The Welsh Government and NHS Wales are taking a number of actions to reinforce the health and social care workforce in response to the coronavirus pandemic. These include:
- actions to expand workforce capacity by asking professionals who have retired or left professional registers to return to the workforce and putting in place some provision for third year medical students to begin practising earlier than may normally be the case: and
- actions to re-deploy and re-train existing staff.
This article summarises the actions taken to reinforce the workforce and provides the latest information available on how they are being delivered.
We’ve produced separate articles on personal protective equipment (PPE), and testing which provide information on how these issues affect the workforce.
Who is returning to the workforce?
The Welsh Government has been asking professionals who left the health and social care workforce to return and provide support to the sector during the pandemic. The medical and nursing councils, professional health bodies and Social Care Wales have put in place temporary registers to allow those wishing to return to temporary paid employment in the sector to do so.
Those included on temporary registers in the health sector have been asked to fill in an NHS survey which indicates the areas in which they are able and interested to work in and how many hours they can work. Registration requirements and procedures differ according to professions, as set out below.
COVID hub Wales has been established with support from the Welsh Government and the NHS Shared Services Partnership to advertise coronavirus related vacancies in NHS Wales for those wishing to work for the NHS during the crisis. Social care vacancies have also been linked to the hub.
Doctors
The General Medical Council (GMC) has established a temporary register which includes all doctors with no fit-to-practice issues who left the register since 2014, or doctors who are on the register but don’t have a licence to practice. Doctors can opt out of the register if they don’t wish to return, otherwise doctors included on the register are asked to fill out the NHS survey.
Final year medical students can apply to be provisionally registered and the GMC says that it will process their application at an earlier point than usual. Medical schools have been asked to bring forward graduation of final year medical students where possible to allow for registration to take place sooner.
Nursing staff
The Nursing and Midwifery Council (NMC) has been writing to those previously on its register in stages, inviting different groups to join the temporary register. As of 6 March 2020, anyone who left the register within the last four or five years has been invited to re-register, as have overseas applicants who have completed relevant registration requirements.
On 7 May 2020 the NMC announced that it will no longer be asking nursing students in the final six months of their studies to join a temporary register.
Allied health care professions
The Health and Care Professional Council, the professional body for allied health care professionals such as paramedics and physiotherapists, has published a temporary register of all professionals who have left the register in the last three years.
Those wishing to return can apply directly for temporary vacancies or fill out the NHS survey. Final year students on approved programmes who have completed all of their clinical practice placements have also been added to the temporary register.
Pharmacists
The General Pharmaceutical Council has published a temporary register of pharmacists and pharmaceutical technicians. It includes all those who have left the register in the last three years who have no fitness-to-practice issues.
Pharmacists were given the option to opt-out of the register before it went live. Those wishing to return to work are asked to fill out the NHS survey registering their interest and availability. There are currently no plans to add trainees or students to the temporary register.
Social care
Social Care Wales has established a temporary register of social workers who were previously registered but have left in the last three years. Those wishing to be registered temporarily can opt-in to the register by contacting Social Care Wales.
How many have returned so far?
Although up-to-date figures do not appear to be publicly available, the Welsh Government outlined that as of 16 April 2020:
- 1,376 doctors and 417 nurses had ‘re-joined the frontline’:
- 257 allied health care professionals and scientists had registered their interest in returning using the NHS survey; and
- 358 pharmacists and pharmacy technicians were included on the temporary register for their profession.
On 5 April 2020 the Welsh Government said that 1,200 registered GP locums were preparing to enter the NHS Wales workforce.
As of 19 May 2020, 68 social care workers in Wales had joined the temporary register.
How many have been needed?
During a meeting of the Senedd’s Health, Social Care and Sport Committee on 14 May 2020, the Royal College of Nursing (RCN) Wales said there has been a mixed response from its members on how well retired nurses have been brought back into the system. Nurses with acute skills have been quickly redeployed into acute environments, but many of those who identified that their skillset might be more suitable to support the 111 system, for example, have not received any contact from the Welsh Government.
RCN Wales believed that the process of moving returning professionals into posts has been too slow. However, it suggested that the required workforce numbers initially estimated (when learning from other countries such as Italy) have not been needed. For example, student nurses have not needed to join the register early.
The Royal College of General Practitioners (GPs) Wales reiterated during the same meeting that although a fair number of GPs have volunteered to return to the profession, the expectations at the beginning of the pandemic have not been realised and the shortage of staff has been less critical.
The nurses that have been through the process have been very complimentary about the support and the training received to carry out clinical work. However, if there is a second wave of the virus, RCN Wales stated that “we do need to get this process to be slicker so that we can quickly move those people from an expression into a post”. Ensuring there are good numbers of appropriately trained staff to deal with future need was also emphasised by the Royal College of GPs.
Support to those returning
The Welsh Government has issued guidance for individuals in different professions who are re-joining or thinking of re-joining the workforce. The guidance covers issues such as pensions, pay, working conditions and training.
The Welsh Government has also taken actions to ensure that all those returning are provided with indemnity for the duration of their temporary practice, either through existing professional indemnity schemes or through new powers provided to them by the Coronavirus Act 2020. This means that all those returning will be covered in the case of any clinical negligence claims that may arise during the course of their temporary return.
The UK Government has also taken actions to ensure that the pension rights of returning professionals who have retired is not affected by their temporary return to work.
Individuals returning to work in the sector will also benefit from the wider support and benefit measures put in place by the Welsh Government, businesses and other bodies for health and social care workers during the crisis.
Some of the benefits and support put in place include:
- a Death in Service Scheme;
- £500 extra paymentfor all social care workers in Wales;
- free bus and rail travelfor NHS staff;
- parking passes and concessionsfor health, care and volunteer workers: and
- free mental health support servicefor all front-line NHS Wales staff.
Measures to re-deploy existing staff
NHS Wales is taking measures to re-deploy existing staff, particularly to provide support in adult critical care services. On 6 April 2020, the Minister for Health and Social Services, Vaughan Gething, said:
Across Wales, training has been provided to upskill hundreds of staff who do not normally work in critical care. The time and space to undertake this training was a key consideration in my decision to pause large amounts of NHS activity on 13 March.
On 25 March 2020 NHS Wales issued a guide setting out principles and guidance for re-deploying nursing staff to assist with any surge in critical care capacity. The guide states;
A surge of coronavirus patients will require increased critical care bed capacity. Therefore, a review of staffing due to the need to increase bed capacity, potential staff absence and staff movement from other areas is necessary. Staff moved from other areas may have limited or no knowledge of acute and critical care services and will be required to support increases in critical care activity.
A joint statement on developing adult critical care capacity and re-deploying nursing staff was also made by the UK’s health departments, professional bodies and trade unions on 25 March 2020.
In relation to the care sector, Health Education and Improvement Wales has introduced an online medication training course to enable more care workers to administer medication to people in their homes. The fear that NHS Wales staff could be overwhelmed in treating coronavirus patients hasn’t currently materialised. However, the uncertainty surrounding the future impact of the virus means that the Welsh Government will need to be prepared and have the extra workforce in place to respond to any further peaks in the virus.
Article by Rebekah James and Nia Moss, Senedd Research, Welsh Parliament
We’ve published a range of material on the coronavirus pandemic, including a post setting out the help and guidance available for people in Wales and a timeline of Welsh and UK governments’ response.
You can see all our coronavirus-related publications by clicking here. All are updated regularly.
