What can the public sector learn from start-up culture?

First published on PublicTechnology.net on the 10th of October, 2019 by Dr Anas Nader, NHS doctor and Founder/CEO of Patchwork.

A mini-golf course in the office. Fridges overflowing with free drinks. The incessant need to make every noun a verb.

There’s a fair amount that can be ridiculed in start-up land. However, it would be foolish to downplay the revolution occurring before our eyes. Last year a record 660,000 new companies were registered in the UK, with a 14% increase in the number of tech start-ups. And with WeWork and the co-work movement snapping up prime real estate across the UK, start-up culture is quite literally changing the map.

But it’s not just the physical landscape that’s feeling the start-up effect.

Employee benefits like unlimited holiday, working from home, and free mental health support are increasingly commonplace. Many in the start-up world realised that a company’s best resource is its people and have set out to protect this.

Promoting employees’ wellbeing is a business boon twice over: stopping talent loss to competitors and boosting individual productivity. This knowledge is now transforming every sphere in our economy.

Well, almost every sphere.

Whilst start-up influence is shifting how we do business across multiple areas, the public sector has been left behind. This comes at a time when the it is facing crisis.

Sky-high churn rates, low morale, and dwindling resources are putting staff under huge amounts of pressure. And whilst their counterparts in the private sector are taking advantage of flexible hours, work-from-home policies, and the latest software, our public servants are operating in workplaces stuck in the past.

That the public sector workforce is under strain isn’t a particularly new diagnosis.

Take NHS staff, for instance.

We’re used to seeing a regular stream of reports about doctors and nurses stretched to breaking point and numbers dropping from the payroll. This year charity the Health Foundation found that the number of personnel leaving due to poor work-life balance has almost trebled in the past seven years. While we can all agree that is a hugely worrying trend, not enough action is being taken to innovate within these workplaces and make them healthier places to be.

So, what would a start-up-inspired HR revolution of the public sector entail?

No-one is advocating for a surgeon to have access to free beers as soon as the clock hits 4pm, but one way the public sector can empower its workforce and reap the benefits is through greater attention to professional development.

Working in a start-up is fulfilling as you get to work at the coal face of a business and see your actions have a tangible effect. By contrast, the bureaucracy of the public sector can quickly lead to apathy and disillusionment.

Whilst standardised procedures are of course important in sensitive public work, this does not mean that we cannot streamline processes to free employees from superfluous paperwork or entangling procedures.

Helpful contributions
Helping individuals make contributions to their field – allowing teachers to trial new learning methods or supporting doctors to make tomorrow’s health tools – is another way to learn from start-up culture. Encouraging innovation empowers employees, whilst harnessing their first-hand experience to enact real, lasting change.

Finally, the public sector would do well to learn from start-up culture’s visible appreciation of its employees and team atmosphere.

It’s easy to stereotype this as branded T-shirts and prosecco on Wednesdays, but this culture of appreciation goes deeper. For all its flaws – which every industry have – start-ups cannot continue without a common mission, shared values and strong team relationships.

Employee appreciation and bonding are crucial in reinforcing these and this is a lesson the public sector must learn as it seeks to build a happier, healthier, more cohesive workforce. Individual departments and workplaces should consider implementing a system of employee rewards and benefits, from simple team lunches to physical recognition of great company work.

Public sector workers can often feel taken for granted and this can start to erode the passion for their institutions in which they work.

The modern workforce is evolving at a rapid pace. To ensure we turn this change into real progress, innovation must be allowed to thrive in every sector.

Start-up culture was born in the private sphere, but it would be a disservice to our brilliant public sector to contain its benefits and stymie the impact such lessons could have on the wider world of work.

As Brexit looms, the NHS desperately needs staff to stay and that means fixing burnout culture

The NHS is preparing for Brexit by stockpiling medicines – but it needs to retain staff too

Stockpiling used to evoke visions of Doomsday preppers or governments on the brink of war. But stockpiling is an idea that now sits squarely in the reality of 2019.

Our NHS, where I’ve worked as an A&E doctor for Chelsea and Westminster Trust since 2014, is hoarding supplies in case of a no-deal Brexit it was revealed last week. NHS Wales, for example, is storing £5m of medical products and food in a secret warehouse.

This news broke at the same time as the Government’s announcement of a ban on certain drug exports, something that’s needed to protect our access to key medicines in the near future. Although ministers rejected the ban’s link to Brexit, the timing seems undeniable.

