Almost everywhere we look in healthcare we find workforce challenges, whether it is lack of supply or burnout (or both, especially during Covid) and it doesn’t matter whether we are talking public or for-profit. Incentivisation is one answer to attracting and retaining staff – usually more than just money is required. But the best solution is one that could be easily put in place if parts of the workforce didn’t stand in its own way.
The solution is not a secret. It’s not a complex theory. You “simply” need to empower and train existing workforce to balance necessity of tasks. Giving optometrists, dental hygienists, nurses or technicians more responsibilities, of course where clinically appropriate and commensurate with ability and requisite training – actually trusting them with that responsibility, frees up the clinicians and doctors to focus on the advanced procedures.
It does happen successfully, but only in pockets. In the UK, fertility nurses can deliver the whole cycle. With the introduction of nurse practitioners in primary care in the UK, patients could see a prescribing nurse over a doctor for more simplistic diagnoses and crucially prescription. Training receptionists or assistants as phlebotomists in some practices has already enabled them to offer an in clinic service to urgent or elderly patients that are unable to travel.
The same is true of optometrists who have the ability to perform tests and have strict referral guidelines, in some countries they can even prescribe. So why isn’t this more widespread? Because when faced with this solution, many doctors and clinicians become protectionist over their roles. Recent proposed changes in ophthalmology, giving greater prescribing power to optometrists in France, was met with outrage from ophthalmologists despite waiting lists in some areas running in excess of a year. But is this really about safety, or self protection?
Is the only answer for governments or training establishments to change how they do things? Are the unions unable to see that they are standing in their own way? Not only would empowering less-skilled staff reduce pressure on clinicians, but it also means the nurses, and technicians, and practice managers will feel trusted and feel value in the job they do. Done properly this surely looks to be win – win.We would welcome your thoughts on this story. Email your views to Kirsty Withams or call 0207 183 3779.