NHS staff in some of England’s most deprived and remote areas are leaving their jobs faster than they can be replaced, and this partnership aims to find out why—and what to do about it. Workforce shortages in primary care and maternity services are acute in regions with high deprivation or geographic isolation, where recruitment and retention are hardest. The problem is not just about hiring more people; it is about understanding why staff burn out, leave, or never apply in the first place, and whether changes to how teams work, are supported, or are paid could make a difference. If successful, this research will produce concrete, place-based interventions—such as redesigned rotas, new support roles, or different training pathways—that could be rolled out across the NHS and social care. The partnership will also generate a cost-benefit analysis of those interventions, so health leaders know which changes offer the best value for money. Over five years, the work could shift how the health system thinks about workforce planning in underserved areas, moving from crisis response to sustainable, locally tailored solutions.
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Purpose of the Partnership Workforce crises in healthcare present risks to care provision. This Partnership will bring together stakeholders from across health and care to develop, implement and evaluate interventions to improve workforce sustainability. We will focus on under-served areas, including those with high levels of deprivation and/or geographically remote location: the Partnership is based in some of the most deprived areas of the country, with a range of geographies. Recognising that health and care sectors do not operation in isolation, we will consider the system as a whole, focusing on exemplars with particular challenges (primary care and maternity services), but with a view to transferability across the system. Structure The Partnership will develop a community of practice across the healthcare system. Led by a Partnership Management Group (PMG), activities will be informed by a Research Advisory Group (RAG), made up of regional and national stakeholders, and 2 Community Inclusion and Engagement (CIE) panels (1 with staff, 1 with service-using populations). These structures will ensure the Partnership is embedded in local health economies, and that proposed interventions are feasible. Methods The Partnership will have 3 objectives– to scope and define problems, co-design solutions, and implement and evaluate those solutions. It will do this through 7 interlinked workstreams (WS), running throughout the Partnership: • Knowledge mobilisation (KM)/Implementation: To ensure rapid, tailored communication to policy, practice and public audiences. • Realist review: To develop theory of why workforce challenges occur, and how they may be addressed. • Analysis of secondary workforce data: To identify predictors of workforce problems. • Staff survey: To provide baseline understanding of, and evidence of interventions’ impact on, staff burnout, perceptions of organisational culture and intention to leave. • Health economics: To identify value associated with career choices, and the economic impact of interventions. • Co-design: To work with staff, patients/service users, and organisational leads to design substantial new place-based interventions, and adapt pre-existing interventions for rapid implementation. • Qualitative data: To develop understanding of problems and implementation of solutions, through interviews, focus groups and other qualitative methods. WSs will run concurrently, overseen by the PMG, and report to the RAG and CIE panels. They will be responsive to a changing political and policy context. Timeline We will develop the Partnership community, and begin research activity, within 18 months. Over the 5-year timeline, we plan iterative WS cycles to deliver projects in our exemplar areas. There will be concurrent activity across both sectors, reflecting their inter-relationship. Dissemination and impact The KM strategy will deliver tailored, timely and accessible outputs from the outset. Primary audiences will be staff and service-using populations affected by changes, organisational stakeholders responsible for enacting change, and policy audiences with authority and budgets to enable change. We will create a Partnership brand and a website accessible for professional and lay networks. All outputs will consider accessibility across language, literacy and digital divides. We will develop a wider community of practice with other partnerships.
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