Evolving to meet a changing world

The need for change is set against a backdrop of rapid and widespread change transition across health and care services, and in working lives more generally – especially in three key areas:

  • Integrated care: The introduction of integrated care systems (ICSs) heralds not just new structures but a new emphasis of openness to working alongside others, ensuring collaboration rather than competition. There will also be increased opportunities to scale up what works, sharing learning and resources. This will include extending people-service support to areas of the health service that have had little access in the past, such as primary care.
  • The nature of healthcare: The way healthcare is accessed and provided is changing, with new technologies advancing communication and interventions. Our people need to be supported to adapt to these new ways of working.
  • The nature of work: Ways of working are changing beyond healthcare, too, with major transformation in the nature of work and what people expect from their employment. People want flexible arrangements that enable them to balance their job with other parts of their life. The pandemic accelerated the move towards novel approaches to care and remote working and many of these changes are here to stay.

Trends in healthcare and work

The trends affecting the nature of healthcare form an important context for how people services need to evolve in the coming years. The people profession will need to support the health and care service as it evolves, to meet a number of challenges. For example:

  • There is a rising demand for health services due to an ageing population with increasingly complex healthcare needs. People are living longer and, as they age, their healthcare needs change. The number of people living with long-term conditions is set to increase, with more individuals managing multiple conditions.
  • Workforce supply challenges are expected to continue as demand rises. For the past decade, workforce growth has not kept up with the increasing demands on the NHS.
  • Significant inequalities in life expectancy are likely to persist. These are linked to deep-rooted inequalities in how care is accessed, further perpetuating unequal outcomes for our patients. The COVID-19 pandemic has caused life expectancy to fall, and has further increased inequalities in mortality and the number of years lived in good health across the population.
  • Health and care will need to be more joined up and co-ordinated, to provide an integrated approach that supports the whole person. To support the growing number of people with long-term conditions, the NHS will need to focus on breaking down traditional barriers between care organisations, teams and funding streams, rather than viewing each encounter with the health service as a single, unconnected episode of care.
  • The role of the patient is likely to change, with more wanting support for self-care and prevention, and greater personalisation, so that their care focuses on the things that really matter to them. Individual preferences on type and location of care differ quite widely. With the right support, people of all ages can – and want to – take more control of how they manage their physical and mental wellbeing.
  • Continued technological and scientific innovation is likely to change the nature of care and how it is delivered – including enabling care to be more personalised. This includes several key areas:
    • Technology is helping health and care professionals communicate better and enable people to access the care they need quickly and easily when it suits them. For example, devices and apps can support remote monitoring for patients.
    • The increasing use of remote phone and video consultations is likely to continue, offering new and flexible ways for clinicians and patients to manage care and treatment together.
    • The ability of artificial intelligence (AI) to analyse large quantities of complex information has the potential to make a significant difference in health and care settings, including speeding up the detection of diseases.
    • Continued scientific innovation, including through increased understanding and use of genomics, will enable faster and more accurate diagnoses for inherited and acquired diseases, which can lead to personalised and effective treatments and interventions.
  • There is a continuing need to take a proactive and preventative approach to health. This includes using population health management as a way of targeting prevention activity, to better support people to stay healthy and reduce health inequalities across entire populations.

Alongside this, the NHS and the people profession need to respond to the changing nature of work, including people’s expectations from their employment. Key trends, identified by external partners based on academic research and international trends, include:

  • Demographics within the workforce are changing. Working lives are lengthening as the UK population ages. As the UK state pension age rises, more older people will be in employment. By 2030, the number of economically active people aged 65 and over is projected to increase by one third. The UK is also now seeing emergence of a four-generational workforce (baby boomers, generation X, millennials and the first of generation Z).
  • There is more competition for the workforce. The UK faces a labour shortage, linked to the ageing population, which results in more people leaving the jobs market than entering it. Alongside this, demand for health and care services is growing, also due to the ageing population, so a larger workforce will be needed. For example, Skills for Care has calculated that if the adult social care workforce grows proportionally to the projected number of people aged 65 and over in the population, the number of adult social care jobs will need to increase by 29% (480,000 jobs) – to around 2.16 million jobs by 2035.

There is likely to be increased global demand, too, with expectations that the expansion of global economic activity will increase the demand for educated labour. For example, the World Health Organization has stated that six million more nurses will be needed by 2030 to deliver the higher standards of healthcare needed once the COVID-19 pandemic has passed. Most will be needed in middle and low-income nations, but it notes that some developed nations will require more, as those currently working in the profession grow older.

  • People’s expectations of work are changing. What people value in a job is changing. People increasingly want ‘good work’ (a term used in the Taylor review referring to meaningful work where people have autonomy, feel their work makes a contribution and feel listened to). They also want to be able to balance their work more easily with other areas of their lives. These factors may become as important to individuals as levels of pay, reward and potential for career progression.
  • There is an increase in non-linear careers rather than ‘careers for life’. People are continuing to work later in life. This shift is likely to lead to people having more stages in their career and perhaps making changes to new sectors or having ‘portfolio careers’, where they work in more than one area simultaneously. This, in turn, may lead to higher expectations of employers to make it easier for people to move in and out of roles, to create more opportunities for non-linear progression, and to show that it is still possible to work in health and care in the longer term while still enjoying a career that encompasses different roles and areas.
  • Technological change is likely to reshape job and skills demands. As technology moves forwards, jobs are more likely to need technology skills. Advances in technology are likely to take over routine, repetitive tasks, allowing workers to reallocate their time to higher-productivity tasks that machines cannot do. This means that many roles will be reconfigured, rather than eliminated, and most occupations will need to reshape job roles. Technology can also free up opportunities for individuals, including providing greater flexibility in where and how they work.
  • A continuous and agile approach to development and training is needed to keep pace with innovation and changing expectations. This may include the need for a more flexible training offer (such as modular training, apprenticeships or ‘earn while you learn’ approaches), as well as increasing training in new areas, such as digital.
  • More is expected of employers on issues of inequalities and social justice. Organisations, particularly public sector organisations, will be expected to lead the way in tackling injustice and inequalities and demonstrably provide equal opportunities for all. Citizens also expect greater efforts to address climate change, with employers expected to play their part as well government and individuals.

By changing the way we work, the NHS and care partners have a chance to genuinely improve the lives of local populations. We can reach into our communities and reduce inequality, acting as ‘anchor institutions’ or ‘anchor networks’. Read more about how the NHS can use these strategies to build a healthy, sustainable post-COVID-19 recovery.

These changes will affect not only the way the people profession needs to lead and act, but how the whole health and care system will deliver. Managers across the sector and at every level will need to play their part, to respond to these changes and use them as an opportunity to transform the experience that our people have at work.

View the next sections in this guide: