Case for Change summary version (published July 2021)

Our infrastructure impedes our ability to recruit and retain our workforce

The very poor condition of our buildings at Royal Preston Hospital and Royal Lancaster Infirmary is a structural barrier to attract and retain workforce. This is now a significant – and increasing – issue for both our ability to operate, and our sustainability as a health service within the region.

Staff recruitment and retention

Our NHS hospitals across Lancashire and South Cumbria employ 40,000 staff, with Lancashire Teaching Hospitals NHS Foundation Trust (LTHTr) and University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) employing 7,000 and 7,500 people, respectively.

Like many healthcare systems, we face significant issues with workforce supply and retention. Regionally, our vacancy gap is 9% – this is above the national average of 6.9% referenced from NHS Digital (opens in new window). More than 20% of the workforce is over 55 years of age, which creates an added retirement risk referenced in our Clinical Strategy (opens in new window).

It is hugely challenging to recruit and retain enough skilled staff to operate our hospitals. As a result, many UHMBT and LTHTr services are heavily reliant on the use of agency staff.

In 2019/20, £49m was spent on Band 5 agency usage alone, with £16m spent at LTHTr. UHMBT agency nursing spend is much lower, but the Trust spends £3m per year on medics, nursing / midwifery and allied health professionals (AHP) agency staff. Poor working environments are a significant contributor to this issue.

Forward-thinking commercial organisations are focusing their efforts on the design of workforce environments that offer healthier, more comfortable and more effective places to work – indeed this is a key consideration for most people seeking employment. Alongside wellbeing, staff feedback tells us that they want a working environment where they can care for patients and operate with the space and facilities they need to perform their roles to the standard that they and patients expect. This is often not the case in the ageing buildings we are asking them to work within.

Research, education and specialist status

There are ground-breaking innovations taking place in research and education in Lancashire and South Cumbria. We want to stay at the forefront of this work for the benefit of our patients and to secure our position as a centre of excellence in specialist care.

Our strong reputation is evident from the NHS in Lancashire and South Cumbria’s significant contributions to the National Institute of Health Research (NIHR). Lancashire Teaching Hospitals NHS Foundation Trust is also home to the NIHR Lancashire Clinical Research Facility and the Health Academy, which has won a number of prestigious awards. However, we cannot attract the best clinical leaders and leading medical researchers in their fields with our current infrastructure.

The outdated condition of our estate, and tired education and research facilities mean that University Hospitals of Morecambe Bay NHS Foundation Trust and Lancashire Teaching Hospitals NHS Foundation Trust are not an attractive proposition for trainees embarking on their career. There should be an opportunity to attract more medical students from Lancaster University, the University of Central Lancashire (UCLan), Edge Hill University and the University of Manchester. New infrastructure will be paramount to encourage recruitment and support the teaching of these students.

We work with a range of external academic and business partners at both a regional and national level. Our links with the university sector are going from strength to strength and there is a shared ambition to drive research, education and innovation across our region. There is a significant opportunity to increase our attractiveness as a partner of choice.

Opportunity for economic contribution

The New Hospitals Programme offers a significant opportunity to enable the people of Lancashire and South Cumbria to train and work in our healthcare system, both within our anchor institutions and through additional investment and economic growth opportunities brought to our region by this development.