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Author: Bevan Commission


This builds on the findings of the Bevan Commission’s 2016 report A Workforce fit for Prudent Healthcare, this paper examines the workforce of the future through a prudent lens, within the context of a social model of health and care.

It recommends that a workforce fit for the future will need to be different to the one we have now and be empowered to put prudent healthcare into practice. Health and care professionals will need to work together with (not to or for) patients and communities and to participate proactively in addressing their own health and care.

This is reinforced by the Welsh Government’s recently published long-term plan for Health and Social Care which puts Prudent Healthcare and its principles at its heart – a concept and philosophy developed and championed by the Bevan Commission.

The Bevan Commission identifies the need for a rapid transformation of traditional health and care roles to take this transformative process even further, proposing new combined multidisciplinary roles and teams across health and social care and other important disciplines such as; health data analysts, wellbeing coaches, health technologists and new ‘core health carers’. This role would put the holistic needs of the individual (environmental, physical, social and psychological) at the core of any role transformation.

There is also a clear need to continue to expand upon the diversification of existing roles focusing on future needs, in an ongoing, flexible and responsive way. The next generation of health and care professionals will need to develop core competencies in problem-solving, emerging technologies and communications.

The Bevan Commission calls for the inclusion of the wider workforce (members of the public, patients, carers and the third sector) within future workforce plans. Maximizing the skills and assets held within these groups through training and other support will be essential to achieve more sustainable health and care in the future.

Creative thinking and bold leadership are needed to trial these transformations in roles and services. It will also require professionals and their representative colleges to embrace the challenge and work together with others to find the best solutions.

Different approaches to training and professional development are required through schemes such as; joint bursaries within the commercial and life sciences sector (all major growth areas for Wales), continued collaboration between the life sciences hub, academia, the NHS. Health and care apprenticeships or bursaries etc. New approaches will also be needed to support the next generation of health and care leaders to drive transformation and develop the new skills and competencies to achieve this.

The Bevan Commission calls for Welsh Government and Health Boards to take urgent action to ensure that the financial resources currently invested in the workforce is prudent and that a fit and healthy NHS workforce is actively promoted. Absence rates are higher in the NHS workforce in Wales (5.5%) than in the wider Welsh workforce (2.6%) and the highest for any region in the UK and leaves Wales particularly vulnerable. Due to absence, sickness and recruitment challenges, agency staff are increasingly relied upon to fill the gaps – a costly and imprudent measure.

Recruitment and retention is an ongoing issue – new roles and more flexible, integrated career pathways to fit with people’s changing family and care needs will be needed, moving away from the more traditional fixed training and development pathways. This should be used to help make Wales attractive to recruit and retain the future health and care workforce in a globally competitive market.

Health Education and Improvement Wales (HEIW) should lead the way in implementing the recommendations of this publication, supported by Local Health Boards, NHS Trusts, Professional organisations and Regional Planning Boards in Wales.