title: Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.
abstract: This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.
authors.affiliation: Department of Epidemiology & Public Health, University College Cork, Ireland. Electronic address: s.mchugh@ucc.ie.
authors.forename: S M
authors.initials: SM
authors.lastname: McHugh
authors.affiliation: Centre of Health Policy and Management, Trinity College Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Tyrrell
authors.affiliation: Centre of Health Policy and Management, Trinity College Dublin, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.affiliation: Department of Public Health, Health Service Executive South, Cork, Ireland.
authors.forename: O
authors.initials: O
authors.lastname: Healy
authors.affiliation: Department of Epidemiology & Public Health, University College Cork, Ireland.
authors.forename: I J
authors.initials: IJ
authors.lastname: Perry
authors.affiliation: Centre of Health Policy and Management, Trinity College Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Normand
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D018672:Community Health Planning / Q000458:organization & administration*; D055088:Early Detection of Cancer / Q000191:economics; D057172:Economic Recession; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006295:Health Resources / Q000191:economics; D006801:Humans; D007494:Ireland; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D008962:Models, Theoretical; D019982:Organizational Case Studies; D016526:Workload / Q000191:economics*
keywords: Breast cancer screening; Health workforce planning; Ireland; Service efficiency under austerity conditions; Skill mix; Workload modelling