Acute hospitals to require ‘thousands more healthcare staff’ by 2035

Acute hospitals in the Republic will require thousands more healthcare staff by 2035 to meet population growth, increased life expectancy and an ageing population, the Economic and Social Research Institute has warned.

Most of the hospital staff that will be needed — including 3,236 more medical staff and 8,868 more nurses and midwives in public hospitals alone — will be required to fill jobs in the east and south of the country. The ESRI indicated that across a range of staff categories analysed, there is a total projected need for between 12,418 and 15,491 additional staff.

Across a range of staff categories analysed, there is a total projected need for between 12,418 and 15,491 additional staff based on whole-time equivalents (WTEs), representing an average annual increase of as much as 2.1 per cent. Some categories will need more than 3 per cent extra staff every year.

[ Healthcare spending runs €366m over budget in first half of 2022 despite recruitment issues ]

The data, compiled by the Economic and Social Research Institute (ESRI) on behalf of the Heath Service Executive also identified the potential need for up to 3,277 more healthcare assistants and health and social care assistants, at the higher end of a scaled forecast.

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The document, published on Tuesday, is tasked with examining additional staffing capacity required to deal with a rising population, and focuses on medical staff, nurses and midwives, care assistants and social care professionals.

The various findings are based on a scale of outcomes between 2019 and 2035, with the highest regional prediction at 5.2 per cent for care assistants in the south of the country.

Overall increases are placed at between 1.7 and 2.1 per cent annually for medical staff; 1.4 and 2.1 per cent in nursing and midwifery; 1.7 and 2.9 per cent for various classes of healthcare assistant; and between 1.8 and 3.3 per cent among health and social care professionals, with the highest rates needed among occupational therapists.

A range of alternative projections is presented by the ESRI, reflecting variations in population growth, life expectancy, hospital waiting lists, and community care delivery, among other factors.

In the Republic, the population is projected to reach 5.4 million by 2035, an increase of close to 500,000, while the number of people aged 85 years and older will more than double.

The largest increases in the workforce are projected for health and social care professionals who are particularly required by older patients. Here, speech and language therapists and occupational therapists are among the most in demand.

Accumulating hospital waiting lists have the most significant effect on service demand — an average of 170,000 additional APDs (adjusted patient days) are estimated to be required to reduce current waiting-list backlogs over the 10-year period from 2022 to 2031.

Clearing backlogs

The report notes that while additional workforce will be required to address waiting lists, most of this extra activity would be temporary. Once backlogs are cleared, the additional resources necessary to maintain target waiting times are deemed “relatively modest”.

“The WTE (whole time equivalent) requirements for all workforce categories considered are projected to increase substantially by 2035,” the report notes.

“These increases are largely driven by increases in the underlying population and, in particular, changes in the age structure.”

The research projects public acute hospital demand at both Hospital Group and Regional Health Area levels, with the results then used to develop projections of public acute hospital workforce demand.

Given the uncertainty associated with several key assumptions, it is based on five projection scenarios which offer a range of possible outcomes.

On the most fundamental level, demand for public acute hospital care is modelled on demographic change and existing assumptions on the relationship between age and service use. Relevant policy, notably Sláintecare reform, is also factored in.

As well as considering the staffing levels required to deal with lengthy hospital waiting lists, the researchers looked at how community care might move some treatments out of acute settings.