Have the lobster

primary_care_training_cleveland_clinic

If you were thinking about a fish-supper in Abu Dhabi you could do a lot worse than Finz.  Not for the view.  No rolling sand-dunes or inviting waters of the Gulf... go in the evening. 

... you'll get a bit of water and an artificial beach but mainly you'll get to look at one of the most weird buildings imaginable; it is 409,234 square metres and makes no attempt to hide its huge mass.  Blocks of structure piled like a giant Jenga.  

... lit, in electric blue, it demands your attention.  

It's the Cleveland Clinic.  Some clinic!  A building that says; 'Look at me!'  

Three hundred and sixty four patient beds, staffed by 175 doctors, 1,501 nurses and other health professionals.  Stunning, inside and out.

I'll leave you to do the bed-to-staff ratio thing...

Here's a little factoid you might enjoy.  

Before the hospital opened there were more than 5,000 physicians, from around the world, who applied for the available 175 doc-jobs. 

Those finally hired had to complete 40 interviews; 20 in the US and 20 in Abu Dhabi.  Technical, medical, psychometric... all sorts. 

Eighty percent of the successful applicants were US-trained, the rest... western Europe.  

In total; staffed by the united nations of health care.

The Cleveland Clinic.  It attracts the best.  Yes, there's the money but the cost of living is high and to be honest, unless you like living in an oven, the climate may not suit everyone.

Why go?  My guess; it's something to do with wanting to work with colleagues who are the best in the world, to work where the kit is the latest, the aspirations are the highest, a place the exudes, oozes and drips quality.

There's a serious lesson to learn... about workforce strategy.  

Like the NHS, most health care systems are focussed on cost reduction; shifting patients to lower cost settings, cutting admin and supplier costs but at the heart of the challenge... workforce.

A 2013, WHO report was forecasting, by 2035, a global shortage of care workers of 12.9 million!

It's not just our-NHS that has a problem with caring for an ageing population.  We've an ageing workforce and the prospect of working in undervalued and underpaid healthcare roles, attracts no one.

HEE's own jaw-dropping data tells us; 

'... 44% of nurses leave because of working conditions, 27% disillusioned with the quality of what they can deliver and 28% the NHS is unable to create working arrangements to accommodate changes in personal circumstance... families and carer responsibilities..'

The increased risks from noncommunicable diseases, such as stroke and dementia creates a demand for labour-intensive care that we can't fund or find.

In developed countries, 40% of nurses will be leaving the profession in the next ten years and very few are self-sufficient in care-workers.

Most systems rely on migrating professionals and others to fill the gaps.  There will be increased competition for a workforce that can be remarkably mobile and for reasons that are not only about money.

We have created an additional problem for ourselves; no longer able to rely on workers from the EU.  There's no prospect of a 'grow-yer-own' policy meeting demand.  Demographics defeat it.  

The Cleveland Clinic is an international destination of choice.   We close our doors to the world at our peril.  What's our plan?

No Phd required, no massive workings out.  We need more people and to attract them we have to be very nice to them and to keep them; look after them...

Be like the Cleveland Clinic...  

Create the right working environment and people will come and value the work... when they know their work is valued in return.

The NHS?  Endemic bullying, prejudice, pay inequalities, unrealistic pressures, sickness-levels, family-unfriendly, oppressive regulation, torturous shift patterns, employment-terms set by politicians who take vocation for granted and forget it is a gift that doesn't pay the rent.

We are not just competing for staff with retailing, commerce and industry.  We are competing for talent on a global scale.

I sense no urgency.   

Take into account leavers, retirees and those who wake-up to the fact there is a life beyond back-to back 12hr shifts... or; you can do great work where there's no oppressive regulation, without vacuous targets and you soon realise... we're not serious about our workforce.  

Not even in the game.

If you are in doubt... have the lobster.

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roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.