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Yes / The publication of the Delivery plan for tackling the COVID-10 backlog of elective care (NHSE/I, 2022:5) contained a number of ambitions, including that, by March 2024, 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have had cancer ruled out within 28 days. By March 2025, waits of longer than a year for elective care should be eliminated and 95% of patients needing a diagnostic test should receive it within six weeks. The report acknowledged the need to grow the workforce to achieve these ambitions and ensure a timely cancer diagnosis, while also proposing the use of digital technology and data systems to free up capacity. To assist West Yorkshire National Health Service (NHS) organisations to meet these ambitions, this report presents the findings of a ‘deep dive’ that focuses on the role of radiology in meeting the ambitions of providing timely cancer diagnosis. Aims 1. To understand current and projected demand for radiology expertise in cancer diagnosis in West Yorkshire. 2. To understand the current and projected radiology workforce in West Yorkshire and determine the gap between the projected radiology workforce and the required radiology workforce. 3. To identify possible solutions to assist in providing the radiology workforce required for West Yorkshire and explore their acceptability and potential impact. Methods A range of sources of data and methods were utilised. We examined publicly available quantitative data concerning cancer waiting times and diagnostic waiting times and activity and used this to forecast future cancer waiting times and diagnostic waiting times and activity. We examined data from Health Education England (HEE) regarding radiologists’ and radiographers’ workforce profile data for West Yorkshire, the number of radiologists completing training, and the number of radiographers graduating, and data submitted by West Yorkshire Trusts to HEE regarding their plans for growing their radiology and radiographer workforce. Interviews (N=15) conducted with radiology service managers, university academics and key strategic and operational stakeholders delivering radiology services were used to understand the current and future issues around strategic workforce planning, workforce changes and transformation, workforce roles and skills, training and education and service changes. A rapid review of the literature examining the impacts of artificial intelligence (AI) on the workload of radiology services was also undertaken. To put this work in context, we also reviewed relevant policy documents and reports. Alongside this, we consulted with the Yorkshire Imaging Collaborative (YIC) and the West Yorkshire Cancer Alliance (WYCA) and attended a series of workshops run by the Yorkshire Imaging Collaborative. Results Overall, the findings show that demand for radiology services is increasing and that both cancer waiting times and the waiting times for diagnostic tests increased, with a concurrent downward trend in activity that, if all else stays the same, is forecast to continue up to 2025. The cancer waiting times data indicate that patients were waiting longer and that their needs were not being met. Moreover, 3 the proportion of people treated within accepted cancer waiting times decreased both nationally and within the West Yorkshire region from 2013. This was exacerbated by COVID-19 which caused a further decrease nationally and for the West Yorkshire region. National data for waiting times for all diagnostic tests show a significant decline between 2006 and 2008, with a decrease in median waiting times from just under 6.0 weeks to approximately 2.0 weeks. Overall, waiting times remained stable until late 2020 when they started to rise with the longest median waiting times at just over 8.0 weeks in mid-2020. The total number of people waiting for radiology tests nationally is decreasing and is predicted to continue to do so, while in West Yorkshire the number of people waiting for radiology tests decreased until 2020 but has since been on an upward trend which is predicted to continue. Nationally, the total number of radiology tests is on an upward trend that is predicted to continue, while in West Yorkshire activity has been decreasing since well before COVID-19 and is predicted to continue to do so. Data examining the current and future workforce showed that the national figures for the total radiology and radiography workforce are small relative to other health professional groups. In West Yorkshire, 265 radiologists and 926 radiographers were employed, and staff turnover was generally low. Trusts’ forecasts for the number of radiologists and radiographers they believe they need suggest a 16% increase in the number of radiologists in post between March 2022 and March 2027 and a 25% increase in the number of radiographers in post. The numbers of radiographers and radiologists being trained in West Yorkshire suggest that this is feasible. Interview data identified a number of main themes and associated issues: delivering diagnostic cancer targets, strategic workforce planning, workforce roles and skills, service transformation, recruitment and retention, universities, artificial intelligence, collaboration, and international recruitment. Across all themes, some reoccurring issues were identified: a lack of staff, increased demands, a lack of capacity in terms of space and staff, a lack of strategic workforce planning with a focus on operational or financial plans. Respondents proposed potential solutions to some of the issues raised that included: new ways of working, upskilling, developing current and emerging roles, Community Diagnostic Centres (CDCs), greater collaboration between NHS Trusts, universities, CDCs, imaging academies and networks and the private sector, and the international recruitment of radiologists and radiographers to address workforce gaps. The rapid review findings helped to identify a number of potential benefits of use of AI in radiology, including contributing to improved workflow efficacy and efficiency of radiology services. However, this is dependent on the nature of the work and the AI function. As a result of faster AI reading, radiologists may be able to focus more on high-risk, complex reading tasks. AI can support automation of image segmentation and classification and aid the diagnostic confidence of less experienced radiologists. Respondents’ views on AI were mixed. There was acknowledgement that AI was already used to support radiology service delivery and both the benefits and problems associated were identified. The implications of AI for radiologists’ and radiographers’ roles were discussed in terms of changing work, AI being used to support or in some cases substitute radiologists and radiographers, and the need for the radiology workforce to adapt to the technological change whilst maintaining a caring service

