Growing collective effort to solve NH’s healthcare workforce shortage

New Hampshire health care – A force to be reckoned with

There have been many stories about the shortage of health workers. We are hearing about this serious problem at the national level and 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 working. This may speak to pandemic-related burnout, but in reality, the health care workforce shortage has been a major problem for years.

Closer to home, the NH Hospital Association has documented more than four years of increased vacancy rates for registered nurses, licensed nursing assistants, medical technicians and more. The average Granite Stater increasingly struggles to find primary care doctors who accept new patients and often has to wait months for specialty care. Additionally, a Helms & Company survey conducted for the Home Care, Hospice and Palliative Care Alliance, shows that nearly all home care agencies in the state have had to turn away potential patients due to ongoing staff shortages. A similar trend is seen in New Hampshire’s long-term care facilities.

An association of 10 state mental health centers reports nearly double the number of open positions compared to when the pandemic began, all while the need for mental health services has increased for patients of all ages. These staffing shortages include potential patient safety concerns, a high burden of illness due to delayed care, and a challenge to the sustainability of the state’s health sector.

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Despite the myriad of serious impacts on quality and access to care in the Granite State, there is very little effort to find solutions. Indeed, hospitals and other providers are making strong efforts to address the labor shortage by offering sign-on bonuses and training programs to keep the job. Many healthcare organizations are also reaching out to the education system to create a pipeline of new talent ready to pursue careers in healthcare. But are we all rowing in the same direction with a unified strategy to deal with the problem? There hasn’t been a massive, concerted effort across sectors, regions and organizations – until now.

Expand and support the NH health workforce

When the Endowment for Health received nearly $2 million from the NH Joint Underwriters Association, we committed to investing those funds to support health care providers serving the underserved. We created the Forward Fund, which to date has invested nearly $500,000 to better understand the regulatory and licensing barriers that affect health care workforce development and improve collaboration across the health sector to address our critical workforce shortage. Throughout this process, we have sought advice from content experts in all health fields. Together, we identified investment gaps in workforce development and identified strategies to address shortages – all important steps to support what is New Hampshire’s largest industry and a significant component of the state’s gross domestic product.

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In a collective effort, the Forward Fund partners with health care providers, physicians and educators as well as leaders in state government and business, as we work to grow, retain and sustain a strong health workforce in the Granite State. Together, we created the New Hampshire Roadmap: Delivering Care: A Strategic Plan to Grow and Support New Hampshire’s Health Care Workforce. The plan outlines 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 health care workforce.

Bringing strategies to life

A new statewide initiative, known as HealthForce NH, was 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 government initiative will combine different efforts in collaborative learning and common approaches to build a strong health workforce of the future.

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This wave of earthquakes has already started. Commissioners at the NH Department of Business and Economics, NH Employment Security, the Office of Technical Licensing and Certification, and the NH Department of Health and Human Services, all agreed on the need for an integrated approach to policy development. Each has appointed employees to the HealthForce NH initiative – an important step in creating an investment strategy that will strengthen the health care workforce pipeline.

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

Yvonne Goldsberry, Ph.D., is president of the Endowment for Health and lives in Walpole.

Maria de Garcia Padin, MD, is chief medical officer, community group practice at Dartmouth-Hitchcock and vice chair of the board of the Endowment for Health. He lives in North Hampton.

Marie-Elizabeth Ramas, MD, FAAFP, is a family physician and medical director at GateHouse Treatment Center. He serves on the board of the Endowment for Health and lives in Hollis.


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