A rapid review of the effectiveness of interventions/innovations relevant to the Welsh NHS context to support the recruitment & retention of clinical staff

Gillen, Elizabeth ORCID: https://orcid.org/0000-0002-3700-3913, Edwards, Deborah ORCID: https://orcid.org/0000-0003-1885-9297, Csontos, Judit ORCID: https://orcid.org/0000-0003-4597-3052, Lewis, Ruth, Cooper, Alison ORCID: https://orcid.org/0000-0001-8660-6721, Edwards, Adrian ORCID: https://orcid.org/0000-0002-6228-4446, Law, Rebecca-Jane and Greenwell, Jane 2023. A rapid review of the effectiveness of interventions/innovations relevant to the Welsh NHS context to support the recruitment & retention of clinical staff. Presented at: HSR UK 2023, Birmingham, 4-6 July 2023.

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Abstract

Background: The National Health Service (NHS) is experiencing an acute workforce shortage in every discipline, at a time when waiting times are at a record high and there is a growing backlog resulting from the COVID-19 pandemic. This Rapid Review aimed to explore the effectiveness of interventions or innovations relevant to the Welsh NHS context to support health professionals’ (HPs) recruitment and retention. The review used the findings of existing reviews supplemented by a more in-depth evaluation of included primary studies conducted in the UK or Europe. Methods: Searches were conducted across seven databases for English language publications from 2015 to February 2022 including: Medline, EMBASE, Ovid Emcare, HMIC, CINAHL, Epistemonikos and Cochrane Library. Organisational websites were also searched for grey literature. Two reviewers title/abstract screened all citations in CovidenceTM, resolving any conflicts. Full-text screening was conducted by two reviewers. All demographic and outcome data were extracted by one reviewer and checked by a second. Eligible systematic reviews were critically appraised by one reviewer and checked by a second using the JBI critical appraisal checklist for systematic reviews. The data were reported narratively as a series of thematic summaries structured around the type of intervention. Results: Systematic (n=8) and scoping reviews (n=1) were included and focused on dentists; general practitioners; physicians; the medical workforce and undergraduates; medical undergraduates; and a variety of different HPs including those in training. Most reviews looked for interventions within rural, remote or underserved areas. The interventions were mapped across five WHO (2010) categories: educational, regulatory, financial incentives, personal and professional support and bundled interventions (activities that cover two or more different categories). Regarding educational interventions, moderate-quality evidence indicated positive association between rural-based training programmes and HPs’ recruitment/retention. Moderate-low quality evidence showed positive association between student selection based on rural background or including rural health topics in teaching and recruitment. Low-quality evidence demonstrated positive relationship between locating education institutions in rural areas, continuing education for rural HPs and recruitment/retention. However, low-quality mixed evidence was identified regarding the effect of rural clinical placements/fellowships/internships on recruitment/retention. All identified regulatory interventions requiring return of service (RoS) in rural areas were based on low-quality evidence. Bonded schemes, scholarships, and bursaries had a positive association with HPs’ recruitment. Loan repayments, accelerated training, enhanced scope of practice, and compulsory service were associated with HPs’ retention. Furthermore, a National Health Insurance scheme had a positive relationship with recruitment/retention, although it was based on one study. Mixed evidence was found regarding the effect of Visa waivers and financial incentives (with RoS). Interventions focusing on access to professional licences were associated with low retention. Low-quality evidence showed that financial incentives without RoS, such as loan repayments, had a positive association with retention. However, benefits that make rural areas attractive (e.g. higher salaries, subsidies for free housing) were found inconclusive. Personal and professional support in the form of improvements in living and working conditions in rural areas had a positive association with retention, although was based on low-quality evidence. There was consensus that bundled strategies positively impacted on recruitment/retention of rural workforce. Implications:The review identified a range of interventions that can be used for enhancing recruitment and retention in Wales, supporting bundled strategies. The findings highlight the importance of providing and locating undergraduate and postgraduate training in rural locations and the use of bursary schemes for training. More robust evaluations, based on comparative studies, are required to assess the effectiveness of interventions to support HPs’ recruitment and retention.

Item Type:	Conference or Workshop Item (Poster)
Status:	Unpublished
Schools:	Healthcare Sciences Prime Centre Wales (PRIME)
Subjects:	R Medicine > R Medicine (General) R Medicine > RK Dentistry R Medicine > RT Nursing
Date of Acceptance:	2 February 2023
Last Modified:	24 Oct 2024 16:57
URI:	https://orca.cardiff.ac.uk/id/eprint/162314

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