Access courses and their contribution to the widening participation agenda in the UK

Reasons for mental health nursing shortages in the UK are many and complex. The COVID-19 pandemic has highlighted the need to fill vacant posts, while at the same time negatively impacting on the UK's international recruitment strategy. Whereas international recruitment is essential to reduce workforce shortages, it offers only a short-term solution and potentially leaves lower-income countries with increased nursing shortages themselves. This article considers that a long-term domestic approach to recruitment is needed to reduce future workforce deficits. It is argued that benefits of access courses are increased if delivered by the university directly, as a familiarity with systems, the campus and supportive networks are promoted, and the potential for targeted support is increased. Further research is needed to establish the benefits, but access courses delivered this way may provide a more sustainable solution to nursing workforce shortages in the UK and beyond.

Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study

Background Healthcare associated infections (HAIs) are the most frequent adverse outcome in healthcare delivery worldwide. In conflict-affected settings HAIs, in particular surgical site infections, are prevalent. Effective infection prevention and control (IPC) is crucial to ending avoidable HAIs and an integral part of safe, effective, high quality health service delivery. However, armed conflict and widespread violence can negatively affect the quality of health care through workforce shortages, supply chain disruptions and attacks on health facilities and staff. To improve IPC in these settings it is necessary to understand the specific barriers and facilitators experienced locally. Methods In January and February of 2020, we conducted semi-structured interviews with hospital staff working for the International Committee of the Red Cross across eight conflict-affected countries (Central African Republic, South Sudan, Democratic Republic of the Congo, Mali, Nigeria, Lebanon, Yemen and Afghanistan). We explored barriers and facilitators to IPC, as well as the direct impact of conflict on the hospital and its’ IPC programme. Data was analysed thematically. Results We found that inadequate hospital infrastructure, resource and workforce shortages, education of staff, inadequate in-service IPC training and supervision and large visitor numbers are barriers to IPC in hospitals in this study, similar to barriers seen in other resource-limited settings. High patient numbers, supply chain disruptions, high infection rates and attacks on healthcare infrastructures, all as a direct result of conflict, exacerbated existing challenges and imposed an additional burden on hospitals and their IPC programmes. We also found examples of local strategies for improving IPC in the face of limited resources, including departmental IPC champions and illustrated guidelines for in-service training. Conclusions Hospitals included in this study demonstrated how they overcame certain challenges in the face of limited resources and funding. These strategies present opportunities for learning and knowledge exchange across contexts, particularly in the face of the current global coronavirus pandemic. The findings are increasingly relevant today as they provide evidence of the fragility of IPC programmes in these settings. More research is required on tailoring IPC programmes so that they can be feasible and sustainable in unstable settings.

Use of The WISN Method to Assess the Health Workforce Requirements for the High-volume Clinical Biochemical Laboratories

Background: The clinical laboratory services, as an essential part of health care, require appropriate staff capacity to assure satisfaction and improve outcomes for both patients and clinical staff. This study aimed to apply the Workload Indicators of Staffing Need (WISN) method for estimating required laboratory staff requirements for the high-volume clinical biochemical laboratories. Methods: In 2019, we applied the WISN method in all 13 laboratories within the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB UCCS). A review of annual routinely collected statistics, laboratory processes observations, and structured interviews with lab staff helped identify their health service and additional activities and duration of these activities. The study outcomes were WISN based staff requirements, WISN ratio and difference, and a recommendation on the new staffing standards for two priority laboratory workers (medical biochemists and medical laboratory technicians).Results: Medical biochemists' and laboratory technicians' annual available working time in 2019 was 1508 and 1347 working hours, respectively, for the workload of 1,848,889 samples. In general, the staff has four health service, eight support, and 15 additional individual activities. Health service activities per sample can take from 1.2 to 12.6 min. Medical biochemists and medical laboratory technicians spend almost 70% and more than 80% of their available working time, undertaking health service activities. The WISN method revealed laboratory workforce shortages in the CMB (i.e., current 40 medical biochemists and 180 medical laboratory technicians as opposed to required 48 medical biochemists and 206 medical laboratory technicians). Workforce maldistribution regarding the laboratory workload contributes to a moderate-high workload pressure of medical biochemists in five and medical laboratory technicians in nine organizational units.Conclusions: The WISN method showed mainly a laboratory workforce shortages and workload pressure in the CMB UCCS. WISN is a simple, easy-to-use method that can help decision-makers and policymakers prioritize the recruitment and equitable allocation of laboratory workers, optimize their utilization, and develop normative guidelines in the field of clinical laboratory diagnostics. WISN estimates require periodic reviews.

