A scoping review: Strategic workforce planning in health and social care

Abstract

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 abstracts, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and abstract 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.