Perspectives on pressing healthcare workforce issues

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Through a global prism, KPMG industry experts share their views and how local organizations are taking action

Through a global prism, KPMG industry experts share their views.

In each edition of Healthcare Foresight, we gain perspectives on hot topics affecting the industry through a global prism of international health leaders. In mid-2021, KPMG surveyed healthcare leaders around the world on workforce issues and found the top three most concerning issues keeping healthcare CEOs up at night were the ability to meet demand, the impact of new operating models upon staff, and supporting workforce wellness. With healthcare systems in many jurisdictions currently responding to the impact of the Omicron variant, we wanted to see if these issues were still ringing true, so we asked KPMG healthcare professionals across the global organization about which of these issues was most pressing in their markets and how local providers were taking action.

What’s clear from my discussions with healthcare leaders around the world is that greater and more complex demand is outpacing health system capacity – especially when it comes to people. That refers not only to clinicians but the many staff that are necessary (and will become necessary) to support the needs of the future. The digital age for healthcare has arrived, and in digitizing care, staff shortages have the potential to be alleviated and capabilities uplifted. Two areas that those in the sector need to address to support a digitally enabled future are: one) clinicians need to be technically capable, and two) that healthcare organizations need to expand the types of technically savvy people they hire who are critical to health service delivery.

With regard to the first area, I was intrigued by a discussion I had a few months ago with Professor Dr. Ernst Kuipers, former CEO of Erasmus Medical Center in Rotterdam and current Minister of Health in the Netherlands, about educational approaches to clinicians-in-training. Erasmus Medical Center had a new learning track in partnership with one of the Netherlands’ top technical universities to provide joint medical-and-technical degrees to train clinicians in technology, as well as training technical people to be clinically fluent. This partnership helps to prepare at an early stage the workforce of the future for the digital age.

On the second point, when I led the Dutch Diagnosis Related Group Office, I knew we were in a war for talent. To analyze, measure, and incentivize value-based care, we needed to compete to get the smartest analysts to support our mission. Healthcare wasn’t seen as the most progressive or highest-paying for that skillset – so I adapted my value proposition to them. I offered them a mission: to help change the way we improved healthcare in the Netherlands, and second, I offered them a flexible way of working – they could have a 4-day work week, so long as they met that mission. With this value proposition, I managed to hire a group of highly skilled and very dedicated analysts.

Dr. Anna van Poucke
Global Head of Healthcare, KPMG International, and Healthcare Senior Partner
KPMG in the Netherlands

All three workforce issues apply to the New Zealand context; however, it is meeting demand that is most pressing.

KPMG in New Zealand has just completed a review of safe staffing in the nursing workforce for the Ministry of Health, working with the Nursing Advisory Group. This review found that our healthcare system is significantly understaffed in relation to nurses.

The problem is more than just a financial one, as healthcare providers struggle to fill already funded positions. As such, we have recommended some short- and long-term actions to increase the number of nurses in the workforce. These recommendations included actions that would reduce barriers to recruiting Internationally Qualified Nurses, increase flexibility around working hours and shift patterns, and remove specialization silos within nursing.

Through this work, we are proud that we have contributed to developing a healthcare system that keeps our hard-working nurses safe, and that ultimately is better equipped to deal with challenges such as COVID-19.

Rachel Scott
Partner, Advisory – Risk and Assurance Services
KPMG in New Zealand

In the United Kingdom, I think the biggest issue is the ability to meet demand – most of that is not having enough people, and the other part is that in the National Health Service (NHS), because of COVID, we have huge backlogs where patients have now been waiting many months for treatment.

The people issue here is deep rooted. Vacancies were a significant issue before COVID, and now we have a very tired, depleted workforce across the NHS, with vacancies and availability of staffing getting worse, not better.

When it comes to workforce planning, historically the lack of data in the public domain has been one of the main problems, organizations have had to rely on broad service demand projections. Decision makers have lacked access to granular insights to make accurate workforce decisions across specialties and care settings. We have got to a place where getting workforce planning wrong is greater than investing in getting it right.

To get things right, an NHS Trust recently worked with KPMG in the UK to codevelop a strategic workforce planning tool that brings together finance, workforce and service activity data, to predict workforce requirements based on real-life scenarios. Working together with the Trust, KPMG professionals have found there is inherent complexity in getting a largely accurate sense of evolving service needs and shifting workforce demand and supply. Using the tool, we’ve been able to correlate the modelling to how services would actually be reconfigured to reflect real interventions and complexity.

Beyond hiring insights and budgets, the tool also provides crucial insights for future transformation in the areas of service growth and skills. Data can be used to redesign care pathways, redesign roles, adjust skills and identify people shortages across all parts of health and care.

This tool has great potential at home and abroad. Ultimately, with a combination of data, technology and human insight, the aim is to give back control to healthcare organizations or systems to better address current and future workforce challenges.

Michael Allen
Global Lead, Future Workforce in Healthcare, KPMG International; Partner
KPMG in the UK

In the Netherlands, concerns about demand, new operating models and workforce wellness are definitely fully connected. Whilst the most pressing issue is the ability to meet demand (especially in some areas during COVID), the underlying need to improve human resources strategies and policies to increase wellness and more digital operating models is crucial. More than before people working in health are recognized in their passion and purpose, still there’s a lot to gain in unlocking the full potential in supporting and positioning healthcare workers. Professionals who are on the top of their game becomes more top of mind: strategies to reduce the administrative burden and optimize workforce are increasingly on the strategic agenda. Domestically, several healthcare providers are taking the first steps in workforce shaping initiatives.

Arjan Ogink
Head of Healthcare
KPMG in the Netherlands

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