ANALYSIS & COMMENTARY: Lessons From England's Health Care Workforce Redesign: No Quick Fixes

In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce r...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2013-11, Vol.32 (11), p.2025
Main Authors: Bohmer, Richard M J, Imison, Candace
Format: Article
Language:English
Subjects:
Business process reengineering
Costs
Diagnostic tests
Health care
Health care industry
Health services
Hospitals
Learning
Medical personnel
Medical referrals
Modernization
Nurses
Performance management
Physicians
Primary care
Productivity
Professionals
Skills
Studies
Workers
Workforce
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Summary:In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce redesign experience offers important lessons for US policy makers. Redesigning the health care workforce is not a quick fix to control costs or improve the quality of care. A poorly planned redesign can even result in increased costs and decreased quality. Changes in skill mix and role definitions should be preceded by a detailed analysis and redesign of the work performed by health care professionals. New roles and responsibilities must be clearly defined in advance, and teamwork models that include factors common in successful redesigns such as leadership, shared objectives, and training should be promoted. The focus should be on retraining current staff instead of hiring new workers. Finally, any workforce redesign must overcome opposition from professional bodies, individual practitioners, and regulators. England's experience suggests that progress is possible if workforce redesigns are planned carefully and implemented with skill. [PUBLICATION ABSTRACT]
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2013.0553