What challenges do healthcare professions currently face and what challenges are they likely to face in the future?
We love a wide question! It means you can take lots of different routes to thinking about it and there isn’t a specifically right answer; it’s worth starting with quite open ideas and then narrowing down.
This short article will outline some of the ideas you could start with; you can do your own research to expand on them. However, remember not to be over rehearsed- it’s better to have a few ideas you can talk about and develop with the interviewer as opposed to memorising an answer that may not end up following the line of questioning.
Having an understanding of the challenges within the profession demonstrates to the interviewer that you have taken the time to develop a more realistic view of working as a doctor in the future. A likely follow up question would be ‘how could we tackle these issues?’ so be sure to have a think about potential solutions to these problems:
Understaffing
From this BMA report (that has a lot of data you can use to bulk your answers up)…’activity in NHS hospital and community services has increased by over 25%. The number of doctors in secondary care has only risen by an average of 2.34% per year over the same period’.
What might the effects on patient safety be if there aren’t enough staff? Will patients get the care they need if there are too many patients per healthcare professional? Remember to consider short-staffing within other facets of the multidisciplinary team.
Ageing population with more complex conditions
As people get older they will (generally) have more illness. Multiple illnesses will interact and healthcare professionals may need to balance opposing issues (eg high blood pressure vs postural hypotension and frailty). As support needs increase, there could be an increase in pressure on primary care or more people could end up in hospital, challenging NHS resources.
COVID
It would be remiss to not mention the issues COVID will cause for medical professionals in the future. Some impacts include:
delays/misses in cancer diagnosis (50,000 in October 2020, Macmillan report) so people will present with more severe disease.
increasing anxiety and other mental health needs due to the pandemic and lockdowns will likely mean increased demand for already overrun services. Children may also need more support due to the heavy impacts they have seen on their education.
loss of community services that people had previously relied on may impact people’s long term health, particularly where carers used respite care or for people who relied on routines to help support their recovery and treatments.
Can you think of any others?
Reduction in GPs
The GP is typically the first form of contact people have with the medical world when they are starting to feel ill. If people can’t present to their GP, maybe due to lower numbers or higher demand, then illness may go untreated for extended periods of time, becoming more and more serious. By the time the condition is critical, damage done may be irreversible and the cost of treating more advanced disease can be much higher than had treatment been started earlier on. Who do you think might be particularly affected by lack of access to GPs?
Interactions of health and social care
There are many useful community-based initiatives that can support keeping people healthy, for example dementia cafés and day centres, however these are seeing reduced funding. Social prescribing of these kinds of social supports may not be as easy and people’s health may not be maintained as it would otherwise, thereby putting pressure on those in the medical side of healthcare.
Once people are in hospital the aim is to get them out again. However delayed transfers of care are a real issue - this is where people remain in hospital beds because appropriate social care arrangements are not easily made. This means people could see increasing stays in hospital which can lead to deconditioning and further deterioration. Furthermore this results in fewer beds available for new patients and an overall additional strain on the service.
Administrative burdens
A lot of paperwork is involved in being a doctor as it is necessary for patient safety, appraisals, inspection purposes etc. However, this also can take away from patient time and cause delays. How might healthcare professionals balance this and what could be done to make this aspect of the job easier?
Other ideas include: Changes in technology (incorporating new tech into care, long term value vs initial cost); retention (think about flexibility in training, work life balances, showing staff they are valued); other changes to healthcare needs (eg increasing obesity, mental health needs); increased population diversity (reaching, communicating with and providing appropriate care for people with English as a second language or from different cultural backgrounds)?
Hopefully this has given you some food for thought to support you in answering questions around challenges in the profession! Remember to start wide, narrow down and be able to have a conversation about it. Particularly at Cambridge the interviewers are interested in your thinking process so you must be able to articulate your ideas well.
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