Psychiatrist workforce planning: contexts, considerations and recommendations

Objective: To provide a clinical update for psychiatrists and trainees on psychiatric workforce-planning in the Australasian context. Conclusions: There is a lack of detailed evidence regarding effective psychiatric workforce planning. Planning may be based on a foundation of psychiatrist-to-population ratios. This would be modified by needs assessment, understanding of service models and existing service demand. Given that it has recently expressed significant concerns about workforce shortages, the RANZCP should lead development of an independent Australasian psychiatric workforce planning model to inform policy advice to governments.

Broadening the scope of task shifting in the organisation of healthcare

Task shifting in healthcare has mainly been initiated and studied as a way to react to/or mitigate workforce shortages. Here, we define task shifting as the structural redistribution of tasks, usually including responsibilities and competencies between different professions. As such, task shifting is commonly focused on highly specialised and trained professionals who hand-over specific, standardised tasks to professionals with lower levels of education. It is expected that this type of task shifting will lead to efficiency and cost savings to healthcare organisations. Yet, there are more benefits to task shifting, in particular its contribution to integrated patient-centred quality of care and a tailored system that meets the changing care demands in society. Hence the importance to broaden the scope of task shifting, its goals, manifestations and how task shifting plays a role in addressing both the strengths and weaknesses in the healthcare system. In this focus piece, trends and conditions for task shifting and its (un)anticipated effects are discussed. We argue that, only when designed to face specific complexities at the workplace and taking into account the balance between specialists and generalists, task shifting may substantially contribute to enhanced quality of care that meets the changing needs of society.

A novel blended placement model improves dietitian students’ work-readiness and wellbeing and has a positive impact on rural communities: a qualitative study

Background Clinical placement models that require students to relocate frequently can cause stress, which may impact the student experience and development of work-readiness skills. A blended placement, where placements are undertaken concurrently at one location has potential to address these issues by providing a positive placement experience. Blended long-stay placements undertaken in rural communities increase consistent service provision and may help encourage students to work rurally, with potential to reduce workforce shortages. The aim of this study was to pilot test the feasibility of blended placement models and explore the student experience and skills development. A secondary aim was to explore a fully blended long-stay rural placement and the benefits to the rural community. Methods An exploratory qualitative design was used. Focus groups were conducted with dietitian student who participated in usual placements (n = 14) or blended placements (n = 9). Individual semi-structured interviews were conducted with five student supervisors who participated in blended placements. Focus groups and interviews were recorded, transcribed verbatim and analysed together using inductive thematic analyses. Results The overarching theme across all blended model placements was ‘enhanced work-readiness’, including increased flexibility, organisational skills and better preparedness for mixed roles. Enhanced work-readiness was influenced by three themes: stress and wellbeing impacts learning, working in two areas of practice concurrently allows for deeper learning, and blended placements meet supervisor needs. Fully blended long-stay rural placements revealed additional benefits. Firstly, in relation to the overarching theme ‘enhanced work-readiness’: students on these placements also developed extra skills in innovation, social accountability, interprofessional collaboration, conflict resolution and teamwork. Secondly, a new overarching theme emerged for fully blended long-stay rural placements: ‘increased community connections’ which included additional health services delivery, deeper personal experience and more rewarding student-supervisor relationships. Thirdly, two extra themes emerged that influenced work-readiness and community impact: ‘local organisational support and resources’ and ‘enhanced innovative and interprofessional learning opportunities’. Conclusions Blended placements enhance work-readiness skills by providing an alternative model to that commonly applied, and providing flexibility in education programs. Additionally, fully blended long-stay rural placements positively influence the local community through impacting the student experience as well as providing more dietetics services and may therefore assist in reducing dietetics workforce shortages and health inequity.

Creating Diverse and Religiously Inclusive Workplace Cultures in Hyper-Connected, Technical, and Cyber-Driven Organizations

Many organizations are driven by technology. If you consider the nature of workforce shortages and recruiting challenges in areas like artificial intelligence and cybersecurity, it is important to understand how organizations need to recruit diverse technology-savvy talent including those from diverse cultures, backgrounds, and religions. There have been several incidents in the United States that point to significant problems with religious incivility in the workplace. In 2016, when the company Chargrill fired 150 non-Christian workers over prayer breaks, the incident points to a growing challenge in the American workplace about what companies can do to accommodate their employees' faiths. This article explores the literature on religious conflict and incivility since there needs to be more exploration on how religious conflict and incivility manifests itself through everyday interactions in the hyper-connected and cyber-driven workplace.

Objective Simulated Bush Engagement Experience (OSBEE): A novel approach to promote rural clinical workforce.

The mal-distributed Australian medical workforce continues to result in rural medical workforce shortages. In an attempt to increase rural medical workforce, the Australian Government has invested in the Rural Health Multidisciplinary Training (RHMT) program, involving 21 medical schools (RHMT program, 2020). This funding requires participating universities to ensure at least 25% of domestic students attend a year-long rural placement during their clinical years and 50% of domestic students experience a short-term rural clinical placement for at least four weeks.