A two-stage rapid umbrella review of interventions relevant to the Welsh context to support recruitment and retention of clinical staff

Article type
Edwards D1, Csontos J1, Gillen E1, Carrier J1, Lewis R2, Cooper A3, Gal M3, Davies LJ4, Law R5, Greenwell J6, Edwards A3
1Wales Centre For Evidence Based Care, Cardiff University
2Health and Care Research Wales Evidence Centre, PRIME Centre Wales, Bangor Institute for Health & Medical Research (BIHMR), School of Medical and Health Sciences, Bangor University
3Health and Care Research Wales Evidence Centre, PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University
4The Royal College of Surgeons Edinburgh
5Ser Cymru, Welsh Government
6Portfolio and Programme Delivery, Cardiff University
The United Kingdom is facing an acute healthcare workforce shortage in every discipline, hindering National Health Service (NHS) recovery from the residual impacts of the COVID-19 pandemic and increasing ongoing endemic pressures.

To investigate the effectiveness of interventions relevant to the Welsh NHS context to support both recruitment and retention of clinical staff.

The Wales COVID-19 Evidence Centre (WCEC) conducted a two-stage rapid umbrella review (RUR) in two and a half months. Following an introductory stakeholder meeting with The Royal College of Surgeons of Edinburgh, who requested the research question, and Welsh Government and patient representatives, a rapid evidence map (REM) was conducted to explore interventions that can help recruit and retain clinical staff including return-to-work schemes. The REM identified 58 reviews, including systematic, scoping and narrative reviews, and the findings were presented at an intermediary stakeholder meeting where the focus for the RUR was decided—assessing the effectiveness of interventions for recruitment and retention in healthcare settings that are similar to Wales, including rural areas.

The RUR included eight systematic reviews and one scoping review (with an evaluation component), mainly focusing on interventions within rural, remote or underserved areas from across the world. In the synthesis, interventions were mapped across five World Health Organization (2010) categories: educational, regulatory, financial incentives, personal and professional support and bundled (activities that cover two or more different categories). Final findings were presented at an evidence briefing for stakeholders and other interested parties to maximise impact. Furthermore, stakeholders’ feedback was that the RUR enabled them to share accurate data with policymakers in Westminster, other Royal Colleges, and Heads of Medical Schools in the United Kingdom.

Although RURs and REMs are less common than other review types, they are viable options for providing timely evidence-based support for decision-makers. RURs and REMs are especially useful when research questions are broad and a large number of systematic reviews are available.

Patient, public and/or healthcare consumer involvement:
The stakeholders included members of the WCEC public partnership group, including patient representatives, and a policy officer from The Royal College of Surgeons of Edinburgh.