If the NHS is serious about Brexit preparations, however, there’s a critical omission on its list. Hidden hangars of syringes are one thing but we seem to have forgotten about the hands who’ll wield them. As 31 October looms the NHS can’t just be protecting its provisions – it needs to start stockpiling staff.

‘Tears are not uncommon’

Brexit is placing additional pressures on every sector that relies on international workers and the NHS is no exception. Some 65,000 of NHS England’s staff are EU nationals, including almost one in ten doctors: government research found that while the percentage of EU doctors and nurses grew between 2009 and 2016, that number has fallen since the referendum.

The fact is, the NHS was already suffering from chronic staffing issues – Brexit has simply accelerated the issue. A 2018 report by the King’s Fund, the Health Foundation and the Nuffield Trust found that NHS staff shortages currently stand at over 100,000, with the figure set to reach 250,000 in just over ten years as we grapple with the demands of an ageing population.

Desperately scrabbling to fill empty rotas, NHS Trusts are increasingly forced to turn to expensive recruitment agencies for locum (temporary) workers to maintain safe staffing on hospital wards: last year Trusts were forecasting spending £5.6 billion in the 2018-19 financial year on this kind of cover alone.

There are simply not enough clinical staff to go around – and while it’s easy to become inured by headline stats, as a doctor I’ve witnessed first hand what these numbers mean in practice.

I’ve watched patients wait for hours on end because my team are rushing to a never-ending string of emergencies. I’ve seen nurses work eleven-hour shifts without a single break. Tears are not uncommon on hospital wards, and not just from the patients. Despite the sheer levels of effort contributed by our hard-working NHS teams, there simply aren’t enough of us.

Keeping staff

So how do we start amassing medics? You can’t lock the hospital doors to stop the rising number of doctors and nurses seeking better work/life balance from leaving. Yet we do need action that’s as decisive as the medicine stockpiling efforts.

For too long the wellbeing of NHS workers has taken a backseat and that’s partly why the staff shortfall developed in the first place. Burnout culture is pushing people past breaking point. This has led to appalling staff retention rates and doctors turning their backs on the profession for good.

If we want to halt this mass exodus we need to be making staff welfare a priority. With Brexit confusion and freedom of movement restrictions putting additional numbers of NHS staff in a difficult position, we literally and figuratively can’t afford to see clinicians walking out the door because of burnout too.

There are a number of ways this can be done. Evolving rotas and shift patterns so they are less punishing on staff is crucial, as is giving medics more control over their working hours – rather than a hard choice between full-time or locum work.

We must focus on empowering clinicians to work flexibly within their hospitals and the wider NHS to cut down on locum agency costs (something I’ve been working on through developing a clinical staffing, platform Patchwork, in collaboration with the NHS), and normalising flexible working practices across all levels of clinical work. Flexible working – in the way other sectors understand it – is still a pretty unheard of concept to the NHS.

Workplace revolution

Most clinicians receive their rotas 12 weeks in advance, making it very hard to plan holidays or special occasions, with opportunities to swap or rearrange nights, lates and weekend shifts almost impossible.

As NHS staff see a workplace revolution occurring in other industries – from new approaches to working hours to employee wellbeing taking on new precedence –  they are becoming all the more aware of the rigidity of the systems in which they work.

We also need to rethink the way we bring in newly qualified doctors to stop fresh graduates from burning out right at the start of their medical career. The appalling statistic is that more than half of junior doctors either temporarily or permanently put a halt to their training once they have finished their first two years in full-time practice, following graduation (known as their F1 and F2 years).

It’s an immense waste in all respects to see this loss of talent and disruption to progression.

Finally, as with any organisation, we should be integrating all levels of staff into the decision-making process so they don’t feel disempowered by a system that seems designed to push them past their limits.

Whilst Brexit is adding pressure, the NHS was already at a critical juncture when it comes to staffing. This is the moment when change must be embraced, welfare of clinicians put first, and a culture of burnout brought to a permanent end.

 

NHS pensions are the tip of the iceberg. How can we stop the snowballing staffing crisis?

In recent weeks, the NHS offered extra money to doctors in an attempt to stave off the current pensions crisis. New tax rules mean doctors and consultants are taxed heavily above the £110,000 threshold, including on their pension contributions. This has seen many cut back on overtime to avoid incurring the higher rates: the BMA found 42% GPs and 30% of consultants have cut their hours because of the new pensions rules. As such, doctors have been offered the chance to opt out of their NHS pension and be given the equivalent employer contribution directly from them. It’s a temporary solution to an entrenched problem and, when it comes to NHS staffing issues, it’s the tip of the iceberg.

