Posted by Philip Satherley
14:30 BST - 20 December 2011
The National Council for Palliative Care (NCPC) has published a survey of the specialist palliative care workforce (nurses, allied health professionals (AHPs) and medics) in England, focusing on numbers employed and in what setting. The survey is based on 2010 data and, helpfully, is compared to similar data gathered over the past 5 years - this allows us to examine changes in workforce patterns. Key concerns are that there is an ageing workforce, and a shortage of professionals in the palliative field. If left unchecked, these may impact negatively the care of terminally ill patients in the years to come.
On a positive note, numbers of dedicated palliative care professionals appears to have risen (or at least stayed steady) over the years. However, the ‘participation’ level of staff (i.e. the % of time they work when 100% is considered the norm) has fallen/fluctuated for nurses (from 86.9/69% in 2005/2009 to 79.5% in 2010) and dramatically fallen for palliative consultants (from 66.2% in 2007 to 58.8% in 2010). Part-time staff have to fill these gaps, which then raises the issue of consistency of care and how to ensure that part-time staff are kept up-to-date with new policy and practice.
An ageing workforce and vacancy rates was also discussed in the report. The proportion of nurses aged over 50 years remains high at 39.2% and there is an 8.7% vacancy rate in nursing nationally. The story is similar for both medics and AHPs (such as occupational therapists and social workers), which has an obvious impact on the delivery of palliative care across the country.
Not surprisingly, the survey found that a large portion of palliative nurses, medics and AHPS work in the ‘voluntary’ palliative sector. There has been a recent push for the commissioners of services to work with the voluntary sector more. This, combined with a policy emphasis on patients being managed at home and/or being able to die outside of the traditional hospital setting, will impact on the palliative workforce over the coming years. Action to ensure that experienced (and new) staff are able to fill the boots of those who might retire soon, and policy to ensure the right skill-mix of health and social care professionals is available is urgently needed.