Kate Bleasdale
Executive vice chairman, Healthcare Locums (HCL)
The UK’s growing and ageing population is going to have a massive impact on the way healthcare staffing is managed and the issues should be raised sooner rather than later

Nineteen years ago I wrote my Master’s thesis on what I and others call the UK’s ‘demographic timebomb’ - the effects that a growing and ageing population would have on the workforce, and on healthcare staffing in particular. An obscure subject at the time, it’s suddenly the political and media hot topic of the day, and it’s going to have a massive impact on the health service, the workforce and the way we staffing specialists go about our business.

As people live longer, and more and more come to the UK to live and work, the population is set to explode from 60m at present to 65m by 2016. By 2011, 12.2m of those people will be pensioners.

In fact, the number of pensioners now outnumbers the number of under-16s in the UK - and there are just four people in work for every pensioner.

Older population
It’s not hard to foresee the effects this will have on staffing companies - more people means more demand for healthcare professionals, with an older population typically needing more frequent care and more long-term care.

At the same time, as healthcare solutions become more technical, the need for increasing numbers of highly specialised niche staff will continue to grow.

At present, there are simply not enough school leavers entering the caring professions. More than 200,000 nurses will reach retirement age in the next decade, with not enough replacing them.

Among doctors, a new EU Working Time Directive imposes less than used to be the case, particularly for junior doctors. And it’s estimated
that female doctors will be in the majority by 2011 - women tend to prefer flexible or part-time hours, and on average work 10 hours less per week than their male colleagues.

All these changes mean that we are moving towards a culture of flexible and temporary working as demand for healthcare workers grows.
And that trend isn’t confined to the UK. The World Health Organisation estimates that there are 4m vacancies for healthcare staff worldwide.

More people means more demand for healthcare professionals, with an older population typically needing more frequent care and more long-term care

US growth
In the US, President Obama is pushing through a $615bn (£375bn) plan to extend healthcare cover to nearly all US citizens. It’s estimated that 1.2m new nurses will be required to register in the US by 2014 (Source: US Department of Human and Health Services study, 2007).

In fact, healthcare staffing is projected to be the fastest growing section of the US labour market, in a report published by the President’s Council of Economic Advisers in July.

The healthcare staffing sector must embrace these demographic factors, and develop strategies designed to meet the rocketing demand for health and social care professionals internationally.

Most hospital managers accept that they need to get the right balance between permanent and flexible staff in their workforce - about 85% permanent to 15% flexible is the optimum - so they can staff up and staff down to quickly meet changing demand. Reaching this balance will lessen the NHS’s pensions burden, reduce costs for the taxpayer and deliver excellent patient care.

Globalised workforce
We also need to take a global approach. Healthcare workers are increasingly a globalised workforce, with the uniquely transferable skills to work wherever they want. Indeed, the governments of some countries such as the Philippines and Nepal, where there is a surplus of certain types of healthcare professional, encourage people to spend some time working abroad through controlled migration programmes.

These benefit the professionals, who receive new training and career development opportunities, and the source country, whose GDP is boosted by the money that the workers send home. These professionals also bring their new skills back home with them.

So what is the future of healthcare staffing? An increased emphasis on flexible, global recruitment, and it will be the companies which already have networks and relationships in place, that will be the most in demand.

It’s a vast market, and we are only just scratching the surface.

power points

• The UK population is expected to grow to 65m by 2016
• By 2011, 12.2m people in the UK will be pensioners
• 48 hours: the legal maximum working week for junior doctors since 1 August 2009
• A third of the UK nursing workforce is due to retire in the next decade
• Around 4m vacancies exist worldwide for healthcare staff
• 1.2m new nurses needed in the US by 2014