This pension crisis is the result of a unique set of factors but it would be a grave mistake to dismiss it as an isolated flare-up. The chaos is symptomatic of deeper issues within the NHS. As the NHS and Government work to resolve its current pension problem, they are still left with the significant resource gaps created by staff resigning in their droves. Scores of clinicians are dropping from the NHS as understaffing, shrinking resources and gruelling shift patterns push them to breaking point. The number of staff quitting over long hours has tripled in six years, further exacerbating the stresses for those who remain.

Of course, these staffing gaps have a direct impact on patient care. This year the Nuffield Trust found that over half of consultants in hospitals and two-thirds of junior doctors said there were ‘frequently’ or ‘often’ gaps in hospital medical cover, which raised significant patient safety issues. We don’t just have regular winter crises to deal with – the emergency is year-round. And no organisation, in any sector, should be relying on its staff working overtime or paying dramatically over the odds for emergency cover to make ends meet.

The frustrating thing is that it doesn’t have to be this way. We’ve become accustomed to headlines detailing NHS woes, but the status quo needn’t be the hallmark of the future. There’s nothing wrong with the original vision of free care at the point of need, nor the staff who give their all to carry it out. They’re doing their best in extreme circumstances and making the most of the tools they’ve been handed.

What does need to change is our approach to delivery. As this pension case shows, waiting for a response to come from the top takes time and there’s no guarantee the solution will be effective. That’s why NHS Trusts have taken the matter into their own hands to offer cash incentives. Whilst there’s no doubt the government has a critical role to play in the future of the NHS, if we want to tackle the staff crisis we also need to work from the ground up. It’s Trusts and the clinicians they employ who have the understanding needed to guide real change. Who better to find the answer than those who wrestle with these questions every day?

There are many steps we should be taking to address the NHS staff crisis. We need to treat doctors as people, not medical robots; giving them the control over their hours and introducing the flexible working options which other sectors enjoy. Allowing grass-roots staff to have a greater say in NHS strategy will also help heal the disconnect between clinicians and management. Then there’s work to be done in reforming the burnout conditions on wards. We need a less gruelling approach to contracts and more options for F1 and F2 medics so that grad doctors don’t quit, exhausted once their second year is done. And we need to look at the systems NHS staff are using and ask ourselves whether they are fit for purpose. Making tools and processes more efficient has a direct impact on patient care as well as staff wellbeing and NHS budgets. In short, we can’t stick to the status quo. We need a new approach, and fast.

The NHS staffing crisis is multi-faceted and as such there’s not a single, catch-all solution that will instantly make it go away. Yet that doesn’t mean we have to give up hope, or that real, radical change isn’t possible. We’re seeing more and more clinicians empowered to craft the tools to help tackle it and I’m inspired by the innovation emerging in this space. If the government is serious about stopping this crisis in its tracks it needs to see doctors as the solution – not the problem.

Patchwork and Allocate team up to deliver interoperability for NHS staffing

Press Release, 19th August 2019 – Two workforce software innovators – Allocate Software and Patchwork – have announced a partnership to provide interoperability between their two solutions. Patchwork’s specialist temporary staffing technology will now integrate with Allocate’s HealthMedics rostering solution, helping healthcare providers staff their wards more effectively whilst reducing agency spend.

The collaboration offers healthcare organisations choice. Combined Patchwork and Allocate customers can access connected workforce management systems for doctors, automate a wide range of recruitment and staffing tasks, remove double-data entry, and safeguard the quality of shift bookings to ensure that safety rules are adhered to at all times. This will enable administrative teams to minimise time spent on repetitive tasks and offer a safer, more efficient experience for clinicians.

This new partnership is part of Allocate’s Connect partner programme, designed to boost the interoperability of workforce systems in the health and care sectors globally. Connect is the first of its kind to bring together technology providers to tackle this issue.

For Patchwork, this collaboration forms part of their mission to offer fit-for-purpose technologies to NHS Trusts, helping them save millions in staffing fees and enabling clinicians to access shifts in a flexible, responsive way.

Nick Wilson, CEO at Allocate Software, comments:

“Our vision is to be a platform of choice for forward-thinking, people-focused organisations. Our technology provides the backbone to enable innovation from like-minded technology companies that share our values, such as Patchwork.  Working in partnership with cutting-edge companies, we will deliver this much-needed interoperability, which is central to our goals at Allocate.

