Healthcare system overly ‘reliant’ on NCHDs – taskforce Chair

Irish healthcare remains too “reliant” on NCHDs while other skilled professionals are not being utilised to their full potential, the Chair of the national taskforce on the NCHD workforce has said.

Prof Anthony O’Regan made the comments at a conference on the future of medical training organised by the Forum of Postgraduate Medical Training Bodies on 31 May.

Responding to a question on the impact of service provision on training, Prof O’Regan said: “I think our NCHDs are being expected to do an awful lot of work where perhaps they are not needed in every situation.” He also referenced legal and regulatory barriers to expanding the scope of other healthcare grades. The taskforce was looking at the NCHD remit and the need to ensure the “right people do the right clinical roles”.

The taskforce’s interim report, published in April, recommended consideration of a time and motion study to gather an evidence base on NCHD work roles and tasks “such that remedial actions can be considered to support the NCHD workforce”.

The Department stated that such a study and/or other appropriate methodologies are being considered in this regard.

Meanwhile, Prof O’Regan also highlighted workplace “culture” as being raised in many of the taskforce’s engagements.

“The culture on sites can sometimes be not supportive and I think we have to be very careful about that,” said Prof O’Regan. He said it was important staff felt “part of the hospital… not just somebody who is passing through”.

The NCHD taskforce was established by the Minister for Health in late 2022. The stated purpose is to “put in place sustainable workforce planning strategies and policies to address and improve” the NCHD experience to support retention.

The taskforce’s interim recommendations covered areas such as induction, medical manpower, infrastructure, and accountable on-site administration to support NCHD education and training.

The taskforce had sought funding to support the interim recommendations and to demonstrate “tangible on-site benefits… and we got that agreement”.

Prof O’Regan said an implementation steering group had been established in the HSE and a project manager was due to be appointed in National Doctors Training and Planning.

The taskforce is now developing medium- to longer-term recommendations and its final report is due in October.