Talent management has become a management priority among business leaders as a result of the transition from a commodity to a knowledge-based economy. Organizations are entering a new era affected by demographical challenges, increased globalization and a generation shift in the labor market that forces organizations to rethink how they attract, develop and retain talented employees. Research predicts that there will be a shortage on labor as a result of the baby boomers retirement in the coming years. Talent management strategies and processes linked to the business strategy is a key to organizational advantage. Organization´s most critical assets are the employees and by having the right people who perform in the right jobs is essential to get a sustainable organization. The concept of talent management is often ill defined and underdeveloped and talent management practice appears to vary widely among organizations. The purpose of this thesis is to get a deeper insight into the concept of talent management processes and framework. Through a single case study approach, this study explores how talent management practice and processes are implemented in a multinational knowledgebased company. The intention is to understand how line leaders and HR managers work with talent management activities by following a hermeneutic research method. A semi-structured interview method has been performed to collect the empirical data. The empirical findings show that many of the talent management activities are implemented in a sophisticated organizational process called the EMS (Employee management system). Employees are rated and evaluated based on their performance throughout the year. Line leaders are mainly accountable for employees’ development and growth in the organization. Findings also show that line leaders are mentors, coaches and a guidance to employees in the daily work. Findings show that HR managers support both leaders and employees in the work with talent management. HR managers’ responsibilities are to influence and coach the leaders in decision-making, in addition to work for employees’ well-being at the work. The organization has presently low turnover. This affects both the recruitment of new employees and hinders presents employee development. The competence level in the organization is estimated to be high and the organization struggle to store critical knowledge.

Yes / Effective strategic workforce planning for integrated and co-ordinated health and social care is essential if future services are to be resourced such that skill mix, clinical practice and productivity meet population health and social care needs in timely, safe and accessible ways globally. This review presents international literature to illustrate how strategic workforce planning in health and social care has been undertaken around the world with examples of planning frameworks, models and modelling approaches. The databases Business Source Premier, CINAHL, Embase, Health Management Information Consortium, Medline and Scopus were searched for full texts, from 2005 to 2022, detailing empirical research, models or methodologies to explain how strategic workforce planning (with at least one-year horizon) in health and/or social care has been undertaken, yielding ultimately 101 included references. The supply/demand of differentiated medical workforce was discussed in 25 references. Nursing and midwifery were characterised as undifferentiated labour, requiring urgent growth to meet demand. Unregistered workers were poorly represented as was the social care workforce. One reference considered planning for heath and social care workers. Workforce modelling was illustrated in 66 references with predilection for quantifiable projections. Increasingly needs-based approaches were called for to better consider demography and epidemiological impacts. This review’s findings advocate for whole-system needs-based approaches that consider the ecology of co-produced health and social care workforce. / Claire Sutton and Julie Prowse are seconded (from February 2022 to March 2023) to the Workforce Observatory, the University of Bradford, West Yorkshire. Their research posts at the Workforce Observatory are funded by Health Education England.