By partnering with Patchwork, we are addressing the appetite of healthcare organisations looking for choice and we look forward to the exciting results we will achieve together. Allocate Connect proactively supports calls for greater interoperability – critical to safeguarding the safety and efficiency of the healthcare sector – by creating an ecosystem of innovative technology partners that celebrate close supportable interfaces as we do.”

Tom Simons, Director of Workforce and People, Chelsea and Westminster, comments:

“I am absolutely thrilled that Allocate is partnering with Patchwork – an exciting and innovative temporary staffing solution that is revolutionising flexible working in the NHS.  The partnership is a huge step forward for Trusts who want interoperable systems and streamlined, safe staffing solutions, and we very much look forward to working with both software providers.”

Anas Nader, CEO at Patchwork comments:

“Our team at Patchwork is on a mission to revolutionise temporary staffing in healthcare.  By connecting NHS organisations directly with a growing pool of healthcare workers, we’re reducing the reliance on locum agencies and helping organisations achieve three key objectives – save money, free up time and improve patient safety.

We’re delighted to announce our partnership with Allocate, the leading rostering solution for healthcare, which will help further streamline processes for our NHS partners and amplify Patchwork’s efforts to transform what it means to truly work flexibly in the NHS.”

 

Further information

About Allocate Software:

Allocate Software is a leading international provider of workforce and resource planning solutions, supporting the operational and administrative needs of healthcare, defence and maritime sectors. 

In the health and care sector, Allocate is enabling the delivery of safe and effective care at optimal cost, by helping organisations to have the right people in the right place at the right time. With over 800 clients and over a million staff rostered daily, Allocate serves the largest public and private sector institutions around the world. Its Optima, Software-as-a-Service (SaaS), platform including HealthRoster and HealthMedics, optimises the complex staffing requirements of large health and care organisations. Alongside automating sophisticated scheduling and ensuring accurate pay for staff that have complex pay rules, it is unique in providing additional benefits to improve the safety of staffing given changing patient needs, the management of contingent workforce, and the engagement of staff through the dedicated app. Optima is used to plan the working lives of half million staff across all workforce groups including doctors, nurses, therapists, care staff, operational staff and administrators.

Allocate Software is headquartered in the United Kingdom, with over 500 employees, including over 190 in research, development and product management functions. It provides services and support to its international customer base through regional offices in the UK, Sweden, France, Germany and Australia. 

 

About Patchwork

Patchwork is an award-winning solution built by doctors and HR managers, that connects NHS organisations to a growing pool of healthcare workers, reducing the reliance on locum agencies and improving the experience of flexible bank working.

Patchwork’s mission is to completely revolutionise the way temporary staffing is currently managed; helping NHS organisations save money, free up time and improve patient safety.

Firstly, Patchwork helps NHS organisations save money and gain financial control by connecting staff banks directly to healthcare workers without agencies. Secondly, Patchwork frees-up time and reduces stress by automating complex and repetitive tasks. Thirdly, Patchwork improves patient safety by increasing bank fill rates to ensure safe staffing levels with compliant workers.

Patchwork does this all via its mobile app for bank workers, and a cloud-based software for hospital managers. The solution is entirely tailored and flexible to each Trust’s unique challenges, and is implemented by Patchwork’s team of specialist temporary staffing advisors.

Patchwork is built in partnership with Chelsea & Westminster Hospital NHS Foundation Trust. It has been appointed as a Crown Commercial Services supplier for Flexible Resource Pool (RM6158) and is co-owned by the British Medical Journal; reaching over 72,000 doctors every week.

 

Patchwork named supplier on new Crown Commercial Service Staff Bank Framework

Patchwork is hugely proud to announce that after a competitive process, we have now been named a supplier on the new Crown Commercial Service Staff Bank Framework (RM6158 Flexible Resource Pool).

As the first framework agreement released in collaboration between Crown Commercial Service (CCS)* and NHS Procurement in Partnership, Patchwork’s appointment will be focusing on the provision of Staff Bank services to NHS Contracting Authorities.

This announcement comes in addition to our re-appointment on the G-Cloud 11 framework for the 2nd consecutive year – offering our NHS partners a wide range of procurement options.

We are delighted to be given the opportunity to shape a new era in healthcare staffing, in line with NHSi initiatives and the NHS People Plan.

