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A genderqueer person sitting in a hospital gown sitting in an exam room

BY Leo Hynett

Healthcare

Could Improving Patient Flow Solve Healthcare’s Workforce Crisis?

Bottlenecks in patient flow are at the core of the current workforce crisis; addressing them is an essential part of the solution.

JUNE 28  2022

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There is no doubt that the NHS workforce remains at a point of crisis. The pandemic has left staff dealing with burnout, loss, and a high turnover rate among their peers. People may be joining the NHS, but they are also leaving in droves. When considering if the workforce can ever recover, it’s easy to focus on supporting staff that are already struggling without addressing the root causes. To truly combat staffing issues, trusts must strive to build a stable working environment that can adapt to whatever gets thrown its way. A major part of this lies in streamlining flow throughout the patient journey, from their initial referral to their final discharge.

 

Absences and resignations

On January 2nd, when COVID was significantly battering the sector on all fronts, there were 82,384 staff absences. However, less than half (39,142) of those were due to Covid-19 sickness or isolation. A significant portion of non-covid absences were due to the pressures of the job.

With so many of their colleagues off sick, the remaining staff have found themselves battling an ever-increasing workload and mounting stress. The more staff are absent, the more this issue compounds; staff ‘find themselves spread thinner and thinner, but they can’t keep spinning plates indefinitely either,’ commented The Royal College of Nursing’s director for England, Patricia Marquis.

Many staff are not simply taking time off, they’re leaving the workforce altogether; in February, 400 members of staff were leaving the NHS every week.

Staff considering leaving their posts largely attribute this to a stressful and challenging working environment, exacerbated by staffing issues and the constant changes necessitated by the pandemic. While the stresses of Covid are largely unavoidable, better management of wards and patient flow can help reduce stress, thus reducing the attrition rate among staff.

 

Long Covid in the workforce

May 2021 estimates by the Office of National Statistics (ONS) suggested that ‘approximately 122,000 healthcare workers and 31,000 social care workers are self-reporting symptoms of Long COVID’. This staggering figure did not cover the entire NHS – it excluded roles such as agency staff and those working within primary care – and, given the time that has passed since this estimate, the number is likely to be far higher. It is clear that the direct impact of Long Covid on the workforce is substantial, and will have knock-on effects on pandemic recovery at a systemwide level.

Not only are the absences presenting a challenge to patient flow, but long absences are also having an impact on staff capabilities. Staff who are absent for long periods ‘will likely require additional organisational support both while on leave, and when returning to work.’ This means that staff will need time to get caught up to speed, which in turn often necessitates additional support from colleagues whose time could be better spent elsewhere.

As well as HR elements – such as organising a phased return to work – it is crucial that patient flow is strategically managed in order to create a suitable environment for staff to return to, as well as mitigate the impact of their absence. If trusts are able to create a stable environment, not only will it be easier for staff to navigate their return but it should also reduce the stress that causes many absences to begin with.

Creating stable and consistent environments is rarely easy in healthcare environments – the very nature of the job means that it is constantly changing and adapting to suit varied patient needs. It is not necessarily the variability that causes a problem, but the fact that many systems and ways of working are not set up to be adaptable.

While Covid restrictions and major peaks may be behind us, staff will still be off with Covid (or Long Covid) for many more months to come. As such, flow management needs to be reactive and able to adapt to the changing needs of patients, the shifting workforce, and any new ways of working that are introduced.

 

Ever-changing demands

Adjusting old traditional systems to accommodate for sudden absences or changes in working patterns can be a laborious task. This is where customisable systems such as Cambio’s PFM (Patient Flow Manager) truly come into their own. New custom functionality can be created and implemented into PFM environments in a matter of days, giving NHS trusts the agility needed to meet variable demands.

Tailored to the needs of individual specialties, PFM can be easily adapted to fit any changes in work patterns. Even at Antrim Area Hospital where wards were regularly reshuffled during the height of the pandemic, PFM made moving entire wards easy:

​​‘PFM was invaluable in containing the chaos and it gave staff and patients confidence that we knew where people were, who needed to be seen, and where they were with their admission. It was always a little bit of light in the darkness.’

When staff are struggling to stay afloat, that ‘light in the darkness’ can go a very long way. Without PFM, staff were being pulled in every direction, wasting valuable time and energy chasing down paper notes, and ending up exhausted as a result. With PFM in place, the workload became considerably more manageable. One of Cambio’s users commented there ‘would probably be a mini-revolution from staff if [they] tried to take away the technology now’.

PFM removes the high-intensity pressure often associated with managing patient flow and allows clinicians to spend more time with patients. Not only does this have patient outcome benefits, but it also greatly improves job satisfaction for staff; when they’re free to spend more time with patients, staff can get back to the reasons they joined the health service to begin with.

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