A resilient health system depends on a well-planned, appropriately skilled medical
workforce. In Ireland, demographic shifts, increasing multimorbidity, and regulatory
constraints such as the European Working Time Directive have intensified the
complexity of medical staffing. Despite national efforts to expand the medical
workforce, there is critical need for a robust, evidence-based framework to guide
staffing and skill mix decisions.
Using a Public and Patient, Knowledge-User and Researcher partnership approach,
this project aims to co-create a comprehensive, context-specific framework for
medical workforce planning in Ireland, focusing on consultants, non-consultant
hospital doctors (NCHDs), and interns (medical graduates awaiting registration).
A mixed-methods design incorporating nested sequential case studies and
framework co-design will be employed. First, a scoping review of medical workforce
staffing and skill mix best practices, including identification of enablers and barriers to
implementation and mapping to behaviour change theory will be conducted. Then, a
baseline case study of medical workforce roles and skills mix in two Irish hospitals,
with multi-level stakeholder consultations on lived experiences of enablers and
barriers will take place (Work Package 1a and 1b). Informed by this study phase,
framework co-design and a desk-based case study application of the proposed
framework at the two study hospitals will be undertaken. The proposed framework
will be assessed using Proctor’s implementation outcomes – feasibility, acceptability,
appropriateness, and cost (Work Package 2). Data sources will be quantitative (e.g.,
staffing levels, workload metrics, Doctors Integrated Management E-System (DIME)
data) combined with qualitative (e.g., stakeholder interviews/focus groups) across
packages. In the final work package, there will be integration of study findings and
mapping to the Behaviour Change Wheel to support identification of implementations
strategies and policy options. Finally, we will co-design recommendations to refine
the framework and associated implementation strategies (Work Package 3). Real time knowledge translation and dissemination activities will take place throughout
