Lexington Health Associate Director shares her interpretation of the current healthcare workforce scene
As someone who used to work at the NHS Confederation, a membership organisation for senior leaders in the NHS, I heard Trust chief executives and senior directors talk all the time about what challenges they were tackling in their organisations. By far and away the most popular topic of conversation, both in public and in private meetings, was workforce. The reason for this is that if you get your workforce right, then everything else follows on from that. If you want good quality care, you want people who have the right technical and communication skills to deliver that. If you want to tackle the demands of an increasingly ageing population, with an A&E or community care service at boiling point – then you need flexible and multi-skilled staff to do the job well and to fill in the gaps.
In the past eighteen months or so there have been a slew of national policy announcements which will affect how NHS organisations view and prioritise their workforce challenges. NHS England’s Sir Bruce Keogh’s work on seven day working is obviously influential, as is Sir Robert Francis QC’s report on the care failings at Mid-Staffordshire NHS Foundation Trust – which underscored the need to treat complaints and whistleblowers seriously, and for the NHS to understand the impact of staffing levels on patient care.
There is therefore pressure on HR directors to work out the most effective way to interpret the NICE guidance published last month on safe nurse staffing levels. And without debating here as to whether minimum staff ratios are the answer, the fact the Labour party backs this policy will place huge pressure on NHS organisations to reduce their agency staff bill to help fund it post 2015 if Labour come to power.
There is also a big workforce issue for smaller hospitals – where it is becoming increasingly difficult to lure the best clinical or managerial trainees away from the bright lights of the big teaching hospitals. National shortages of appropriately-skilled clinical staff in areas like emergency care, are putting some smaller hospitals, often those in rural and more deprived areas, under intense strain.
Exacerbating these workforce shortages, is on the one hand a policy push for more ‘generalists’ – who can work across clinical or organisational silos in order to provide the integrated care that Trusts and patients desire; and on the other hand a worrying lack of people working in areas such as geriatrics, where up to half of consultant posts remain unfilled.
So what’s the solution? With the financial squeeze ever tightening, and the new system roles and responsibilities still unclear – ensuring inspirational leadership exists from board to ward level has become increasingly difficult. And although all parties have pledged to protect the NHS ring-fence, no radical injection of cash is expected post the 2015 general election, particularly if no one party has an overall majority.
Staff who can work across the community services, social care, acute and mental health care divide are what’s desperately needed. There also needs to be a revamping of training modules and courses to reflect this need. We’re also crying out for a national approach to workforce which is flexible and that takes into consideration the difficulties faced by some hospitals in recruiting permanent staff. Perhaps a scheme, like Teach First for the NHS is the answer – where the brightest trainee doctors and nurses are channelled into smaller Trusts for the first two years of their career? This would hopefully guarantee a pipeline of talent for some of the country’s struggling Trusts in order to level the national playing field.
In September we will discover if the 450,000 NHS members of the Unite and Unison unions have voted to strike over pay. The move comes after Jeremy Hunt rejected the independent Pay Review Body’s recommendation to give a 1% pay rise for all staff this year – which would have cost an estimated £500m. The ballot, backed by the Labour party, will bring workforce in the NHS into the headlines, just as the party conference season get underway.
All in all, it looks like staff, politicians and NHS managers are set to be on a collision course in 2015. We’re certainly going to be in for a bumpy ride.
[testimonial name=”Recruitment Influencer – Jenny Ousbey” who=”Associate Director of Lexington Health” imagelinks=”https://totalassist.co.uk/wp-content/uploads/2014/09/Jenny-e1409566443986.jpg” vertical=”no”]”Jenny is an experienced public affairs professional with an in-depth understanding of the health and care industry. In the past, Jenny has worked as part of the NHS Confederation team, and as senior political advisor to a Coalition government health minister. “[/testimonial]