New Hampshire’s health care: A force to be reckoned with

The news has been plentiful about the healthcare workforce shortage. We hear about this deep-seated problem on the national level as well as here in New Hampshire. According to National Nurses United, there are 4.4 million registered nurses in the United States but only 3 million are currently working. This could well speak to pandemic-related burnout, but in truth, the healthcare workforce shortage has been a pressing problem for years.

Closer to home, the NH Hospital Association has documented more than four years of increasing vacancy rates for registered nurses, licensed nurse assistants, medical technicians and more. The average Granite Stater increasingly struggles to find primary care doctors accepting new patients and often must wait months for specialty care. Additionally, a Helms & Company survey conducted for the Home Care, Hospice and Palliative Care Alliance, indicates nearly all agencies providing homecare in the state have had to turn away prospective patients due to ongoing staffing shortages. The same dynamic is evident in New Hampshire’s long-term care facilities.

The association for the state’s ten community mental health centers reports nearly twice as many open positions now compared to when the pandemic began, all while the need for mental health services has increased for patients of all age groups. These workforce shortages add up to potential patient safety concerns, a greater burden of illness due to delayed care, and a sustainability crisis for the state’s healthcare sector.

Despite myriad, serious implications for quality and access to care in the Granite State, less abundant have been efforts to find solutions. Certainly, hospitals and other providers are mounting valiant efforts to address workforce shortages by offering sign-on bonuses and training programs for career progression. Many healthcare organizations are also reaching into the educational system to create a pipeline of new talent ready to pursue healthcare careers. But are we all rowing in the same direction with a unified strategy to address the problem? There has been no large-scale, collective effort across sectors, regions and organizations – until now.


Expanding and Supporting NH’s Healthcare Workforce

When the Endowment for Health received almost $2 million from the NH Joint Underwriters Association, we committed to invest those funds to support healthcare providers serving medically underserved populations. We created the Forward Fund, which has, to date, invested nearly $500,000 to better understand regulatory and licensure barriers affecting healthcare workforce development and to improve coordination across the health sector to address our acute workforce shortages. Throughout the process, we sought advice from content experts across health professions. Together, we have identified investment gaps in workforce development and pinpointed strategies to address shortages – all crucial steps to supporting what is, by far, New Hampshire’s largest industry and a significant portion of the state’s gross domestic product.

Through a collective effort, the Forward Fund has partnered with healthcare providers, practitioners and educators as well as leaders in state government and business, as we work to grow, retain and sustain a robust healthcare workforce in the Granite State. Together, we have created a roadmap for New Hampshire: Giving Care: A Strategic Plan to Expand and Support New Hampshire’s Health Care Workforce. The plan details more than 100 strategies for near- and long-term solutions, including best practices for education, recruitment and retention, licensure and credentialing, and statewide data collection on the healthcare workforce.


Bringing the Strategies to Life

A new statewide initiative, known as HealthForce NH, has been created to help coordinate and guide the implementation of this new roadmap while identifying common policy barriers and data gaps across the healthcare sector. Our work to implement this state plan will bring disparate initiatives together for shared learning and common approaches to build a strong healthcare workforce for the future.

This seismic wave has already started. The Commissioners at the NH Department of Business and Economic Affairs, NH Employment Security, the Office of Professional Licensure and Certification, and the NH Department of Health and Human Services, have all agreed on the need for a coordinated approach to policy development. Each has appointed staff to the HealthForce NH effort – an important step to creating an investment strategy that will strengthen the healthcare workforce pipeline.

The collective efforts of the Endowment’s Forward Fund and HealthForce NH aim to make it easier for Granite Staters to access healthcare in its various forms, including primary care, behavioral healthcare, specialty services, long-term care and home care. We all need that access to maximize our health and wellbeing and to keep our economic engine operating at peak performance.

Yvonne Goldsberry, Ph.D., is president of the Endowment for Health and resides in Walpole. Maria de Garcia Padin, M.D., is chief medical officer, community group practices at Dartmouth-Hitchcock and vice chair of the Endowment for Health board. She resides in North Hampton. Marie-Elizabeth Ramas, M.D., FAAFP, is a family physician and medical director for GateHouse Treatment Center. She serves on the Endowment for Health board and resides in Hollis.