Towards an evidence-informed statement of intent: key messages on workforce development

National responses to COVID-19 showed that the health and care workforce is capable of hugely positive change. The lessons generated offer powerful evidence on how best to develop a sustainable workforce to deliver on the ambitions of universal health coverage (UHC), health security and the sustainable development goals (SDGs).

If governments are to take forward the policies and practices that worked, they should know that:

1. Changing scopes of practice and introducing team-based roles is central to an effective, sustainable workforce and can be achieved.

   • Health and care workers (HCWs) have proved that they are willing and able to adjust and optimize their roles and meet service needs.
   • There is an opportunity to capitalize on this and adapt team-based practice across all health and care services, including the essential public health functions. Options include:

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     optimizing multidisciplinary work and expanding the skill-mix

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     configuring professional and support roles to maximize available personnel by better leveraging their respective educations, competencies and licences

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     involving patients and their caregivers in home-based prevention, care and support.

   • The changes that worked during the pandemic can be sustained best when:

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     health professional bodies engage with change

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     incentives are adjusted

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     protection and support for HCW are in place.

2. The use of technology and digital tools has taken huge steps forward – and needs to continue and expand to all countries.

   • Information technology (IT) and digital tools – especially for remote consultations – allowed health systems and health professionals to overcome COVID-19 challenges and maintain care continuity.
   • Expanding the use of technology in the way care is provided can counteract the challenges associated with shortages, maldistribution and skills mismatch.
   • Care must be taken to avoid exacerbating inequalities, particularly for the digitally excluded.
   • Health outcomes need to be monitored to ensure quality is not compromised.
3. Flexible regulation is the way forward.

   • Exceptional measures made changes in scope of practice and the introduction of digital tools possible during the pandemic.
   • Systems need to be able to adapt as health systems evolve and this means:

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     reviewing the legislative framework that defines the space in which the health and care workforce (HCWF) operates

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     considering how regulation works and how quickly it can be adjusted

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     tackling licensing issues.

   • The lessons of the pandemic suggest the value of flexibility in regulation and the importance of:

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     high-quality training and education that will allow the HCWF to meet new responsibilities

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     monitoring and review of change, transparency and accountability.

4. Protecting the health and care workforce is essential.

   • Governments made real efforts to protect the security, safety, and physical and mental health of workers during COVID-19.
   • Improved working conditions and support are obligations of employers and help to retain workers. It requires governments to:

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     provide physical security and decent working conditions

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     address diverse needs and psychosocial risk factors, and tackle stigma and discrimination

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     consider wider measures around childcare, transportation and safe accommodation.

   • Getting support and protection right enhances retention of the existing workforce and will attract a new generation of HCWs.
5. Providing political leadership starts from the top and sets the agenda throughout government and society.

   • Heads of state and government leadership and their focus on health made whole-of-government commitments tangible during the pandemic and delivered both resources and solutions.
   • The challenges facing the HCWF are immense and demand the highest-level political commitment and engagement to:

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     secure financing

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     strengthen governance to achieve real collaboration across sectors

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     prioritize the long-term commitments the HCWF needs.

   • Implementation means political investment in:

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     building HCWF capacity to deliver health and care services as well as public health measures

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     filling critical gaps in public health, and making the HCWF ready for future emergencies

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     using data monitoring and analysis to plan for the right people and the right services

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     ensuring education and training fosters the ability to adapt to future change.

   • The HCWF is central to UHC and health security, and repays political commitment through promoting social cohesion, solidarity and security.

Contents

• Acknowledgements
• List of abbreviations
• Executive summary
• POLICY BRIEF
  • 1. Introduction
  • 2. What strategies did countries adopt during the pandemic to surge, optimize, and protect and support their health and care workers, to what effect, and what have we learned from this?
  • 3. What has been done to implement HCWF strategies during COVID-19 and what are the lessons?
  • 4. Conclusions and policy considerations for the future
• Appendix 1
• Appendix 2
• Appendix 3
• References
• The Policy Brief Series

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