How can we tackle the NHS burnout crisis?

Dr. Anas Nader

In this exclusive interview with Business Leader, Dr. Anas Nader, Co-founder and CEO of workforce management platform Patchwork Health, discusses how we can tackle the NHS burnout crisis.

What is your background and what inspired you to co-found Patchwork Health?

Originally from Canada, I moved to the UK in my early twenties to train and work in the NHS.

During this training period, my co-founder Jing (also a doctor) and I gained first-hand experience of the toll that long shifts, relentless pressure and sporadic days off can take on one’s mental health and wellbeing. It was sad to watch numerous colleagues go through the same stress and burnout cycle, many pushed to the brink of leaving the profession to which they’d dedicated their whole lives.

We saw the knock-on impact that many outdated NHS workforce policies and technologies were having on staff, patients and organisations. Retention was poor, as staff struggled to achieve a fulfilling career balance. Inflexible rotas made it difficult to fill shifts at short notice, and external agency staff had to be over-relied upon to plug the gaps.

Driven by a mission to make NHS careers sustainable and aspirational again for the benefit of everyone, Jing and I founded Patchwork Health. The business has scaled quickly and successfully: today we work with over 70 NHS organisations to deliver workforce management solutions for all health and care staff, that reduce rates of staff burnout and improve patient care delivery.

What is the cause of the current workforce crisis in the NHS?

The causes of the current workforce crisis are complex, but burnout is certainly a critical factor.

The way that NHS workforce planning currently operates means that staff have little to no say in when they are scheduled for shifts. This makes it very difficult to balance an NHS career with family or other professional responsibilities, further study or personal development. Shifts are often long and exhausting, leave is assigned rather than safely chosen, and this has been the norm since long before the pandemic.

More and more staff are turning to external agencies in order to achieve the flexibility they want, and this is fuelling a cycle of full-time staff shortages, which intensifies the pressure on those who remain in the NHS system. Although they are undoubtedly doing their best to deliver outstanding care, the detrimental impact of burnout on staff mental health is sadly pushing thousands out of the system altogether every year.

Have things improved since your time working as a doctor?

There’s certainly an increased awareness of burnout and the importance of wellbeing, both in healthcare and across other professions. I’m pleased to say that many NHS organisations have made excellent progress in improving flexible working opportunities for their staff, and dozens more have shown a real enthusiasm for change.

However, unfortunately, this is not yet the norm. Across the UK as a whole, the underlying causes of burnout and staff exit remain largely unresolved. Many of my colleagues continue to be faced with a Catch 22; stay and struggle within a system that’s not working in the best interests of all involved, or step away to seek alternatives that better safeguard their mental health.

How is Patchwork Health helping the NHS to address the current workforce crisis?

It’s clear that it’s system failures, not people failures, that are preventing the very best outcomes from being achieved in the NHS. If we are to see positive change, transformation of workforce technology systems is where we must start.

We have developed a unique, innovative approach in collaboration with our NHS partners, which is called ‘Outcomes-Based Staffing’. We are thrilled to see this approach being embraced by the NHS nationally, with over 70 NHS organisations having adopted it so far in the UK. This method of workforce management combines technology and services to connect the healthcare ecosystem, allowing organisations to safely collaborate across boundaries, giving clinicians more control over their own schedules, and ensuring the patient receives exceptional care.

It also reframes traditional approaches to the roles of clinicians, moving away from the approach of only allowing clinicians with the right ‘title’ to do a particular job, and instead replacing it with a ‘skills-first’ strategy for task assignment. All of this is geared towards helping employers manage rotas guided by what they need, rather than struggling with what they have.

In short, there’s no silver bullet or quick fix for the workforce crisis. But the Patchwork Health team is helping to make NHS careers sustainable, attractive and aspirational, and that’s exactly where we need to start to see positive change.

What effect has the pandemic had on NHS staff?

The pandemic has really shown us the skill, compassion and dedication that lies within the people of the NHS. However, it’s also been a long and exhausting two years for workers across all parts of the NHS. With no sign of pressures abating, rolling out wellbeing support and initiatives is more important now than ever before.

It’s been particularly tough for newly-qualified doctors – many were enlisted to help in the fight against COVID-19 before even finishing their studies. Thrown straight in at the deep end, they’ve faced a real ‘baptism by fire’. And because this generation understands the importance of prioritising mental and physical well being and achieving a sustainable career balance, they’re now joining calls for fundamental change to existing systems.

Do you feel the government has done enough to alleviate the strain being placed on NHS staff?

The government clearly understands the importance and urgency of tackling the workforce crisis. But rather than trying to solve the problem with cash injections, they must prioritise building an affordable, sustainable NHS workforce that isn’t constantly scrambling to fill gaps with an over-reliance on agency staff.

Ministers must not turn a blind eye to the needs of NHS staff, but rather work with them to create and deliver effective remedies for the specific pain points which underpin the crisis. This means investing in retention initiatives, adopting modern fit-for-purpose workforce management technologies and services, re-imagining what we expect a ‘typical’ NHS career to look like and prioritising staff wellbeing with immediate effect. Our health and care staff – and our patients – deserve better.

What are the future plans for Patchwork Health?

We’re marking a step-change in how healthcare organisations manage their workforce and support their staff. The last two years have shown us the power of the NHS when it’s allowed to truly collaborate. Now it’s time to harness that energy and push for long-term transformation.

We’re working hard with our NHS partners to make Outcomes-Based Staffing a reality for patients, staff and organisations across the UK. Over the months and years to come, we’re aiming to support many more healthcare organisations to embrace this solution, laying the foundation for a stronger, happier, healthier NHS for everyone.

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