Following the publication of the NHS Long Term Plan [available here], the NHS has now published its Interim NHS People Plan which you can view here. The focus is not only on recruiting extra staff, but also on the steps which urgently need to be taken to improve staff retention and transform ways of working. The Interim Plan outlines how the NHS needs to recruit, retain and develop staff to meet rapidly growing demand for 21st century healthcare.
There are five themes to the Interim Plan:
- Making the NHS the best place to work: making the NHS an employer of excellence, valuing, supporting, developing and investing in its people.
- Improving the leadership culture in the NHS: positive, compassionate and improvement focussed leadership locally and nationally.
- Addressing urgent workforce shortages: in nursing in the first instance, and in other NHS staff groups.
- Delivering 21st century care: growing and transforming the NHS workforce.
- A new operating model for the workforce: working collaboratively and devolving people planning to integrated care systems.
The Interim Plan runs to 74 pages, but the headlines are:
- Rapid increases in staff numbers is a key aim, starting with the nursing workforce. Steps to increase the number of undergraduates studying nursing will be implemented, such as offering Universities 5,700 extra hospital and community placements for student nurses. The number of nursing associates will increase to 7,500. Those who have left the NHS will be targeted and encouraged to return. "Lead" recruiter agencies will grow the number of nurses and doctors recruited from overseas.
- The working environment and current terms and conditions are to be tackled. The pensions issues which have been described as discouraging experienced doctors and nurses from undertaking extra work and may result in them leaving the NHS will be tackled. A consultation has begun on a proposal to allow senior clinical staff to reduce their pension contributions by 50% in return for halving the rate at which their NHS pension grows. The BMA has expressed concern this proposal does not meet the concerns of consultants reaching the annual pension allowance.
- There is to be a major staff engagement exercise over the Summer, led by Chief People Officer, Prerana Issar focussing on the issues that most matter to staff. Frontline NHS managers are to be provided with more support and the NHS Graduate Trainee scheme is to be doubled in size from 200 to 500 participants.
- The NHS Digital Academy is to be expanded and intensive digital skills training is to be provided to boards and senior leaders and a pipeline of digital experts in the NHS created. Workforce planning is to be devolved to integrated care systems; new models of multi-disciplinary working to support the integration of primary and secondary care will be developed and there is to be a national consultation exercise to establish what the NHS, patients and public require from 21st century medical graduates.
We understand that a full five year People Plan will follow the Interim Plan. We are promised that this will put more meat on the bones of the steps which must be taken to translate the aims of the Plan into reality. We are to expect costed action plans and a detailed implementation plan for the NHS Long Term Plan. We understand that this will follow the Government's next Spending Review when the total investment available for education and training and for digital and capital transformation is due to be confirmed. In the meantime, the Interim Plan sets out a whole raft of key actions for 2019/201, including:
- The development of a new offer for all people working in the NHS, through widespread engagement with staff and staff representatives, during the Summer of 2019.
- All local NHS systems and organisations are to set out plans to make the NHS a better place to work as part of their NHS Long Term Plan implementation plans.
- An independent review of HR and OD practice in the NHS will take place, with recommendations as to alignment with the best of the public and private sectors.
- A new "NHS Leadership Compact" to establish cultural values and leaderships behaviours across the NHS.
- There will be competency, values and behaviour frameworks for senior leadership roles combined with a greater focus on the NHS Oversight Framework and the CQC "Well Led Framework".
- There are to be targets for BAME representation across the workforce, including at senior levels.
- A central database of directors will be established, holding information about qualifications and history, combined with other steps to assure leadership across the NHS.
- The Direct Support Programme will be expanded to improve retention, with focus on supporting early years retention, and reviewing best practice in preceptorship arrangements.
- Support is to be provided to STPs and ICSs to develop five year workforce plans.
- Plans for further expansion of undergraduate medical placements will be developed.
- The implementation of post-foundation Internal Medicine Training to expand number of doctors with generalist skills.
- The establishment of a national programme board to address geographical and speciality shortages in doctors.
- The establishment of a healthcare science workforce development programme.
- The production of an ICS maturity framework to benchmark workforce activities in STPs/ICSs.
- A collaborative system-level approach to delivery of international recruitment and apprenticeships.
What it means for employers
Without knowing the full People Plan and budget to back it the Interim Plan is necessarily a stepping stone to the NHS' final workforce strategy. Most critically recruiting to fill the many clinical vacancies will take much time, resource and money. However, the Interim Plan does give welcome and clear direction on developing employee engagement, leadership standards and behaviours and creating integrated workforce plans aligned to STPs and ICSs.
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