You know what they say… wait for a bus… two come along at once.
Is it true? Yes and no. Top line; it’s about frequency, flow and a sprinkle of queue theory.
Bus number one leaves the garage a bit late, or is delayed in traffic.
By the time it gets to the first stop a bigger than normal queue has formed. Bus timetables allow for embarkation time, but more people take more time. A couple of buggies and mums with kids, that’ll take longer.
The bus travels to the second stop, a bit later still…
… there again, a bigger queue has accumulated. Repeat activity at stop one. Add a bit more of a delay. And, so it multiplies.
Meantime, the second bus leaves the garage and is quicker at the bus stops as bus number one is doing all the work.
By the time bus one reaches the forth or fifth stop, bus number two has caught up… hence two come along at once.
Bus companies call it bunching.
They try to avoid the problem with dispersive scheduling… which I will leave you to entertain yourself, finding out about!
The upshot; buses are most likely to come in threes before the bunching resolves.
The NHS is struggling with the, ‘two come along at once’ problem, right now.
The first; the missing workforce plan. Workforce is in such a state, it’s going to take years and a shed-load of money to fix.
Trusts and others are obliged to recruit from overseas.
As there’s a global shortage of healthcare staff and the NHS has emerged from Covid with the reputation of being a sweat-shop employer, it’s getting difficult.
All developed healthcare systems are having the same problem. Hence, in panic mode, the WHO has developed a ‘red-list’ of countries where their health systems are fragile and staff shouldn’t be poached.
So desperate is the NHS… it ignored the list. Last year we recruited from Nepal and Nigeria,(until it was stopped) both on the red-list.
It’s emerged that the NHS now intends to facilitate Trusts going overseas to hire allied health professionals. Physio’s, OTs and the like.
Around 16.5% of NHS people come from overseas.
This whole workforce thing is not going to end well. To be honest, and I won’t be popular for saying this; a workforce plan, given the implications of cost and training lead-times, is becoming almost irrelevant.
All the time we can plunder the rest of the world and create time for technology to develop and provide decision support for trained workers, based on tasks… we’ll muddle through and the shape of the workforce could be completely unrecognisable.
Think about the speed of developments in AI.
Whatever is in the workforce plan is likely to be out of date.
That said… here’s the second bus-load of aggravation, catching up.
The Commissioner of the Met Police has helpfully announced, by the end of the year his Coppers are not going to attend mental health call-outs.
Last year they turned up at over 27,000.
There are plenty of reports that have headlined the fact that all police services are struggling to cope with MH call-outs.
For instance, a police vehicle is used to transport people to a place of safety in over half of cases.
It’s only a matter of time before police services around the country all say… enough is enough.
NHS Digital does not know exactly, how many vacancies there are in the NHS, but we can glean staff retention within NHS mental health services is becoming ‘an increasing challenge’.
According to the NAO, during 2021-22 some 17,000 staff left the MH workforce, up from 13,000 the year before.
The MH workforce plan; ‘Stepping Forward’, in 2017, promised to establish 21,000 new posts and employ 19,000 additional members of staff by 2020…
… where are they? Dunno.
As far as I can tell, there are over 20,000 vacancies. The establishment has gone from 36,177 to 39,472. An increase of only 3,295.
If the police stop handling MH call-outs, there is no other public service to step in to cover.
There is no prospect of the NHS stepping-up with community psychiatric nurses because we don’t have enough of them and can’t train any by Christmas, and…
… there seems to be no new MH facilities planned in the latest capital programme.
Just like buses. Problems come in bunches.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
