Public acute hospital workforce requirements set to increase across all geographic regions

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New ESRI research, funded by the HSE, provides projections of public acute hospital workforce requirements both nationally and regionally in Ireland between 2019 and 2035. This is a Phase I report as part of a broader research programme to develop regional workforce projections. In the report, the regional workforce projections are presented in terms of both hospital groups and Regional Health Areas (RHAs). A range of alternative projections are presented which reflect varying assumptions in relation to population growth, trends in health and life expectancy, waiting list management, enhanced community care delivery, and changing the mix of workforce involved in care delivery.

Main findings

  • Nationally, the population is projected to be 5.4 million by 2035 under the Central population growth scenario, an increase of close to 500,000 between 2019 and 2035. The number aged 85 years and older is projected to more than double.
  • Driven by projected demographic change, particularly population ageing, workforce requirements for all staff categories examined are projected to increase substantially by 2035. The largest increases in workforce are projected for health and social care professionals who are particularly required by older people in hospital.
  • The largest projected increases in workforce requirements are recorded for regions located in the east of the country.

By 2035 the projected additional workforce requirements are for:

  • medical staff of between 2,575 and 3,236 whole time equivalent (WTE), nationally, representing an increase of between 1.7 and 2.1 per cent on average per annum. Across scenarios the highest projected regional increase per annum was 2.2 per cent, recorded in the east of the country (RHAs A and B).
  • nursing and midwifery staff of between 5,726 and 8,868 WTE, nationally, representing an increase of between 1.4 and 2.1 per cent on average per annum. Across scenarios the highest projected regional increase per annum was 2.2 per cent, recorded in the east of the country (RHAs A and B).
  • healthcare assistants and health and social care assistants of between 1,802 and 3,277 WTE, nationally, representing an increase of between 1.7 and 2.9 per cent on average per annum. Across scenarios the highest projected regional increase per annum was 5.2 per cent, recorded in the south of the country (RHA C).
  • health and social care professions which are higher, in terms of overall growth rates, relative to other workforce categories examined. Most notably, highest per annum growth is projected for occupational therapists (2.7–3.3 per cent) and speech and language therapists (2.3–3.3 per cent). As with other workforce categories examined, larger projected WTE requirements overall are reported in RHAs in the east of the country.

Projections are sensitive to both the grade and skill-mix assumptions modelled. For example, in terms of skill mix, they model an increase in the proportion of total nursing and midwifery staff operating at advanced practitioner level to 4 per cent. Under this assumption, projected growth in advanced practitioner workforce requirements increases from 1.7 to 8 per cent on average per annum.

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Policy implications

This report highlights that population growth and ageing will be key drivers of additional workforce requirements for the public acute hospital staff categories examined. However, the report also considers how changes to the workforce mix, addressing waiting lists, and enhancing community care delivery may also impact acute hospital workforce requirements over the medium term. Findings from this report raise important considerations for policymakers in terms of acute workforce investment, workforce planning and training both nationally and regionally over the coming years and in the context of the implementation of Sláintecare reforms.

Commenting on the report, Ms Anne Marie Hoey, National Director of Human Resources, HSE, said“This first report, focusing on Acute Hospitals, is a key output from our programme of research to determine workforce projections as we progress and prepare for the implementation of Sláintecare and RHAs. Its findings raise important considerations in terms of acute workforce investment, workforce planning and training over the coming years. Importantly our second phase focussing on requirements in Community services will further strengthen our planning and implementation of Sláintecare.

The workforce projections, provided on a regional basis, better inform our decisions and resource planning for the RHAs will be a critical enabler for our joint discussions on workforce planning both with our funders and stakeholders. Furthermore, this will facilitate the medium and longer-term planning necessary in areas such as training and education to ensure the availability of graduates to fulfil the workforce requirements within the domestic market.”

Commenting on the report, Stephen Donnelly, TD, Minister for Health, said: “I welcome the publication of this ESRI report which was funded by the HSE and undertaken in conjunction with the Department of Health. The report demonstrates the projected workforce demand that is expected to arise in the publicly funded acute hospital sector into the medium and long-term. Sláintecare recognises strategic health and social care workforce planning as a critical enabler of reform. This report makes a key contribution to inform the needs of the health sector for the future in the context of the wider work in strategic workforce planning being undertaken in my Department. It informs our efforts to ensure the availability of suitably qualified individuals across a range of healthcare disciplines to support integrated care across the health service.”

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