Ambitious plans to overhaul NI health system

The Department of Health has unveiled its new strategy - aimed at addressing serious problems among the medical workforce.

The "Health and Wellbeing 2026 – Delivering Together" report, is the outworking of the recommendations of the Expert Panel on transforming health and social care, chaired by Professor Rafael Bengoa.

It acknowledges that our health and social care services were designed to meet the needs of the 20th century population, and therefore transformation is essential if they are to meet the challenges of the future.

It says the system at the moment would need a 6% budget increase every year - just to stand still.

The Department of Health strategy's launch came as it was confirmed how £15 million of a £100 million pot already allocated for health service transformation in 2018/19 will be spent.

Around £5 million will be directed towards the nursing, midwifery and Allied Health Professional workforce.

This will include funding for 74 additional pre-registration nursing places, and 25 additional midwifery places, meaning a total of 1000 nursing and midwifery training places are being commissioned from universities in 2018/19 - a total the department said represents an all-time high in Northern Ireland.

The transformation funding will also support other training investment in nursing, midwifery, nursing assistants, physiotherapy, radiography, paramedics and medical specialties.

Department of Health permanent secretary Richard Pengelly said: "Health and social care colleagues work tirelessly to provide the care needed by patients and other service users.

"The system could not run without the skill, dedication and commitment of our talented, hard-working colleagues, across all disciplines, professions and levels.

"We therefore owe it to them, and to the people of Northern Ireland, to address the workforce issues that need to be fixed. And we need to ensure that we aren't just fixing the problems from 2006 or 2016. We need to look forward to 2026.

"The investment announced today is certainly welcome and will make an important difference. The workforce challenges are certainly not unique to Northern Ireland and resolving them is a long-term task, inextricably linked to the need to transform the way we deliver services.''

More than 122,000 people work in health and social care in Northern Ireland, including the public, private and voluntary sectors. Around £2.3 billion a year is spent employing those who work in the public sector.

Key targets outlined in the 2026 strategy include:

• Explore and establish non-salary incentive programmes as a means of recruiting and/or retaining people and/or dealing with pressures in less popular specialties and locations.

• Set up and roll out a regional health and social care careers service targeted at the existing workforce, young people from the age of 14, and possible returners to service.

• Develop and integrate new ways of working and jobs across health and social care, and fund sustainable training and development programmes that meet service needs.

• Adopt and roll out new regional staff health and wellbeing policy and invest more in occupational health services

• Co-produce a regional work-life balance policy for health and social care workers.

• Simplify employment arrangements, including examining whether a single employer for all HSC staff is feasible and will produce benefits for staff/patients/ clients.

Mr Pengelly added: "This strategy recognises that we need to meet the challenge of making the Northern Ireland health and social care sector an employer of choice, by ensuring that the service is fully staffed, well-trained, and that workers can balance their work around the other commitments in their lives.

This is much easier said than done, but there is no alternative other than to ensure that we address these issues so that by 2026, we have the health and social care service that meets all of our needs.''

The Department of Health’s Workforce Strategy, BMA Northern Ireland Council chair Dr John D Woods says it's an important step in the right direction which will help address serious problems among the medical workforce:

“Without the appropriate numbers of staff working in the right environment, who are supported and resourced to do their jobs properly, we cannot have the health service we all aspire to.

“The plans to develop multidisciplinary teams, address staff health and well-being and improve occupational health are welcome but it needs to be coupled with a reduction in waiting lists, pay parity and more staff on the ground.

“Doctors are looking for increased flexibility in their working lives. They have transportable skills and we need to offer staff the right mix of opportunities and remuneration to make sure they want to stay in the NHS.

“We particularly welcome the work the Department is committed to in relation to having a single lead employer for doctors in training. The current system where junior doctors change employer every six months is inefficient, with doctors having to repeat mandatory training and the process of signing on to a new employer.

“A single lead employer will save both time and money, meaning junior doctors have more time to spend with patients.

“We also welcome the planned work on addressing the lack of proper rest facilities and access to nutritious food throughout the week and at night."

• Department of Health
• the health and wellbeing 2026 – delivering together