An NHS workforce for integrated care

A workforce designed to deliver integrated care based in the community where possible would improve user experience and deliver better value for money. A primary factor driving future demand for healthcare is the increase in the average age of the population. The changing composition of the population has implications for the amount and type of healthcare that is required. Older people are more likely to have multiple, complex and long-term health conditions. Such individuals are best served by integrated care.

The Five Year Forward View recognises that "caring for these needs requires a partnership with patients over the long term rather than providing single, unconnected 'episodes' of care". However, the current lack of integration between different aspects of the health service prevents the highest quality service being delivered.

Integrated care is not possible without an integrated workforce. Yet the current workforce operates in isolated components and is imbalanced towards the acute sector – a trend which is on track to worsen. Centralised management of the NHS workforce has not delivered with nearly three times more doctors, and four times more nurses in the acute sector than in the community.



The shape of the workforce

Since 2009, the number of consultants has risen by nearly a third, whilst the number of GPs has fall.

Freedom of Information requests made for the report, Getting into shape: Delivering a workforce for integrated care, found that, across 61 acute trusts, only 6 per cent of consultants work in the community for at least one session per week.




Overcoming professional boundaries

The NHS must seek to deliver a workforce capable of working across boundaries, both professional and structural. This will require both an overhaul of the training of health care professionals and of their regulatory frameworks. Getting into shape: Delivering a workforce for integrated care proposes a devolved strategy for workforce planning whereby local areas are free to train and retain the staff they need.


Kate Laycock, Senior Researcher, Reform

Maisie Borrows, Researcher, Reform


Read the full report at: www.reform.uk