Resource allocation in NHS secondary care is a growing concern, with issues like under-resourcing, service delays, and difficulty in prioritising patient care placing immense pressure on healthcare professionals. The ability of clinicians to work at the “top of license,” coupled with innovative approaches like remote working, can offer partial solutions. However, without strategic workforce planning and strong leadership, secondary care risks continuing down an unsustainable path.
The Workforce Planning Dilemma
A primary pain point for secondary care is the persistent challenge of overworked staff due to under-resourcing. The lack of an adequate, well-distributed workforce not only contributes to burnout but also affects the overall quality of care. This issue is exacerbated by delays in service provision, which frustrate both patients and staff. These delays often occur due to insufficient numbers of trained professionals, particularly in specialties like radiology, where demand for services is rapidly increasing.
Workforce planning remains critical, yet it frequently falls short of addressing these systemic issues. Long-standing vacancies, inadequate training opportunities, and the unpredictable nature of patient demand create barriers that compromise timely care. When resources are stretched thin, difficulty in prioritising patient care becomes unavoidable, further burdening healthcare workers and delaying essential services.
Working at the “Top of License”
A promising approach to alleviate resource constraints is enabling clinicians to work at the “top of license.” This concept involves ensuring that every member of the care team—from nurses to consultants—focuses on the tasks that fully utilise their expertise. Currently, many healthcare professionals spend time on administrative tasks or activities that could be handled by support staff, pulling them away from their core clinical duties.
For instance, nurses are often called on to manage tasks that detract from their ability to deliver direct patient care. With appropriate support, administrative responsibilities could be delegated, allowing nurses to focus on more critical aspects of care. Similarly, consultants could be more effective if they were relieved of repetitive, non-clinical duties, thereby improving both patient outcomes and staff morale.
Remote Reporting and Remote Working
Innovations like remote working and remote reporting hold significant potential for addressing resource allocation challenges in secondary care. Remote reporting, especially in radiology, allows specialists to work offsite, enhancing their flexibility and optimising time management. This not only increases productivity but also accelerates diagnostic processes, reducing waiting times for patients.
The introduction of remote working, however, requires investment in technology, infrastructure, and proper training to ensure seamless integration into existing workflows. Furthermore, leadership must prioritise creating a culture of accountability, where clinicians feel empowered to work remotely without sacrificing care quality. The successful implementation of these models depends on clear policies, data security measures, and a strong commitment to team communication.
The Role of Leadership and Process Improvement
Leadership plays a vital role in navigating the complexities of resource allocation. Leaders in secondary care must develop forward-thinking strategies that address both immediate and future needs. This includes supporting staff to work more efficiently, advocating for flexible working arrangements, and focusing on workforce planning that is responsive to the demands of the modern healthcare landscape.
Additionally, process improvement methodologies like Lean and Six Sigma can help identify bottlenecks, streamline workflows, and ensure that resources are used effectively. These methods not only improve operational efficiency but also empower healthcare workers to actively participate in enhancing their work environments.
References:
British Medical Association. (2023). Workforce shortages in the NHS: A health system under pressure. Retrieved from https://www.bma.org.uk
The Royal College of Radiologists. (2023). The radiology workforce crisis. Retrieved from https://www.rcr.ac.uk
NHS England. (2023). Working at the top of license in NHS care. Retrieved from https://www.england.nhs.uk
