PhD: NHS staff skills mix and local labour markets

PhD: NHS staff skills mix and local labour markets: the role of reward structures, shortages and competition in determining the mix of the NHS workforce

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The NHS has undergone rapid changes in recent years. These have had a significant impact on the pay and work of all major staff groups in the NHS including medical and nursing staff. The drivers of change include the new consultant contract and the introduction of Agenda for Change – the new system of pay for all non-medical staff. These changes come at a time when there are shortages of staff in some areas of the country. Research undertaken has revealed how local labour market conditions impact on the NHS workforce. Health providers faced with staff shortages but unable to adjust pay, as a means of alleviating the shortage, will find alternative ways of resolving the problem. One way is to adjust skill-mix, to change the relative contributions of health professionals by workforce restructuring.

Outcome and Translation

This research provided evidence on the use of alternative staff configurations by health providers as an instrument to resolve staff shortages as opposed to pay.  In particular it extended the analysis to France where a significant private-hospital sector exists. The wage competition from this private sector does not have a significant impact on public-sector hospitals suggesting that it is non-wage competition that plays an important role between the public and private sector nursing labour market.

Phd Student: J-B Combes

Supervisors: Robert Elliott and Diane Skåtun (HERU)

Publications

Combes, J-B. (2012) 'An investigation of the impact of the local labour markets on staff shortages and staff mix of hospitals in England and France', PhD Thesis, HERU, University of Aberdeen.

Combes, J.-B., Delattre, E., Elliott, R. F. and Skåtun, D. (2015) 'Hospital staffing and local pay: an investigation into the impact of local variations in the competitiveness of nurses’ pay on the staffing of hospitals in France', European Journal of Health Economics, 16(7), 763-780.

Combes, J.-B., Elliott, R.F. and Skåtun, D. (2018) 'Hospital staff shortage: the role of the competitiveness of pay of different groups of nursing staff on staff shortage', Applied Economics, 50(60), 6547-6552.

Presentations

Combes, J-B., Elliott, R. and Skåtun, D. (2009) ‘Skill mix and labour market competition: how hospitals adjust the nursing skill mix in response to local labour market conditions’, Health Economist’s Study Group, Sheffield, 2009.

Combes, J-B. (2010) ‘Nursing workforce skill mix and the competiveness of qualified nurses pay: a local labour market analysis. Ecole Nationale de la Statistique et de l'Analyse de l'Information’, Seminar Health Economics, Rennes, France, January 2010.

Combes, J-B., Elliott, R. and Skåtun, D. (2010) ‘Nursing workforce skill mix and the competiveness of qualified nurses pay: a local labour market analysis’, Econometrics of Healthy Human Resources, Rome, May 2010.

Elliott, R. (2011) ‘Local labour markets, nurse recruitment and retention and skill mix in English hospitals’, Melbourne Institute of Applied Economic and Social Research, Melbourne, April 2011.

Elliott, R. (2011) ‘Local labour markets, nurse recruitment and retention and skill mix in English hospitals’, Monash University, Melbourne, April 2011.

Combes, J-B. (2011) ‘The effect of the local labour force on the NHS workforce’, University of Aberdeen PhD Symposium, Aberdeen, June 2011.

Elliott, R., Combes, JB. and Skåtun, D. (2011) ‘Local labour markets and nursing skills mix in England’, iHEA, Toronto, July 2011.

Combes, J-B., Elliott, R. Delattre, E. and Skåtun, D. (2012) ‘Hospital staffing, skill mix and local pay: an investigation into the impact of local variations in the competiteveness of nursing-pay on the staffing of hospitals in France’, HESG/CES, Marseille, January 2012.