It’s hard to know how to make my point with greater emphasis. Should I hire a company for a bill-board campaign?

How do we create a sense of urgency…

Urgency, not panic. Somewhere between dread, terror and horror! Urgency, not doom… it’s a leadership skill.

Pulling it off needs the five ‘always’;

• Always, demonstrate a sense of seriousness and commitment to finding a solution.

• Always, share the reality of bad news with the organisation.

• Always, talk directly with people in the organisation; share data, make sure there is a full understanding of the issues.

• Always, get buy-in to solutions however tricky, unconventional or different.

• Always, showcase success, however small.

Right now, I don’t see any of that. I don’t know what it’ll take to poke NHSI enough, to make them realise the only job they have, their entire focus must be, every ounce of energy has to be given over, to sorting out the workforce crisis.

Here’s a vignette of the scale of the problem. Paediatric rota gaps; the vacancy rate is 14.6% on tier 1 rotas and 23.4% on tier 2 rotas. It’s not safe and not the right way to look after sick-kids.

There is almost no part of the NHS that does not have a people problem. If you don’t want to listen to me, listen to Mark Britnell.

His job takes him to the far-flung corners of global health. Listen to him.

In his latest book, ‘Human’ he has uncomfortable news. Bad news. Very bad. Our crisis is part of a global workforce crisis, it’s landed here and already coming down our street. Before we know it’ll be kicking down the front door.

Britnell tells us, there is no easy way out.

• Global shortages puts ‘importing’ a solution out of reach.

• Growing our own will take too long.

• Putting our fingers in our ears and singing committee won’t work…

… changing the way we do things is painful, uncomfortable and contested but is probably the only way out.

Britnell calls on us to reframe the debate about workforce-planning and shift our thinking to productivity, health and wealth creation. He has been to 77 countries. He knows what’s what.

He points to Israel, India, Germany, China, Australia, Japan, Brazil, the EU and the US for warnings, comparisons, pitfalls, ideas and solutions.

There is no global solution, only things to learn, from the four corners of a world, puzzling over the same troubles.

We need open minds that are soft-spoken, concentrating, taking heed.

There is no arrogance to Britnell’s messages. He gives us a courageous optimistic view of 2030;

… much face-to-face care, supplanted by remote, digital and artificial intelligence.

Primary care will step-up; population health management, patient segmentation and stratification, all main stream.

Patients doing more for themselves.

Integrated pathways of care and hosptials full-filling their potential as centres of excellence.

Britnell is looking for a 20% increase in productivity. Jobs, skills and innovation. Read his take on Singapore.

None of this is whimsey, it is doable and being done but it pulls us up short and pushes us to face the reality we are careering towards.

Promoting health as jobs and careers? Do it like Norway; 20% of its population proudly work in the sector. Greece struggles with 5%.

This book is a cornucopia of painstakingly researched information, statistics, graphs and numbers. More than worth its cover-price, donated to charity, as a work of reference, alone.

Interwoven are the paradoxes; technology changes faster than we are prepared to evolve our services. Outpatients, fingered by Britnell and singled out in the LTP, the unreformed backwater of a 60’s NHS.

In an OECD survey 70% of doctors and 80% of nurses reported being over-skilled for aspects of their work. It’s a criminal waste.

Intriguingly, Britnell tempts us with a redesigned future; generalists and peripatetic community workers supported by artificial intelligence.

My worry; NHSI, now in charge of rebuilding the workforce, is a regulator and believes solutions are only found by regulating from the C-Suite.

Britnell knows, we know, solutions can only be discovered ‘out-there’, among the people doing the job, here and in the world outside our world.

Listen to Britnell. Read his challenging, thoughtful, testing, elucidating book. No member of a Board has business to be without a copy.

• We are edging to a crisis but it is not our destiny to fail.

• We can learn, from the world.

• We must take courage from what works and redesign and retrain for what does not.

If we are nimble enough, savvy enough, honest enough, we can succeed… because as Britnell reminds us, we are human.

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Reproduced at by kind permission of Roy Lilley.