Strategic workforce planning: a health sector case study

Never has it been more relevant than in today’s health sector, with its acute skills shortages and uncertainty around retention capability, to have a strategic workforce plan (SWFP). Deloitte’s Kieran Devery writes.

At its simplest, SWFP compares internal and external demand and supply data to identify workforce gaps which, in turn, inform decisions on how to address the gap. It requires the use of sophisticated statistical techniques and other analytical tools to articulate workforce trends that lead to actionable insights.

Health system workforce planning is hugely complex, even in a steady state environment. But with the extent of reconfiguration and the emergence of national models of care, forecasting what may happen in the health system is challenging.

In particular, workforce models for the health sector need to take into account:

• Health system configuration – in a hospital this means number of beds, rooms/wards, operating theatres and the different modalities in radiography that needs to be supported.
• Workforce details – employee costs, demographics, skill profiles and retention rates. are all critical for workforce forecasting.
• Activity – there are some rich sources of activity data in the hospital environment (e.g. Hospital In-Patient Enquiry data), but there are also some fundamental deficits in terms of health and social care professional data and referral patterns between specialties. Furthermore, with data one needs to be able to forecast how that will shift with demographic changes, and how it will change to reflect dealing with unmet need. Not all activity is equal so we need to understand the time taken to deliver particular activities, and we need to understand how acuity levels dictate dependency. 
For instance, a baby in a paediatric intensive care unit may require 
one-to-one nursing care, whereas acuity levels in general wards allow nursing staff to care for multiple patients.
• In the absence of activity data, benchmarks, professional guidelines and the emerging models of care are useful data sources. However, with benchmarking it can be notoriously difficult to compare ‘apples with oranges’. In the absence of activity data or robust benchmarks, one may have to rely on the professional judgement of senior practitioners.
• Operating Models – operating models also dictate resourcing. They dictate organisation structure and management and supervision levels, they dictate whether services are outsourced and or delivered through shared services, they also dictate how services can be delivered by multi-disciplinary teams and, by extension, models of care are a type of operating model input. So whether services are delivered in a tertiary setting or in a satellite or in the community will ultimately impact on your workforce requirements.
• Workforce characteristics – these vary by workforce category and effectively limit the available hours for each employee provided.
• Technology Enablement – how technology supports the organisation impacts on resources. For example, the pace of implementation of the HSE’s eHealth Programme, including projects such as the national electronic health record, will have significant impacts on different workforce categories.

With this level of complexity, it is critical that when implementing work force planning there is executive sponsorship. SWFP is an enterprise wide effort not just a HR exercise. Finally, a robust business case is fundamental to the delivery of a successful solution. Demonstrating the business impact of workforce plans is critical to justify investment and drive continuous improvement.

Kieran Devery is a Consulting Director with Deloitte.


Tel: +353 1 417 2532


Email: kdevery@deloitte.ie