Workforce planning

Transcript

Introduction

Welcome back to Neighborhood Health Conversations, the space where we explore how health and care can feel more human, more connected, and more grounded in the realities of people’s lives. Today, I want to talk about something that might sound a bit technical, but it’s actually one of the most human things we can talk about in healthcare.

Workforce planning. Yes, I know it doesn’t immediately warm the heart of everyone, but when we approach workforce planning through the lens of neighbourhood health, I think potentially it becomes one of the most powerful tools we have to help people live better, more confident lives.

What’s Wrong With Traditional Workforce Planning

Most traditional workforce planning starts with the same question. How many staff of each type do we need? GPs, nurses, physios, pharmacists, etc. etc, etc. But this is a bit like trying to cast a play before you’ve read the script. How can we possibly know who we need in the team if we haven’t agreed the story we’re trying to tell for the neighbourhood? If we haven’t understood the lives people want to live, the challenges they face, or what really matters to them.

Starting With People, Not Roles

Neighbourhood health planning should turn this around. The starting point isn’t the workforce, it’s the people, those living with real needs in real places, with real aspirations for their lives. Only when we understand that can we design models of support and care that might actually work. And only then can we sensibly ask, okay, who do we need on the team to make this happen?

At the heart of this is co-design. It’s the simple idea that the people who live with a need should help design the support they receive alongside the professionals who deliver it.

When you do this well, a few things become very clear very quickly. Many of the things that help people stay well are not traditional clinical tasks. The skills that matter most, listening, confidence building, goal setting, navigating housing or benefits, reducing loneliness, are often spread across many people and roles. And the best workforce plans are built around skills, not job titles.

Designing Care With, Not For, People

I appreciate this might all sound a bit abstract, so let me take you back to where this first came alive for me. Some years ago, when I was working at the Western Grove Partnership in Buckinghamshire, we were experiencing what many practices see. More older people living with frailty, dipping in and out of crisis, and feeling that life had become harder than it needed to be. It was clear that the traditional model, the GP review, the district nurse visit, the medication adjustment, although important, wasn’t enough.

We were treating the flare-ups, but not changing the conditions that were leading to them. This was when Dr. Pippa Morton stepped forward to lead what became known initially as the Western Project. What made it special wasn’t a particular tool or protocol. It was a different starting question. What would good look like for you?

We brought older residents, families and carers together with GPs, nurses, receptionists, social care colleagues and voluntary sector partners, not to design the support and care they needed for them, but to design it with them.

Building the Team Around What Matters

The residents told us what mattered, confidence in walking, going out, socialising, continuity, someone who knew their story, practical support, warmth, transport, finances, meals and safety, fewer crises, less chaos, fewer urgent peaks and troughs. None of these fits neatly into a single professional boundary. It didn’t describe a GP role or a nurse role or a social work role. It described a set of skills that would require a team.

And based on the required skill set, we created a team from a frailty nurse with a holistic approach to needs assessment and care planning, core nursing skills, a GP with core biomedical skills and protected time for continuity, a healthcare assistant who could support people with improved mobility and nutrition, a receptionist who kept things running smoothly, knew everyone by name and noticed early wobbliness, volunteers who could run walking groups or lunch clubs, a benefits advisor and most importantly, the residents themselves setting their own goals.

Impact and Evolution

The impact was soon clearly visible. People felt safer, they felt more confident, crises reduced, families felt supported and the team felt renewed. Not because we were working harder, but because we were working in a way that made more sense.

One of the things that I loved about the Western project is that it kept evolving. Today at Western Grove it lives on as the complex care team, still doing proactive, relational, whole-person care, but with a richer skill mix encompassing prevention matters, social care, more of the voluntary sector and carer support. And that’s exactly how neighbourhood teams should evolve.

They rarely start fully formed. They begin with whoever is already rooted in the community. The GP, the district nurse, the receptionist who knows everybody, social care, voluntary sector. And over time, as the model matures and skills deepen, the team should evolve to become what the neighbourhood needs it to be. And that evolution is not a luxury, it is the work.

Four Reflections on Workforce Planning

So what does all this mean for how we think about neighbourhoods workforce planning? I think it probably comes down to four things. The first is that we should start with the lives people want to live. Not with diagnosis, not with utilisation data, but with lived experience. The second is we should co-design the model with residents and frontline staff.

This reveals what actually helps and much of it sits outside traditional medical roles. The third is to identify the skills needed and build the team around that rather than simply job titles. The starting point will invariably be those who are currently working in the neighbourhood, but it is of critical importance to enable the team to evolve to best meet what really matters to people. And finally, equip the team to work as a real team.

Workforce Planning as an Act of Humanity

A workforce plan only works when people stay anchored to what matters to residents, trust each other and work together to share risk and reflect on their strengths and the opportunity for continuous improvement.

If a multidisciplinary meeting is where professionals share updates, then a neighbourhood team is where people share purpose. Workforce planning is an exercise in humanity. It asks how do people here want to live? What support do they really need? Who has the skills or could develop them to help make that possible? And how do we bring these people together so they can make a difference every single day? When we start with the lives people want to lead, everything else, the skills, the training, the team, even the joy, everything else flows from there.

Conclusion

Thanks for listening to the Neighbourhood Health Conversations. If today’s episode has sparked ideas, especially if you are planning changes to your workforce, please share it with your colleagues, your team and your communities.And join us next time as we continue to explore how health and care can feel more human, more connected and more grounded in the realities of people’s lives.