The need for standardising healthcare recruitment in the digital age

Jim Campbell, Director of Health Workforce at the World Health Organization, speaks to Sarah Cartledge about the need for an international healthcare workforce register in the current climate

Workforce has always been a pivotal issue within healthcare discourse, even before the Covid-19 pandemic threw global healthcare systems into total disarray. As the world’s population continues to increase exponentially in some areas and ageing populations further develop in others, the question of how we can continue to provide and better our healthcare systems is a conundrum with no simple answer.

However, the pandemic has provided us with more information than we once thought. By showing us what doesn’t work and which systems are no longer sustainable, we can garner key lessons and kickstart a new strategy that will enable healthcare systems to thrive. Slowly but surely, governments are beginning to recognise the major healthcare problem is with workforce and it needs to be addressed e ectively.

“A series of reports and reviews of the Covid-19 pandemic recommendations clearly say that in European healthcare systems, the public health requirement, and the preparedness element of our organisations have seen massive underinvestment for far too long,” says Jim. “A good comparison is a budget airline; there’s no bandwidth. If you sell every ticket and 10 per cent of the tickets twice to account for no-shows, if everyone does turn up, you’re overcrowded - and overcrowded means underfunded and understa ed. It’s the reality.”

As such, the world is waking up to the workforce problem. With underfunding, lack of resources, and poor recruitment into health services greatly exacerbating the issues which we have faced throughout the pandemic, now is the time to refocus e orts. Yet, when the issue is not only monetary, but largely a human resource issue, where do we begin?

The digital solution

The rise of digital health solutions has been one of the most important aspects of the pandemic. Innovators and entrepreneurs have responded rapidly with platforms and apps that have accustomed healthcare workers and patients alike to a new way of viewing their health. Telehealth and mHealth technologies, health monitoring apps, and tracing have all been tools which have rapidly developed throughout the past two years, and the benefits of which have been seen in all fields - chiefly due to the requirement born out of social distancing.

Yet this is not something which only fulfils a purpose within the pandemic. Digital health will continue to be the sharp end of healthcare in the 21st century, and long a er the pandemic becomes endemic.

However, what can digital do to improve the issues within the healthcare workforce? The answer, Jim suggests, lies in regulation.

“I personally believe that we should have a global register. We have the technology to do this, instead of having separate registration systems and medical registers, a global system which still operates through licences. We’ve been seeing the use of digital solutions around data, information, recordkeeping and vaccinations all come through into a totally di erent age and now being used to enable public health and safety measures.

“Yet, are we ever going to see this change in regulatory behaviour? In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions - and could potentially save the industry billions of dollars.”

Jim Campbell Director of Health Workforce WHO

“In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions”

The global scramble for health workers

In the UK, a huge portion of the NHS relies on sta who are not domestically trained but have been brought in from abroad - chiefly Asia. However, this is not a sustainable model nor a strategy for a pandemic, especially now that many NHS sta are leaving the organisation to work elsewhere. So, how can the NHS continue

to attract, and most importantly, deliver talent?

“At present, the NHS has put £25m on the table to pay for flights for anybody who wants to come and take advantage of the vacancies in the NHS. To say we welcome you with open arms, we will facilitate your migration to the NHS is very positive, especially within the context of the pandemic,” observes Jim.

“There was recently a discussion between President Kenyatta of Kenya and Boris Johnson which touched on the unemployed nurses in Kenya who have the opportunity to come and work in the NHS. But you have to ask the question - why are they unemployed in Kenya? It’s not that Kenya doesn’t need these nurses; they just can’t a ord them.”

So despite arguments to the contrary, the wealth in healthcare is in the population. As education improves and the standard of living continues to rise in LEDC’s, people will naturally begin to expect more out of life. Within the NHS, career development aspirations, especially for people with tertiary education, are much more available. The person who comes to the NHS is going to benefit, but they will take their skills home.

But the pandemic has seen travel restrictions and other curtailments that have impacted the healthcare workforce. “We have seen a moratorium placed on the licensing of health professionals to travel abroad, which can have a huge impact on migrant workforces. The Philippine government put a moratorium on newlylicensed nurses which has since been li ed because they needed the people to be working through the pandemic,” says Jim.

Thankfully, the only stoppages of migrant workers we have seen so far have been temporary. However, if situations deteriorate in future, we know that it is feasible for governments to entirely halt the movement of healthcare workers abroad - which could be devastating for those healthcare systems that rely on foreign workers.

In the meantime, a global register of healthcare workers would give an instant overview of availability and capacity. It would cut down recruitment times and enable testing to take place easily. Such systems already exist to enable nurses to renew their licences in some countries, so it could easily be extended to create a global directory.

There are still issues which this shi can pose - and many questions which arise from it. Who regulates the data? How can we standardise this? These are issues which need consideration - but at least we understand that we have the ability to do so. Only time will tell if we can successfully achieve this - or not.