Recruitment
Reports show that the international workforce has a predominant role in the selection and recruitment of skilled healthcare staff. The NHS should actively negotiate with the Brexit community to flag restrictions, especially on the healthcare workforce that can be imported from outside the EU.
Reflection
In analyzing the challenges faced in the recruitment process by the NHS, I have discovered that the institution has a more prominent role to play to retain workers and not have to deal with the problem of the massive exodus of essential personnel from a healthcare organization.
Organizations have a significant role to play in employee retention. Most individuals in any workplace crave purpose and satisfaction. When one or both of these lacks, it is likely to create dissatisfaction among individuals. Job satisfaction can be achieved in individuals through motivation ineffective leadership. Healthcare personnel carries out exemplary work on day-to-day basis. Employee motivation can be quickly done through recognition and awarding of job commitment efforts. This can come in the form of paid vacations and scholarships to continue in education. At the end of it, all employees feel motivated and much appreciated at work. As a result, there is less chance that one would seek to leave due to lack of satisfaction.
For incentives such as a paid vacation to work, there have to be enough personal to stay behind. The lack of balance between work and social life is because healthcare jobs come with a lot of hours on-demand. Employees are exhausted and can only think of having to retire to enjoy their social bit of life. Hospital management teams have the responsibility of starting dialogues on the need for better policies. Some of the policies that have to be implemented within the hospital include preparing a better work plan for international personnel. In addition, they can push for open dialogues for the case on immigration for international healthcare personnel.
The Winston constraint model is a straightforward but effective method of looking at constraints. Alternatively, it makes it easy to classify plans that could be done to curb the constraint. Additionally, it is easy to point on areas where organization has to put on more effort and where healthcare organizations have to collaborate with other partners.
Reference List
Buchan, J., Gershlick, B., Charlesworth, A. and Seccombe, I., 2019. Falling short: the NHS workforce challenge. The Health Foundation.
Charlesworth, A., 2021. What action is required to make NHS workforce shortages a thing of the past? | The Health Foundation. [online] The Health Foundation. Available at: <https://www.health.org.uk/news-and-comment/blogs/what-action-is-required-to-make-nhs-workforce-shortages-a-thing-of-the-past> [Accessed 18 July 2021].
Hardie, J.A., Green, G., Bor, R. and Brennan, P.A., 2021. Cutting edge selection: learning from high reliability organisations for virtual recruitment in surgery during the COVID-19 pandemic. The Annals of The Royal College of Surgeons of England, 103(6), pp.385-389.
Latham, K., 2021. How can Credentially help solve the NHS recruitment problem?. [online] Credentially.io. Available at: <https://www.credentially.io/insights-posts/nhs-workforce-crisis-and-recruitment-challenges-in-2021> [Accessed 18 July 2021].
National Health Executive. (2019). The NHS Workforce Challenge: How to plug the gap. Available at: <https://www.nationalhealthexecutive.com/Health-Service-Focus/nhs-workforce-challenge> [Accessed 18 July 2021].
The King’s Fund (2018). The health care workforce in England: Make it or Break it? Available at:<https://www.kingsfund.org.uk/sites/default/files/201811/The%20health%20care%20workforce%20in%20England.pdf> [Accessed 18 July 2021].
van Schalkwyk, M.C., Hervey, T.K., McCarey, M., Dayan, M., Barlow, P. and McKee, M., 2020. How will Brexit affect the healthcare workforce?. bmj, 371.
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