School of Health Sciences, Queen Margaret University, QMU Drive, Edinburgh, EH 21 6UU, UK.
Hum Resour Health. 2012 Jul 12;10:16. doi: 10.1186/1478-4491-10-16.
This paper examines issues related to the future supply of registered nursing staff, midwives and health visitors in the National Health Service (NHS) in England at a time when there are major public sector funding constraints and as more of these staff are reaching retirement age. Based on available workforce data, the paper reviews different possible scenarios for the supply of NHS nurses over a ten year period, assessing the impact of different numbers of new staff being trained and of varying retirement patterns from the ageing profession.The government in England has more policy levers available than is the case in many other countries. It determines the number of pre-registration training places that are commissioned and funded, it is the major employer, and it also controls the inflow of nurses from other countries through migration policies. Scenario models provide a picture of what the future might look like under various assumptions. These outcomes can be quantified and the results used to assess the risks and opportunities of alternate policy decisions. The approach used in this paper is that of the aggregate deterministic supply model.As part of this exercise, eight scenarios were selected and modelled. These were:A. "No change"- current inflows and outflowsB. "Redundancies" - current inflow with higher outflowC. "Improved retention" - current inflow with lower outflowD. "Reduced training intakes A" - lower inflows with lower outflowE. "Reduced training intakes B" - lower inflow with higher outflowsF. "Pension time-bomb"- current inflow with a higher rate of retirementG. "Pension delayed"- current inflow with a lower rate of retirementH. "Worst case" - lower inflow and higher outflow including higher retirementMost of the scenarios indicate that a reduction in the supply of nursing staff to NHS England is possible over the next ten years. Small changes in assumptions can make a substantial difference to outcomes and therefore emphasize the point that it is unwise to base policy decisions on a single projection. It is important that different scenarios are considered that may be regarded as possible futures, based on a realistic assessment of the available workforce data, policies and broader labour market and funding outlook.
本文探讨了在英格兰国民保健制度（NHS）面临重大公共部门资金限制，以及越来越多的这些员工达到退休年龄的情况下，未来注册护士、助产士和保健访视员的供应问题。基于现有的劳动力数据，本文回顾了 NHS 护士在十年内供应的不同可能情况，评估了培训新员工数量和老龄化职业退休模式变化对供应的影响。英格兰政府拥有比许多其他国家更多的政策杠杆。它决定委托和资助的注册前培训名额数量，是主要雇主，还通过移民政策控制来自其他国家的护士流入。情景模型描绘了在各种假设下未来可能的情况。这些结果可以量化，并用于评估替代政策决策的风险和机遇。本文采用的方法是总体确定性供应模型。作为这项工作的一部分，选择并模拟了八个情景。这些情景包括：A. “无变化”- 当前流入和流出B. “冗余”- 当前流入量较高，流出量较高C. “提高保留率”- 当前流入量较低，流出量较低D. “减少培训人数 A”- 较低的流入量和较低的流出量E. “减少培训人数 B”- 较低的流入量和较高的流出量F. “养老金定时炸弹”- 当前流入量较高的退休率G. “延迟养老金”- 当前流入量较低的退休率H. “最坏情况”- 包括较高退休率的较低流入量和较高流出量大多数情景表明，在未来十年内，向英格兰 NHS 供应护士的人数可能会减少。假设的微小变化会对结果产生重大影响，因此强调了基于单一预测做出政策决策是不明智的。重要的是，要根据现有的劳动力数据、政策以及更广泛的劳动力市场和资金前景，考虑可能被视为可能未来的不同情景。
