The future of healthcare depends on people, Dr Navina Evans CBE, Visiting Honorary Professor Warwick University, Executive in Residence UCL Global Business School, Advisor, Global Health Partnerships, tells Sarah Cartledge
The global workforce sits at the centre of almost every challenge facing healthcare. Ageing populations are increasing demand while many countries struggle with shortages of clinical and allied health professionals. Technology and patient expectations are also transforming how care is delivered and the skills that organisations require.
Against this backdrop, workforce planning has become far more than a question of recruitment; it is now a strategic issue that encompasses the resilience and future performance of health systems around the world.
Dr Navina Evans CBE, former Chief Workforce, Training and Education Officer at NHS England and Chief Executive of Health Education England, has led workforce planning and transformation at the highest level. A child and adolescent consultant psychiatrist, she is also Special Advisor to Coventry University’s School of Health and Care, Visiting Professor at Greater Manchester Medical School and Senior Fellow, Institute for Healthcare Improvement.
From clinician to systems leader
Throughout her career, Navina has remained convinced that the quality of healthcare ultimately depends on people: how they are trained and supported, and how effectively they work together. Her move into management began with a fascination for organisational performance, observing how health organisations could face the same pressures yet achieve very different results.
“I always saw immediately the value and the magic of teams and people,” she explains. “The same number of staff, the same pressures, the same issues, whether it’s beds or infrastructure or waiting lists, but differences in culture and behaviour led to productivity and outcomes.”
Navina’s perspective has also been shaped by her own journey. Born outside the UK before building her career in the NHS, she has experienced first-hand how international healthcare has become.
“Healthcare is a global endeavour,” she says. “You cannot think about workforce in one country without understanding what’s going on in other parts of the world. When you think about the demographics of population, there will be a lot of younger people in the Global South and a lot of older people in the Global North, so who’s going to look after them?”
In her opinion, governments must think decades ahead, considering demographics and international mobility rather than annual recruitment targets. She also wants different language to be used: “We should be talking about movement rather than migration.”
International partnerships
International recruitment is often far more nuanced than public debate suggests. Some countries deliberately educate more healthcare professionals than they require domestically, recognising that international employment contributes significantly to their economies through remittances sent home by overseas workers. Others may appear adequately staffed at a national level while experiencing severe shortages in rural communities or specialist disciplines.
Navina believes the debate is trapped between the needs of wealthier countries and attempts to restrict movement. High-income countries depend heavily on overseas professionals, while critics argue that recruiting from countries with more fragile systems can deepen existing inequalities. “At the end of the day, people will move as they want to,” she says.
Neither position reflects how professionals view their careers – such movement is driven by education, family opportunities and career progression as well as salary. Shortages can also vary sharply between cities and rural areas. The answer, she believes, lies in mature international partnerships. “We need to think more about how we could have better agreements between high-income and low-middle-income countries.”
By enabling people to work across professions and borders, rather than treating international recruitment as a one-way transfer, countries could develop partnerships that strengthen workforce capacity on both sides. Shared education programmes, specialist training, faculty exchanges, structured international placements and joint investment in workforce development could all contribute to a more balanced relationship.
Time for human care
In the midst of this debate lies the ‘threat’ of AI. Navina sees AI less as a replacement for people and more as a way to help them focus on what humans do best. “What AI should do is take on the tasks that release people to do what only people can do.”
Roles will change and new ones will emerge, so she is insistent that leaders must support skills development, rather than focus only on savings. Healthcare will continue to require human skills, from recognising changes in a patient’s condition to helping someone navigate grief.
She also encourages clinicians to work constructively with patients who have consulted AI. Information may be inaccurate, but informed patients can participate more fully in decisions. “We have to assume the way we do things now is just not fit for the future,” she says. In her opinion, healthcare’s future will depend on how people are trained and supported.
As demand for healthcare continues to grow worldwide, a wider collaborative approach may become increasingly important. For Navina, countries must work together to build the global workforce that future health systems will need.
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