The demands on the NHS over the next decade present a major challenge to those working within it. Our NHS@75 programme highlights that by 2023, when the NHS reaches its 75th anniversary, organisations will need to have transformed the way they deliver care. This means addressing difficult questions on the size, shape, role and productivity of the workforce.

‘The NHS has relied on staff wanting to work for it, but motivation among new staff may change’

How will roles change? Our research finds that with a shift to whole person care will come a shift to care closer to home. More staff are likely to work in the community. Technology will drive and enable this, demanding new skills from staff. But many jobs will also demand public health skills − helping patients to self-care and to prevent or delay illness.

We will see more general roles across community and hospital nursing. Other jobs are likely to become more specialised with, for example, greater opportunities for specialist nurse skills in some areas.

Increasingly workforce planning needs to take place across the whole health economy, with active engagement from both providers and commissioners, as well as from private and public sector stakeholders.

Rise to the challenge

How will the NHS support the workforce to make this transition? Naturally, training will be important. The additional skills needed to fulfil changing roles should be identified, and training needs to focus on making staff more effective in quickly delivering the outcomes needed. Overcoming hierarchy, removing micromanagement and engendering better engagement between clinical and non-clinical staff will all be key, with the medical director role crucial to aligning managerial and clinical priorities. A renewed focus on staff wellbeing is also essential.

The NHS has relied on staff wanting to work for it, but motivation among new staff may change, especially if new providers emerge and the NHS has significant performance pressures. This could mean some jobs in the private healthcare sector look more appealing than those in the public sector. Will the NHS be prepared to respond?

How will the workforce be incentivised to deliver what people need and want? Basic pay rates in the NHS over the last few years have been frozen but many staff have still had annual incremental rises. Individual based performance related pay presents many issues in the NHS, but performance management systems which balance clinical outcomes, staff feedback and patient experience could be powerful in improving productivity. Regional pay could also be used, such as to attract high calibre healthcare professionals to deprived areas.

These questions are all difficult, but they must be answered if the NHS is to rise to the challenges of the next decade.

Ian Tomlinson-Roe is HR function effectiveness practice leader and Janet Dawson is healthcare lead partner at PwC

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