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In this month’s Hospital Times, Lyn McIntyre MBE, UK Director of Healthcare, writes about flexibility in the workforce. We have reproduced the article below, and you can download a PDF of the published article here.

If we want a meaningful conversation about flexibility and the healthcare workforce, we need to define our terms and consider our perspectives, writes Lyn McIntyre MBE, UK Director of Healthcare at Allocate Software.

In practice, flexibility in the health and care  workforce is more a matter of perspective. What  an employer, an employee and a patient want out  of flexibility may be three different things. So how can we try to reconcile them?

Any sensible organisation operating in a health and  care system in 2019 should support flexible working. But it’s crucial that we define what flexibility means to  the three key stakeholder groups: providers, workforce  and patients.

The shortage area for healthcare globally is the  workforce, a case powerfully made in Dr Mark Britnell’s excellent book Human: Solving The Global Workforce Crisis In Healthcare. It is very clear that there are just  not enough skilled doctors and nurses globally to  meet our current, let alone future, demands.

Flexibility: different things to different people

“Workforce” is an impersonal, technical word;  “people” is far better. For some people working in  health and care, the idea of flexibility might be one of  complete predictability. For example, “I only want to  work on Wednesdays, and I need the system and my  employer to have the flexibility to cope with that.”  Other people’s definition of flexibility is at the  opposite end of the spectrum. They might want to  work as much as possible. Some NHS nurses prefer  to work their contracted hours in consecutive 12-hour shifts, and then do agency work on the other weekday and/or weekend day. This is flexibility manifested as income maximisation.

There are other versions of extreme flexibility. It is  now possible to introduce self-rostering, obviously  with systems to deal with the less-requested shifts.  The “Uberisation” of work for clinical people is not  anywhere near to being a reality because of the  mismatch between supply and demand, but as  things now stand, the ultimate flexibility is probably  working via an agency or staff bank only when you  want to do so.

Of course, organisations need to plan for safe and  adequate workforce cover for patients. And patients  need predictable and adequate staff to deliver the care they need, when they need it. This is another kind of flexibility.

These are three distinct perspectives on what  flexibility means in health and care systems. Trying  to reconcile them all affordably and safely introduces  inherent complexity to running the system. With  the right technology, the systems do not have to be  complex to run or to navigate.

Technology for the health and care workforce is  ultimately about trying to match available people  with the right skills against the rostering and staffing  gaps.

The key thing for every health system is to know  where your gaps are and in what staff groups. In the NHS, we have an interesting opportunity  here around New Care Models and Integrated Care Systems to get a real understanding about population health. This is about the health and care organisations  in an area coming together to ask what the nature  and make-up of the population is they are serving,  how many patients are covered and what the local  pressures are.

Demand might be predictable

Demand might actually be more predictable than many think. For example, GP surgeries and A&Es are always busy on Mondays and quiet during major sporting events. Winter and Christmas also come around predictably.

Technically, matching availability and demand  is not hard with the help of digitisation. The crucial  element in flexible working within the health sector is the people: how your system makes your staff feel; what quality the conversations and listening that  you have with them.

What is the demand for care?

A key part of the picture is to determine the effect on  patient care. Patients are often reported as valuing  consistency and continuity, and these are open key  elements in safer care delivery.

Employers need to think in terms of flexibility for staff, but also about patients and patient outcomes.  Therefore, it’s vital to do this matching of demand  and supply through effective, proved and reliable systems.

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