Graduate Studentship Award Project Highlight
The costs of healthcare workforce shortages
Led by David Jones, Master's candidate, Munk School of Global Affairs & Public Policy
Interview in Q&A Format for Newsletter Highlight
IfP: Please tell us about yourself and your journey to the Munk School of Affairs Master's program here at U of T.
David: I am a dual citizen of the UK and Canada. I have lived most of my life in the UK, but have many special childhood memories of traveling to Canada to visit my grandparents. My previous job in the UK was at the National Health Service (NHS). I had the opportunity to work there for about 4 years, including over the pandemic. The work intensity was high during the Covid-19 lockdowns and by 2022 I was considering reducing my hours slightly, such as through training or research opportunities. Following some googling, I found the opportunity to study a 2-year Master of Public Policy program at the Munk School of Global Affairs and Public Policy, and made the leap to take a career program.
I have loved the program. Previously, much of my training was as an economist, and whilst working for the NHS, I realized that I wanted further grounding in skills that would help me to be a better public policy maker and advisor. This was exactly what I have received during my time at the Munk School.
The classes have been top class. The professors – experts in the field – have helped me to learn a huge amount, but from lectures and wider conversations and events. For myself and my fellow classmates, it has put us in a strong position to apply for work with across public and private sectors.
IfP: What are your research interests and foci? How did you find yourself in this field?
David: I am interested in public policy, economics and impacts on society. Both my parents were anesthesiologists, and my father – having worked in the public healthcare system in England –instilled in me the value and importance of working to benefit society and the country. I have enjoyed opportunities to study and work in healthcare economics, because that brings together two crucial concepts: First, the need to truly care about people, which is a strong focus in healthcare; And second, to deliver productivity and efficiency, so that public resources are used in the best possible way.
Using my studentship award from the Institute for Pandemics, I was able to apply this background to my research as I considered the social and economic impacts of healthcare workforce shortages.
IfP: Can you tell us about your project?
David: The scope of the project has changed over time. In the working world – and particularly during Covid-19 – sometimes NHS executives had to make extremely quick decisions, and to make the best possible use of the evidence available at a particular moment in time.
Naturally then, I was quite ambitious in my research scope. Workforce shortages increased significantly during the pandemic, so I was keen to focus on this area. My original idea was to undertake a cost benefit analysis of interventions to address workforce shortages – compared to a ‘do nothing’ counterfactual scenario. I aimed to provide evidence and analysis to inform policymakers deliberating the circumstances in which it would be most beneficial to undertake early investment.
But returning to university has reminded me of the importance – particularly when undertaking research – of utilizing a precise and scientific approach. So I had to narrow the scope significantly, to look at the causes and effects of healthcare linked to workforce shortages.
In particular, there was some existing academic papers that present workforce planning and delivery models for healthcare services, and I looked at whether feedback loops existed which might perpetuate healthcare worker shortages. For example, a shortage of staff may increase workload, cause burnout and reduce retention.
Interestingly, I have been able to find evidence in the literature – subject to peer review – that workforce causes and effects are linked, and therefore these feedback loops may exist.
IfP: How does your project align with Ifp themes of recovery, readiness, and/or resilience?
David: In a sense it aligns with all of them. But as I have undertaken my work, increasingly I view it as contributing to readiness and recovery. If policymakers are aware of potential vicious spirals, it helps them to be proactive with policies, which supports readiness and preparedness.
For example, thinking back to the start of the pandemic, when health systems were faced with rapidly deteriorating staffing issues, I think having this extra information could have been helpful to support policymakers in mitigating some of the impacts.
IfP: What do you hope will come out of the research?
David: This scoping review can increase both pandemic readiness and resilience.
This can be done by identifying opportunities to optimize the use of virtual care in community pharmacy services, and also increase access to healthcare services to maintain continuity of care, especially with social distancing measures that are applied during the pandemic.
IfP: What do you hope will come out of this research?
David: Whilst I still need to submit my research for peer review, I hope that the knowledge of these feedback effects can helpful to support policymakers in the future – both in preparing for future shocks, and also in responding quickly to unexpected events.
I hope that is also provides springboard for further research. For example, a subsequent testable hypothesis would be that countries which intervened early (in response to staffing issues) would experience lesser final impacts, by avoiding the development of vicious spirals.
Finally, I’d like to give a huge thanks to IfP for their support, and in particular to my supervisors Drs. Sara Allin and Stephan Heblich. I learnt a huge amount along the way and was very fortunate to have this opportunity. It has been a real pleasure to work with the Institute this year.
For more information about the Graduate Studentship Awardees, and to read more about David's project, click here.