Magister Curationis - MCur / In 2011, a structured electronic system for the staffing of agency nurses was implemented in the Western Cape as part of the Nursing Information Management System (NIMS). This electronic system was developed to ensure a fair tendering process for the procurement of agency staff, providing information on agency expenditure, maximum wage rates and adherence to principles and rules of supply chain management. Although technology is used more and more in healthcare services within the Western Cape, some professional nurses could lack the skills needed to implement the electronic system appropriately. A descriptive and quantitative design was followed to determine the competence levels of professional nurses in utilising the electronic staffing system for agency nurses in public hospitals in the Metropole, Western Cape. The aim of the study was to develop guidelines for nurse managers according to which they can train professional nurses in hospitals to utilise the electronic system for staffing of agency nurses. Assumptions were adapted from the theoretical framework of Benner (1984) on different levels of competencies and used as theoretical departure of the study. The accessible population for this study was all the professional nurses in hospitals within the Metropole of the Western Cape Government Health registered as users on the database, called the Nursing Information Management System (NIMS) (N=278). This population served as the total inclusive sample for the study. The method of data collection was a self-administered structured questionnaire. The data was analysed by using the SPSS Version 24 software program and descriptive and inferential statistics were conducted.

As in many service organizations, hospitals use a variety of shift types when scheduling nurse resources. In general, the operational decisions of workforce planning can be divided into two interrelated problems: (1) midterm planning in terms of shift assignments for up to six weeks at a time, and (2) the short-term daily adjustment of schedules. Individual nurse profiles are a function of a unit's skill requirements, labor laws, and other qualifications, and are results of the long-term planning decision. At the midterm level, the goal is to match nurse resources with the expected workload over the planning horizon. Rosters are designed to maximize personnel preferences as well as minimize cost. To investigate this problem, a large-scale integer program model was developed and solved with two methodologies. The first is based on Lagrangian Relaxation based heuristic, which uses a combination of subgradient optimization and Bundle methods, with variable fixing strategy and IP-based heuristic. The second methodology is a branch-and-price algorithm that makes use of several new branching rules, an extremely effective rounding heuristic, a dual bound procedure, and specialized aggregation scheme. To extend the algorithms to solve different levels of nursing skills, a downgrading strategy is used by giving scheduling priorities to higher level of worker. The midterm schedules provide a blueprint for the monthly work assignments of the staff. Because of absenteeism and unpredicted demand fluctuations, though, a hospital-wide reallocation of resources is needed on a daily basis. While the overall goal is to ensure adequate coverage at minimize cost, a secondary goal is to minimize changes to the assigned rosters. Nevertheless, to allow more flexibility, nurses are permitted to work in several units during a shift rather than just their home unit. An IP-based column generation methodology was developed to solve this problem and applied within a rolling horizon framework. The idea is to consider 24 hours at a time, but implement the results for only the first 8 hours. All algorithms were tested on data obtained from a 400-bed US hospital. The results show an order-of-magnitude improvement over current approaches in terms of solution quality and computation times. / text

Yes / Introduction: The international recruitment of healthcare workers remains a UK strategy to manage workforce gaps and maintain service delivery. Although not a new phenomenon, this has been exacerbated by chronic shortages. There is a need to profile the current international recruits and identify individual motivators to understand the opportunities for future recruitment and retention initiatives. Method: A UK-wide electronic survey was conducted using the Jisc platform. The survey was promoted using social media and researcher networks. Eligibility criteria were diagnostic radiographers, internationally educated, and currently working in the UK. Results: 226 responses were received. Most were working in England (90.7%) and 58.0% were under 35 years of age. The majority had migrated having moved to the UK since 2020 (63.7%) and the main drivers were career and/or training opportunities. Initial education was in 30 different countries, the highest number originating from Africa and Asia, with a median of 6 years post-qualification experience (IQR 4–11yrs). Despite experience, most were employed in band 5 (n = 72) or band 6 posts (n = 95). 56% had postgraduate qualifications on entry and a third had undertaken postgraduate study in the UK. Conclusion: Based on the survey responses, the profile of internationally recruited diagnostic radiographers is relatively young but with pre-migration experience originating all over the globe. They are motivated to work in the UK particular for career progression opportunities. Implications for practice: This study provides an insight into the motivations, demographics and employment patterns of internationally recruited radiographers working in the UK.

