Health and Social Care Committee (Wales) call for evidence on workforce strategy - consultation response

In September 2021, we responded to this consultation to provide our views on the workforce strategy. We welcomed the strategy and its implementation with other priorities and actions. We highlighted the need for the delivery of the strategy to align with the Welsh Government's plans for population health, so that health services are supported to embed and role-model healthy behaviours.

Our response

We highlighted that pre-pandemic, we had published a Workforce census: spotlight on Wales, which drew upon the most accurate and up to date data available to us in 2019 to present a picture of the paediatric workforce and made recommendations specific to Wales. A lot has changed but the issues identified, and recommendations made remain relevant. 

Following this we published a snapshot of general paediatric services and workforce in the UK – a study about general paediatric services and workforce conducted in September 2019, prior to the COVID19 pandemic. The results reveal a stretched general paediatric service, with a great deal of variation in services across the UK.

We have since published Impact of COVID-19 on child health services between December 2020 and February 2021, which shows findings from child health services across the UK about the impact of the COVID-19 pandemic, from the end of November 2020 to the end of February 2021.[consider updating this text, as duplicates title!]

Earlier in 2021, we also published Paediatrics 2040, which presented a vision for the future of paediatrics in the UK focusing on four areas - data, innovation, models of care and working lives.

Our recommendations

  • We felt it was important to know what progress had been made on the health and wellbeing of the health and social care workforce; and how the delivery of the strategy aligned with those other Welsh Government strategies, including the vision set out in A Healthier Wales which of course includes “improved population health and wellbeing” as one part of the ‘quadruple aim’.
  • The consultation set out the need for better workforce modelling based on robust data which we had highlighted previously. We felt it would be useful to understand how much progress had been made here and whether workforce planning could be informed by up-to-date and reliable data. In particular, we wanted to understand whether modelling and workforce planning in health services would be based on widely accepted and recognised standards developed by medical Royal Colleges and others, which set out models for safe services.
  • In terms of the mechanisms, indicators and data that would be used to measure progress in implementing the workforce strategy and evaluate its effectiveness we felt it would be helpful to know how these changes to service models would be evaluated; and how we would know if the necessary capacity building and development of skills across services, such as our call for developing primary care capability in child health, are being successfully implemented.
  • The consultation asked the extent to which the strategy and its implementation were inclusive and reflected the needs/contribution of the whole workforce. We welcomed the flexibility such as working less than full time, however, it raised questions around paediatric trainee full-time-equivalent numbers and ensuring that the number of training places available was designed to respond to those changes. We felt it would be helpful to take this opportunity to explore how the strategy would respond to these issues. We consider the Specialty, Associate Specialist and Staff Grade (SAS) doctor group as an important part of the workforce who need support to avoid this trend becoming reality. Again, we said it would be helpful to understand how the strategy would support this.
  • We have identified that there are also concerning trends ahead for community paediatricians, whose numbers are forecast to decrease proportionally, based on the last ten years of trends. Community paediatricians are part of and often lead the multidisciplinary teams responsible for diagnosis and support within ND services. It would therefore be reassuring to know that this review is feeding into implementation of HEIW’s strategy as it applies to workforce modelling and design. 
  • We also suggested that it would be beneficial for the strategy to consider how it informed and interacted with plans for recovery within the health and social care workforce from the Covid pandemic with the huge additional pressures this has brought upon the Welsh NHS.