One of the issues that the good and the great are pondering is the role of different professions in the future.
With more medical, nursing and allied health professionals employed in the NHS and independent sectors than ever before, it is a timely question - more so when we consider the advances being made in medical science.
Just as open surgery has moved to laparoscopic, robots loom and gene therapy becomes a reality, what will be the role of the doctor in the future? And what about nursing? With more and more specialist nursing roles, the number of people willing, able and available to do the traditional nursing duties of hands-on care will inevitably become an issue.
Thinking more laterally, the different non-clinical professions such as housekeepers, receptionists and health records clerks can all have a major impact on the care provided too. Consider the impact of the incomplete set of medical notes, the odd offhand remark by a receptionist or poor cleaning on not only the patient experience, but also patient safety and direct care too.
If you have wandered round your place of work recently, have you ever noticed the age profile of your staff? This may be a function of ageing myself but at Brighton and Sussex, I presented a report to our board and management teams which demonstrated the stark reality of the age bubble. We have therefore decided not to have a compulsory retirement age despite the recent decision to the contrary in the Heyday case considered by the European courts.
By doing this, we will keep the skills and importantly the experience of our older workers for longer at a time when they themselves are fitter than comparable people of their age would have been some 20 or 30 years ago and at a time when they wish to continue working in any event. Most importantly, there will be continuity of service and an environment where younger staff can feel supported and can learn from the invaluable experience and life skills that older staff possess.
So we have an ageing workforce whose members therefore will be required to retrain perhaps several times during their career. We are also expecting staff to maintain enthusiasm while being innovative in the quality of the service they provide. Oh, and to do so more cost-effectively as well.
The first principle of medical care is to do no harm. Medical students are taught that this is fundamental to the practice of medicine. As a non-clinician, I have seen the sense of this increasingly over the years. It could be argued this is simply common sense and intuition but I suggest it is a bit more complex. In the same way, why would a health service employer want to implement workforce measures which lead to a dilution or diminution in the quality of care offered?
So no compulsory retirement age please. Let's not score the completely avoidable own goal which would have the infamous triple whammy effect of worsening care, reducing morale and increasing cost. Let's follow that first principle in all its senses.