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With a skills, values and behaviour framework due from Health Education England (HEE) and a 15-year government strategy for the NHS and social care workforce hot on its heels, BSR’s Public Affairs Manager Sarah Berry sketches out what to expect and what this could mean for the crisis in the rheumatology workforce.

There are two key publications coming. First, HEE has committed to publishing Framework 15, which sets out the skills, values and behaviours needed for the future health workforce and, for the first time, the regulated social care workforce. BSR contributed to the consultations on these proposals.

The Department of Health and Social Care asked HEE to look at the key drivers of workforce demand and supply over the longer-term. HEE is to consider how these drivers “may impact upon the required shape of the future workforce to help identify the main strategic choices facing us, develop a shared and explicit set of planning assumptions and identify the actions required at all levels across social care and health using all our system levers.” (HEE, May 2022)

Second, by the end of 2022, the government is expected to publish a 15-year plan for the NHS and Social Care Workforce. The plan will “include a breakdown of the workforce numbers needed, across different specialists”, but publication of these figures requires cross-government departmental agreement.

Public affairs, like medicine, is a constantly changing environment. The events of the last couple of weeks, culminating in a Conservative leadership contest, departing Prime Minister and new Secretary of State for Health and Social Care, will impact these announcements: only time will tell exactly how.

The pivot to party politics until a September leadership election takes focus away from public policy discussions, and there are also unknowns: how the new Secretary of State feels about the framework and workplan and whether this will impact content, funding and publication dates.

So, to the new Secretary of State for Health, what must these plans do to address the crisis in rheumatology?

  1. Our call for more clinicians and healthcare professionals to deliver high-quality, safe and personalised care pre-dates the pandemic. To achieve the fully staffed multidisciplinary teams (MDTs) that evidence shows deliver better care, workforce planning must be backed by a credible level of responsive and flexible investment.
  2. It will take time to address the crisis in the rheumatology workforce and for the long-term benefits of any plan to kick in. As such, clinicians deserve an even greater focus on retention, through more flexible working and learning, with staff feeling that they have a better work/life balance. Short to medium-term approaches will also demand that healthcare professionals are supported to adapt to new ways of delivering care and be enabled to practice at the highest possible level.
  3. Digital developments will help to deliver a more personalised experience closer to home for some. However, it’s not a replacement for qualified, fully staffed teams in every service across the NHS and social care workforce, and will require rapid investment in local infrastructure and digital literacy and skills.
  4. More generalist approaches to medical education and training exist because more people live with co-morbidities, and the NHS must treat greater numbers. However, specialisms have a purpose in diagnosis, care and treatment and it’s important that rheumatology expertise and experience are not lost.
  5. Rheumatology teams must feel fully empowered to take the time and resources to engage with Framework 15, alongside a litany of other new initiatives, programmes and structures being introduced across England. Teams are already understaffed and over-stressed, so it’s vital that systems support MDTs to understand these policies and how to implement them. It’s not yet clear what the Fuller Stocktake review: Next Steps on Integrating Primary Care introducing ‘neighbourhood teams’ might mean for specialist rheumatology teams in relation to patient pathways developed through Best MSK or GIRFT. Too much activity in different areas risks diluting rheumatology’s core focus at a time when we can least afford it.
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