An integrated health and care workforce – a reality?

In our continuing series of blogs on the recently published Integration White Paper, we look at the health and care workforce proposals. The White Paper finally shows the part that the workforce can play while emphasising that it is our ‘biggest asset’ and central to delivering integrated care.

Workforce planning

A number of proposals are made to support the workforce to deliver an integrated healthcare service. Central to this commitment is the proposal to strengthen the role of workforce planning at ICS and local levels. The Paper explains that staff numbers and skills across teams should be planned to meet the need of their local populations and places.

To improve workforce planning, in July 2021, the Department of Health and Social Care commissioned Health Education England to review long-term strategic trends for workforce. For the first time, regulated adult social care professionals will be included in this framework which aims to take a 15-year forward view to guide planning, education and training for the workforce. This information will support Integrated Care Boards to fulfil their role on shared workforce planning across health and social care to meet the population needs of people now and the future. The report is expected later this year.

The proposals to support workforce planning build on the Health and Care Bill proposals for a new workforce accountability report which will cover the whole of the NHS from primary care to secondary, community health and where sections of the workforce are shared between health, public health and social care.

The Paper sets out key priorities for NHS leaders at national level, ICS and place-based levels on workforce planning, with the DHSC working closely with ICS leaders to support the development of ICSs’ “people operating model” and to support places to develop a ‘one workforce’ approach.

Proposals on place-based workforce integration are focused on local leaders deciding which model of integration will work best at place, for example ICBs will have the flexibility to determine governance arrangements in their area – including the ability to create committees and delegate functions to them. This would allow systems to create local ‘place’-based committees to plan care where appropriate.

Local leaders are encouraged to think about what workforce integration looks like in their areas, the conditions that are needed, the practical steps required and who needs to be involved in shaping it. According to the White Paper, this should prevent duplication across health and care and allow leaders to consider the impacts of one sector on the other, ensuring individuals’ contact with members of both workforces is coherent and coordinated.

Barriers to workforce integration

To help further facilitate workforce integration, the Government plans to review the regulatory and statutory requirements that currently prevent the flexible deployment of health and social care staff across sectors.

Other measures to support cross sector movement between health and care are set out in the workforce chapter of Adult Social Care Reform White Paper, People at the Heart of Care to improve career pathways and linked investment in learning and development to support progression for care workers, for example. This is welcome but as NHS Confederation point out, while additional competencies for social care staff are possible, questions around whether there are pay implications will need to be addressed along with how new tasks will be identified.

It is of note that the issue of parity of esteem, pay and workforce conditions between health and care staff are not addressed in the White Paper.

What next?

We have several commitments on workforce coming down the track with ICSs and places focused on workforce integration planning. The White Paper also sets out five questions on which it seeks views – you can find these set out at page 69, with section five of the White Paper covering the workforce theme.

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