No / The mental health workforce is continually evolving and competing for resources, influenced by local and national factors however effective, provision of mental health care depends on the most important resource—staff.

Yes / Aim This aim of this scoping review was to undertake a detailed review of the pertinent literature examining strategic workforce planning in the health and social care sectors. The scoping review was tasked to address the following three questions: 1. How is strategic health and social care workforce planning currently undertaken? 2. What models, methods, and tools are available for supporting strategic health and social care workforce planning? 3. What are the most effective methods for strategic health and social care workforce planning? Methods The scoping review utilised the five-stage scoping review framework proposed by Arksey and O’Malley (2005). This includes identifying the research question; identifying relevant studies; study selection; charting the data and collating, summarizing, and reporting the results. The search included a range of databases and key search terms included “workforce” OR “human resource*” OR “personnel” OR “staff*”. Relevant documents were selected through initially screening titles and s, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and screening, 654 were identified as potentially relevant. Screening of full texts resulted in 115 items of literature being included in the synthesis. Both national and international literature covers strategic workforce planning, with all continents represented, but with a preponderance from high income nations. The emphasis in the literature is mainly on the healthcare workforce, with few items on social care. Medical and dental workforces are the predominate groups covered in the literature, although nursing and midwifery are also discussed. Other health and social care workers are less represented. A variety of categories of workforce planning methods are noted in the literature that range from determining the workforce using supply and demand, practitioner to population ratios, needs based approach, the utilisation of methods such as horizon scanning, modelling, and scenario planning, together with mathematical and statistical modelling. Several of the articles and websites include specific workforce planning models that are nationally and internationally recognised, e.g., the workload indicators of staffing needs (WISN), Star model and the Six Step Methodology. These models provide a series of steps to help with workforce planning and tend to take a more strategic view of the process. Some of the literature considers patient safety and quality in relation to safe staffing numbers and patient acuity. The health and social care policies reviewed include broad actions to address workforce planning, staff shortages or future service developments and advocate a mixture of developing new roles, different ways of working, flexibility, greater integrated working and enhanced used of digital technology. However, the policies generally do not include workforce models or guidance about how to achieve these measures. Overall, there is an absence in the literature of studies that evaluate what are the most effective methods for strategic health and social care planning. Recommendations The literature suggests the need for the implementation of a strategic approach to workforce planning, utilising a needs-based approach, including horizon scanning and scenarios. This could involve adoption of a recognised workforce planning model that incorporates the strategic elements required for workforce planning and a ‘one workforce’ approach across health and social care.

Given the urgency of climate-change and the speed and scale of the structural transition to a low-carbon economy, there is a critical need for research that accelerates the diffusion of learning in the field of employment and workforce planning. While efforts to align workforce development and planning with the introduction of green policies are rapidly intensifying and maturing, there are gaps in coherence. The transition to sustainable economies involves significant shifts in employment, including application and use of skills and workplace practices. New occupations are emerging and existing occupations are being greened at a rapid rate (Globe Foundation, 2010 a; ILO, 2011, pg. 4; 2012: OECD, 2013 pg. 47). Keeping equilibrium in employment while climate-change forecasts and technological innovations are rapidly evolving is a growing challenge for workforce planning and policy. This is also a ‘rate of change’ problem, and it needs to be better understood if governments are to provide leadership, adapt more quickly, and provide continuous high levels of services to citizens while maintaining strong economies. Governments that understand this will be at the forefront of mitigation and adaptation efforts (OECD, 2012 a, b). But how should that challenge be met? This study tackles that question, seeking to clarify how workforce development and planning can be directed toward improving employment prospects and reducing employment dislocations as the planet changes around us in the face of a changing climate. The implications of the findings are outlined and recommendations are then made as to how labour policies and workforce development and planning measures can best be targeted and integrated into the larger green policy framework to improve coherence of policies, institutional and organizational capacity and data capability. / Graduate