Media revelations of dramatic unexpected shortages in NHS nursing capacity, excessive dependence on overseas recruitment and costly agency staff (often NHS workers doing private shifts) are contributing to the public perception of a health service that doesn’t know how to effectively plan and manage its workforce.
The exact size of the NHS workforce remains a mystery; recent estimates put it at 1.3 to 1.6 million people and staff costs at around £136.7bn). The need to get a grip on this situation was recognised some time ago, leading to the procurement and implementation of a new Human Resource Information System (HRIS) for the NHS in England and Wales; with a similar programme underway in Scotland. In theory this should enable a smarter, more agile NHS, ensuring that personnel with the right training and experience are deployed when and where they are most needed, forecasting and planning for changing requirements, and improving the cost-effectiveness of patient care. However, these benefits aren’t guaranteed and similar programmes elsewhere have failed spectacularly. Our own research reveals that there has been little robust evaluation of the effectiveness of HRIS, suggesting that decision-making is being guided more by vision than evidence which, with the latest NHS England contract costing c.£400M, represents an expensive leap of faith. The complexity of these programmes calls for social and organisational research alongside evaluation of impacts on efficiency, quality, safety and patient care.
Clearly, information systems won’t plug the need-capacity gaps that we are observing in the NHS workforce today, for which organisational and policy solutions must also be found, but they are a step in the right direction. With luck, we will see evidence of benefit in the near future but this needs to be properly monitored and evaluated.
Claudia Pagliari leads the Global eHealth Programme at the University of Edinburgh’s Usher Institute for Population Health Sciences and Informatics and is a member of the Administrative Data Research Centre for Scotland, the Farr Institute of Health Informatics Research (Scotland) and the Global Health Workforce Council.
Aizhan Tursunbayeva is a visiting doctoral researcher at the Farr Institute of Health Informatics Research (Scotland), studying information systems in healthcare under the supervision of the other co-authors at the Universities of Molise and Edinburgh. She previously worked as an HR manager for HSBC.
Competing interests: We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.