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Case for Change

9. Our infrastructure impedes our ability to recruit and retain our workforce

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

Investment in new infrastructure is essential if we are to increase the supply of a talented, exceptional workforce into priority specialisms. We need investment in our infrastructure to provide state of the art facilities and technology, which will strengthen our position as a centre of excellence for research, education and specialised care. This will promote a step-change in the attractiveness of Lancashire and South Cumbria to potential recruits and the highest calibre of clinicians and wider staff.

Investment will create jobs and support the economic regeneration of our region, since the global pandemic has disproportionately impacted those most in need. It will also increase our attractiveness as a commercial partner of choice.

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 (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% (source: NHS Digital (opens in new window). More than 20% of the workforce is over 55 years of age, which provides an added retirement risk (source: Lancashire and South Cumbria Health and Care Partnership’s Clinical Strategy (opens in new window). Some of these challenges are national shortages. However, the very poor condition of our infrastructure at Royal Preston Hospital and Royal Lancaster Infirmary is a structural barrier to the Trusts’ ability to recruit and retain a sufficient and high calibre workforce. This is now a significant – and increasing – issue for our ability to operate and our sustainability as a health service within the region.

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 (LTHTr) and University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) are key contributors to the NIHR portfolio studies, with two of the North West coast clinical leads working in both Trusts. LTHTr is also home to the NIHR Lancashire Clinical Research Facility and the Health Academy. Since its establishment in 2015, the Health Academy 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.

Despite the strength of our reputation, the outdated condition of our estate and tired education and research facilities mean that UHMBT and LTHTr are not an attractive proposition for trainees embarking on their career. There is a large student body at all sites and with the expansion of medical student places, 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. However, to help with recruitment and support the teaching of these students, new infrastructure will be paramount.

We need investment in our infrastructure to provide state of the art facilities and technology, which will strengthen our position as a centre of excellence for research, education and specialised care. This will promote a step-change in the attractiveness of Lancashire and South Cumbria to potential recruits and the highest calibre of clinicians. 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.

New hospital facilities could potentially be part of a larger development linking directly with local research and academic institutions. There are exciting possibilities to explore, connecting NHS health research to the growth sector of applied health technology, pharmacological and medical device manufacture. This sector is expanding rapidly and brings with it high-quality jobs and opportunities for local people.

The workforce supply challenges we face are a contrast to the communities we serve, where there is wide variation in the levels of economic participation and intergenerational worklessness. 65% of Barrow-in-Furness residents work at Furness General Hospital or BAE Systems.

One of the core aims of the New Hospitals Programme is to reduce health inequalities and to bring jobs, skills and contracts to our residents and local businesses.

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.

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© 2021 Lancashire and South Cumbria New Hospitals Programme.