Crunching the numbers: why we need an analytical capability and workforce plan

The 10 Year Health Plan is packed full of ideas and changes, and whilst there is still no single delivery plan around it, there is now a flood of specific policy, guidance and plans that have followed. And government is busy elsewhere too, not least in its English devolution plans which, in my view, hold much promise for health but make the landscape more complex still. All of this will have to be implemented locally, and guided by the analytical capacity and capability to make sense of it in practice. But do we have enough of this capability and is it capable of doing what is needed? These are two related but distinct questions.  

Analytical capability takes many forms and comes from different places, but broadly refers to the people, skills and data needed to turn information into insight. It has significantly grown and changed in parts of the NHS and wider health and care system over time. For example, there has been an investment by NHS England in population health management analytical capability – including in developing new roles in data science – supplemented by an active consultancy market delivered by in-house NHS commissioning support units and external providers. There is also vital – though scarce – public health analytical capability in the NHS, local government and regional bodies. System leaders and regulators such as the Department for Health and Social Care (DHSC), NHS England, UK Health Security Agency, NICE and CQC all have their own analytical teams and capabilities too. 

Individual systems have also invested. In Greater Manchester, for example, the NHS works in partnership with the combined authority (made up of ten local councils and the mayor). In the past few years some integrated care systems have developed in-house ‘academies’ too, often with a focus on health inequalities or population health. And finally, the UK is fortunate to have world-leading academic centres in health economics, epidemiology and statistics.    

So, there is a plethora of analytical capacity and capability distributed across the health and care ecosystem. The real question is not really about how much exists, but whether all of this adds up to what is needed in a rapidly changing technical, structural and policy landscape. And, crucially, who is responsible for asking – and answering – that question?   

One clear challenge is automation. In reality, many analysts in the NHS are currently working in business information and reporting roles, and not involved in understanding and solving the problems that beset it. Many are under-utilising their existing skills or aren’t developing the skills needed for the future. Although the impact of AI on jobs in health care as a whole is likely to be complex, much business reporting will become automated, and these posts will be heavily reduced over time. This means there is a potential pool of people who could be doing much more meaningful analytical work, but where is the recognition of this, or a plan to upskill, reskill or redeploy them? 

A second challenge is poorly coordinated policy. For example, commissioning support units are set to be abolished as part of the wider cull announced around the 10 Year Health Plan. They were set up in 2013 to support the then Clinical Commissioning Groups to become ‘world class commissioners’. This change is happening at the same time the government is reshaping integrated care boards to be commissioners, as outlined in its strategic commissioning framework, and is expecting them to set out a baseline of their analytical needs and a five-year strategic plan by the end of March – a heroic timetable to say the least. The commissioning framework itself is also just one of a set of further important documents and frameworks, the most recent of which is the neighbourhood health framework. All of these require analytical capability to implement. At such a time of change, this capability – embedded in people – is being dislocated and fragmented, and faces uncertainty in how it will be redeployed and rebuilt in the future. 

The third challenge, related to the other two, is what analytical capability is going to be needed in the years to come. AI clearly brings with it huge potential, but also significant risks. Meanwhile, the basic day-to-day understanding and analysis of the vast data flowing through the health and care system remains under-connected, under-explored and under-utilised. The analytical profession, wherever it sits, has immense potential value. It needs the status, skills and leadership positions to make the most of that value to map out and shape the future. It is not all about the data itself. 

The upshot of all this is that there is a desperate need for a considered strategic assessment of the situation: how it is expected to work through, how to make best use of the capability that currently exists – including potential sharing between the NHS, local government and the new mayoral strategic authorities – and what skills and workforce will be required in the future. Is this happening? I hope the answer is yes – and lies with DHSC and the awaited NHS workforce plan.