Patchwork will continue to revolutionise flexible working in the NHS – helping NHS organisations save millions by connecting them to an increasing number of flexible bank workers, in order to grow their staff banks, reduce reliance on locum agencies, and improve the experience of flexible working.

We will continue to help save time, money and effort, so that it can be better spent on patient care.

 

* Crown Commercial Service supports the public sector to achieve maximum commercial value when procuring common goods and services, delivering £354 million in commercial benefits including savings for central government, and £247 million for the wider public sector in 2017/18.

To truly help the NHS, healthtech companies must collaborate

First published on DigitalHealthAge.com on the 10th of July, 2019 by Dr Anas Nader, NHS doctor and Founder/CEO of Patchwork.

In May, NHSX announced plans to stop adding new features to their flagship NHS app. Instead, they hope to open the door to further innovation by allowing companies to ‘plug into’ and use their tech. This sets the stage for an interesting next chapter in the evolution of digital health; one marked by collaboration rather than competition.

As the number of healthtech companies have proliferated over recent years, competition between them – whether for NHS contracts or clinical attention – has intensified. A dangerous mentality thus developed; one characterised by a race to scale and a desire to beat off any and all competition. Such a philosophy might be good for the bottom line, but healthtech companies taking this stance are not prioritising the most crucial thing of all; benefit to the NHS and its patients.

The move from NHSX to position its platform as a hub for other innovators is a welcome one. Its new CEO, Matthew Gould, stated his intention to “keep the app thin and let others use the platform that we have created to come up with brilliant features on top”. This mentality will not only foster exciting innovation, but also accelerate a new trend of collaboration emerging amongst the most forward-thinking tech players.

Thanks to announcements such as this and calls from NHS Improvement for greater interoperability between systems, increasing number of digital health companies are starting to view each other as collaborators rather than competitors. We are seeing platforms integrate their services to ensure NHS teams can maximise their benefits.

As most clinicians will tell you, there is creeping (or in some cases, blatant) tech fatigue occurring across NHS wards. Clinicians are in danger of being overloaded with solutions – saturated with new tech to the point when it becomes a burden rather than a bonus. To ensure tech solutions are fit for purpose, we must ensure we stay close to the frontline of healthcare delivery and respond to the direct needs of NHS clinicians and staff. And a core part of this will be opening our minds, (and our business strategies), to partnerships and integrations.

If you provide a temporary staffing solution, ensuring you’re compatible with rostering software or training platforms already in use by that hospital is just good sense. Tech companies must make every effort to simplify processes – from log-ins to interfaces – to ensure they add value to the NHS, not invoke exasperation. If integration with other systems have clear benefits to your end users, then collaboration must be part of your product road map.

It’s inevitable that different players in the same space will continue to maintain a healthy competitiveness. But any healthtech player worth their salt, regardless of size, should put the needs of the NHS at the heart of their strategy. Those who can therefore reach across commercial divides and broker partnerships that will bring the greatest benefit to clinicians, patients and the NHS at large will be those which stand the test of time in a rapidly changing healthcare environment.

NHS’s People Plan: Recognising the importance of work-life balance

Last week, the NHS released an interim People Plan. Following on from the NHS Long Term Plan released in January, the People Plan focuses on the health service’s vision for NHS employees and the immediate action needed to stave off a staffing and culture crisis.

There is a huge amount to be encouraged by in this report. It’s an honest, nuanced look at the challenges currently facing our health service. In recognising that the NHS needs to become an “inclusive and modern employer if we are to attract and retain the people we need”, the institution is taking a big step towards accelerating much-needed modernisation of how it supports its staff.

To see the People Plan acknowledge that “our people want to have more flexible careers and a better work/life balance” is music to my ears, as of course Patchwork’s core purpose is to create tools that help clinical staff achieve greater work-life balance. We enable them to use technology to retain their skills within our hospital wards, whilst also protecting NHS budgets.

As the wider world of work has rapidly evolved, the NHS has been stuck in a time-warp. As clinicians have seen friends and family benefit from an increase in flexible working, and the introduction of technologies to automate mundane tasks and make others easier, NHS teams have been battling decades-old systems and frustrations.

With increasing pressures and, in many cases, decreasing resources, it’s no surprise that sickness absence in the NHS is “2.3 percentage points higher than in the rest of the economy” and that we lose one in eleven staff permanently each year. Staff are doing their best, but as we know, many are reaching breaking point.

