The Irish Medical Times - From Famine to Future: Workforce Planning in Modern Healthcare

 


Like every 5th class student in Irish Primary Schools, my daughter had to do a project on the Great Famine. As the days ticked by and I could see no sign of coloured paper, a scissors, printstik, a big tome of a book with pictures of miserably thin people, I began to wonder if my child had any intentions of starting the project at all. I was informed that I wasn’t to worry as she had developed a strategy. It involved a brainstorm, a mindmap, and a multimedia platform. 


My entire primary school years passed with no strategy. My projects looked the very same as everyone else's, executed the same way, with pretty much the same content. 


Strategies are everywhere nowadays, there’s one for eating, for sleeping, certainly for exercising, people can’t even keep to schedules without having a 10 step strategy to help them. 


But there are times when a strategy is vital, and that is workforce planning. I’m no expert, but my misspent youth did include obtaining a Masters in Business Studies (yes, back in the day when they handed them out willy nilly). If I recall my Biz Org class correctly, a business should think in four categories: 


  1. Superstars - must keep

  2. Business as Usual - people essential to running the business

  3. Outsource - what work can be fielded out to other experts

  4. Obsolete - what work can we drop altogether


A good business will review these four categories every 1-3 years. It struck me, how often are we doing this review in healthcare, every 1-3 decades? Centuries?

The healthcare sector in Ireland, like many other industries, is undergoing a significant transformation due to technological advancements and changing demographics. Workforce planning has become increasingly important to ensure that healthcare organizations can adapt to these changes and provide high-quality care.

WIth the advent of AI, telehealth, electronic records, an emphasis on preventative care, patient centred care, a more diverse population, and the widespread use of smartphones in Ireland, I feel like we are already in the midst of an organic healthcare review. Healthcare professionals who can adapt to these changes and acquire the necessary skills will be well-positioned for success in the future. 


For argument's sake, let’s say the Superstars are the doctors and nurses, they are indisputably a must. However, Ireland, among many countries, has struggled with retention, recruitment, workload, and fair pay, to name a few issues. To combat this the government has launched recruitment campaigns, notably in countries like India. Efforts have been made to improve working conditions and staff morale, including a focus on mental health. Strike action has improved pay somewhat. The much awaited Slaintecare hopes to provide more funding to attract and retain staff. 


Will AI become another superstar in healthcare? Certainly the engineers who devise and operate the technology will become an important part of the staffing landscape, that did not feature as heavily in time gone by. 


The meat and bones of the healthcare business that keep everything going as usual include the cleaners, catering staff, maintenance, builders, administrators, radiographers, lab technicians, pharmacists, social workers, and the allied health professionals including physiotherapists, OTs, speech therapist, dieticians, health care assistants, etc. 


In the past people had to venture to the UK from Ireland to seek qualifications in some of the allied health professions. The government has tried to increase the availability of training and programmes in these disciplines. Hospitals have provided clearer pathways for specialisation and advancement. More flexible working hours is also an attraction for shift workers. 


New facilities are being built to provide more work in these business-as-usual roles. However, embarrassing fiascos ensue such as the new children's hospital earning the title as the most expensive hospital in the world, and it has yet to open its doors and treat a single patient. 


Non core functions have been outsourced in recent years. I was delayed in paying my A&E 100 euro levy (while I dared to recover), when I received a gruff call from a man I had never heard of demanding I pay up! I had no idea who he was, why he was calling me, and what episode of Eastenders he was reciting. It transpired my local hospital had outsourced their debt collection to some South Dublin gang (or the like). I don’t respond well to bully tactics so I reverted back to the hospital and dealt with them over the matter of the outstanding 100 euro. They were extremely apologetic about the gangster call and said they had several complaints. 


Outsourcing is great when it works, when it doesn’t your reputation can dissolve in a day. Areas less likely to be run by gangsters, but ripe for outsourcing, include scheduling, data entry, and maintenance. 


The area of obsolete work is particularly interesting and timely in this digital age. My GP’s office recently asked me to download an app to allow me to book my own appointments. Of the two receptionists who both asked me to download the app, I can assume one of them will be gone once her contract runs out, and the other perhaps not far behind her. Check-in kiosks in hospitals are a similar change. Although, we are years into their existence and a human still stands beside them helping people to use them. Is this a generational handover or will a human always lurk in the shadows of the machine?


AI in radiology, diagnostics, and pathology may see a reduced need for staff in those areas. Automated dispensing may see pharmacists thin out. Robots may boot out the HCAs. As mentioned above the GP receptionist may be the first to go, although they are a resilient breed, they are the first to face every disease and still wield their scheduling power with ferocity.


It’s possible that AI and technological advancement will create new job roles for humans that we can’t even imagine yet, so it might be a balancing act, what we lose we gain elsewhere. 


As Ireland continues to navigate the challenges and opportunities presented by the changing healthcare landscape, it is essential for healthcare organizations to adopt a proactive and strategic approach to workforce planning. To quote a strategist - “Motivate the right people, in the right way, at the right time”. 






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