The ambition, therefore, to “make the NHS, already the largest employer in England, also the best” is laudable. Putting this at the top of the agenda is long overdue.

As a health tech provider, it’s not surprising that we also agree with the report’s assessment that technology will enable staff “to work to their full potential”. We are strong believers in the impact that carefully designed, empathetic technology can have on the NHS and its people. Money-saving and efficiency are core benefits, naturally, but the impact technology can have on well-being and workplace satisfaction is just as important.

As the report states: “we must put workforce planning at the centre of our overall planning processes”. Without its staff, the NHS wouldn’t exist. All stakeholders must therefore do everything in their power to ensure the ambitions of the People Plan are realised before it’s too late. We must protect, support and retain our clinicians to stem the tide of those leaving.

And, at Patchwork, we’re working hard to play a small part in this most vital of revolutions.

Walk in their shoes: why empathy is the key to unlocking true innovation in healthcare

If you haven’t experienced it, how would you know what it feels like? Dr Anas Nader, NHS doctor and co-founder of Patchwork Health explains why the digital revolution isn’t taking off in the NHS as it should. And offers a simple way to fix the issue

If you read the headlines, you’d be forgiven for thinking that healthtech is being heartily embraced across all levels of the NHS – swooping in to solve its woes. Indeed, the creation of NHSX and the digital mindset of the new Health Secretary have created a culture within the health service which is embracing technology like never before. Yet ask clinicians on the front line what they think of the latest gizmo or system and you’re more likely to get an eye roll rather than evangelism.

The reality is that a lot of the tech and innovation on offer today does stand to make a big impact on the NHS. Where it’s falling down is the approach to implementation. How new offerings are launched and incorporated into our existing system leaves a lot to be desired. Over-stretched clinicians are battling a wave of new initiatives that, in theory, are set to make their lives easier. In reality, they are adding to their daily burden.

Know your user

So how can we ensure clinicians and Trusts truly benefit from these innovations? The answer: empathy.

Whilst empathy might not sound like a natural bed-fellow to cutting edge tech, we must remember that context is everything. A product roll-out at Google HQ will never shakedown in the same way as introducing a new software system to a busy A&E department. The product itself, the way in which it’s introduced, how people are expected to use it; everything must be bespoke for the environment.

And that’s where empathy comes in. If you don’t understand the minutiae of how an NHS ward works, or sympathise with the complex challenges that come with being a clinician, how on earth are you going to create innovation that makes a difference?

We will continue to see new systems or products falling flat (with precious resources wasted along the way) unless we put empathy at the heart of the NHS’ digital strategy. The teams and start-ups behind any healthtech proposition must take the time to explore the unique challenges that come with working in our health service. They must work with frontline staff and truly listen to their needs and priorities. They must look to form partnerships and foster collaboration, rather than seeking to disrupt.

From my own experience when it comes to working within and with the NHS, the presence of empathy has strong bearing in long-term success. Our NHS staffing software, Patchwork, was conceived by following direct experience navigating flexible working within the NHS as junior doctors. And our original roll-out took the form of a public-private partnership with Chelsea and Westminster hospital; empathy with the end users was built into the DNA of the whole initiative.

Less disruption, more humility

In the fast-paced world of tech start-ups, it’s all too easy to lose touch with the realities of your users or customers. But by ‘living’ the problem we were trying to solve, then remaining as close to the ground as possible whilst we built a solution, we retained empathy with frontline staff and management teams. This means we’ve built a product that Trusts need and that NHS staff actually want to use.

While that might sound simplistic, health tech start-ups all too often fail to fully empathise with the institution they are ultimately looking to sell to. The NHS is unique, complex and multi-layered. Its structure is by no means perfect, but it handles a mind-boggling complexity of challenges 24 hours a day, every single day of the year. For the 1.5 million people who make that happen, there is barely a chance to catch their breath in the daily quest to keep the show on the road.

Healthtech start-ups who turn up with a Silicon Valley attitude or disruptive mindset often fail to make the lives of these clinicians easier, despite that being their intention. After decades of failed IT roll-outs and countless ‘innovation’ initiatives abandoned, there’s a deep (and understandable) sense of change fatigue on NHS wards. Those who don’t account for this, or take the time to engage with stakeholders at grassroots level, will flounder when it comes to adoption of their tech. And, when that happens, it’s ultimately Trust budgets and clinicians’ patience which suffer the most.

And that’s why empathy is the key to unlocking truly impactful innovation in the NHS. We must ensure those creating technology for our health service put clinicians, patients and Trusts at the centre of their priorities. Whilst jazzy technology might be eye-catching, the ultimate priority must be engaging the hearts and minds of those who’ll use it.

Why GPs leaving medicine is a symptom of an NHS-wide problem

Figures released by the BBC yesterday show the first sustained fall in GP numbers in the UK for 50 years. As our population increases and ages, the numbers of GPs is declining rapidly. The report makes for depressing reading.

That our NHS staff are under pressure is not news. Headlines about the strain clinicians are under are increasingly common. But what we’re now seeing are tangible statistics on just how many people are leaving the profession, and the impact this is having on patients.

Many of us will be familiar with how hard it can be to secure a GP appointment. They are a scarce commodity, with available slots often weeks away. A smaller number of GPs are having to cope with an increased amount of patients per head, alongside a marked rise in people living with chronic or complex conditions. Lack of access to primary care is pushing people towards overstretched A&E departments. As so the pressures increase across the whole NHS.

Increased Government funding for more primary care providers, including physios, pharmacists and other allied health professionals, is most welcomed. But the problem goes much deeper. And that means more revolutionary, more wholesale solutions are needed before the crisis escalates any further.

Junior doctors thinking about going into GP practice (or indeed any clinical setting) today are faced with relentless rotas, hugely pressurised shifts, and a lack of support from colleagues battling the same pressures.

In our all or nothing clinical culture, medics both new and established are opting for ‘nothing’.

We must start exploring ways to shift the culture within the NHS and change what working as a doctor in today’s health service looks like. We must of course invest in the training and recruitment needed to safely staff wards and GP practices, redressing the grim statistics that today’s report highlights, but we must also change what it means to practice medicine once you’re in post.

CCGs and Trusts must put the health, well-being and job satisfaction of their clinical staff at the very heart of their strategies, with central Government providing the funding needed to make structural changes to how we retain staff.

Then, technology must be championed to streamline these processes and take pressure off clinicians. New systems that dramatically reduce admin, minimise appointment no-shows, and more effectively triage patients will all help. As will educational programmes focusing on healthier lifestyles, those which promote a better understanding of pharmacists and physios, and the role of NHS 111.

There is no silver bullet to solving the NHS’ woes. But we must start with easing the burdens of our hard-working clinicians. Unless we do this, we cannot hope to continue to provide the level of care which patients expect and deserve.

NHS Workforce Statistics-why an increased headcount is both good news and cause for concern

This morning, the NHS released its latest workforce statistics. After last month’s quarterly figures revealed a dire state of affairs – with record numbers of clinical staff leaving citing poor work-life balance – teeth were gritted for more sombre statistics.

But this month’s analysis (relating to the workforce as of January 2019) show a slight upturn in overall staffing numbers. Across England, a 0.6% increase in overall staff was recorded – a total of 7,601 additional people.

This is, in many ways, encouraging. More NHS staff that ever are deciding to leave the profession, finding the pressures untenable. The response of Trusts and NHS England to the staffing crisis has shifted in recent months, with more concerted efforts being taken to recruit and retain clinicians. Hopefully, these latest figures are the beginning of a trend; the additional staff our health service so desperately needs, rather than a statistical blip or knee-jerk reaction to falling staff numbers amongst increased pressures.

Recent reports of hospitals laying on better support for clinicians feeling the pressure, such as yoga sessions, food and drink during night shifts, and mindfulness classes, are also welcome signs of a shift within the NHS when it comes to working culture. Because the more staff we can retain, the better care patients receive and the more money that can be diverted into infrastructure, training and patient care instead of emergency staffing.

Because whilst we must see an increase in clinical staff in order to handle the ever increasing NHS workload, long-term energy must be focused on retention, not gap filling.

We cannot hope to reverse the trend when it comes to retaining staff unless we fundamentally rethink how the NHS acts as an employer. The dichotomy of full time work versus locuming must be dismantled. Introducing accessible options for flexible working by empowering the hospital bank, reducing reliance on agencies, and reviewing our approach to training will all help create a healthier working environment for clinicians and recoup crucial resources currently flooding to agencies.

Every clinician is a vital contributor to the overall success of our health service. An upturn in overall numbers is therefore welcome, but fundamental changes to the foundations of how we recruit, train and retain our clinical staff cannot come soon enough.