Normal…

Training Primary Care - NHS - GPs - Normal...

The WikiLeaks War Logs, Watergate, MP’s Expenses…

Why do people leak things?  Ethical concerns?  Prevent harm?  Journalist leak, to other journalists, to show ‘they are in the club’.  Has-beens, wanna-bees, saboteurs.  Who knows?

Quite often it suits an organisation to have something leaked, to see how the public react.  How it ‘plays’ in the media, unions, thought-leaders and public opinion.  It’s called kite-flying.

Yesterday, the HSJ published a really interesting leak about NHSI’s People Plan, workforce modelling.  The thought that occurs to me; what’s the motive?  

NHSI should have said we don’t comment on leaks.  Instead, they said it is ‘based on old data’.  It’s October data.  Mmm…  as far as NHS data goes that’s as fresh as a new-laid egg.

The leaks says we will have to rely on more nurse assistants.

That tells me the leak could be from a malcontent working on the People Plan, or, more likely, NHSI, flying a kite, to see what the reaction is.

Workforce planning is complicated.  You need to achieve eight things.

1.  Have a good look at the organisation’s business plan.  

What does it want to achieve and have we got the right number of staff to cover all the projects?

Actually, we don’t have  business plan.  We have a Long-Term-Plan that is more of a narrative and takes the NHS away from strategic plans… that usually turn out to be wrong.  

What we can deduce is; we do not have enough money to cope with the 3% growth in acute and specialty demand; we don’t have enough capacity to reduce the 4.4m on the waiting list; and not enough money to clear-up the £3bn Trust’s underlying deficits.

2.  Forecast the external environment.

Brexit, migration, political turmoil, public unrest, carbon-saving, terrorism, economic stagnation or decline… they are all in the mix, so good luck with that.  

And, the current Agenda-for-Change deal runs out during the 5 years of the plan so another pay-rise is will have to be funded.

3.  Identify the hard-to-crack problems where there are consistent issues.

That’s nursing, nursing and nursing and if current trends continue, we are looking down both barrels of a service-wide 250,000 staffing shortage.

We don’t train enough nurses, we have fewer nurses in our system than most of the EU and Australia.

4.  Figure out what the organisation’s current competencies are… decide if they are the competencies the organisation needs in the future.  The nursing work-group has grown by 3% but support-staff grown by a massive 14%.  That’s a huge shift.

5.  Develop ‘gap-reduction’ strategies… between what you’ve got and what you are going to need.  You can’t do that until you’ve done number 1, on the list.

6.  Look at how the current workforce is used… can it be more efficient.  

LTP productivity growth assumptions tell us, staff are delivering a lot more care per hour.  That’s because we have fewer nurses dealing with more people, but hides the waiting-patients, queueing around the block.

7.  Examine the organisation’s structures... do they impede the best use of the workforce?  Vertical integration is the long-term plan… how does that impact the workforce and who employs them?

8.  Overcome internal and external resistance… to change and remodelling.  That’s what kite-flying is about.

That’s all top-line, ‘easy stuff’.  You’ll still have to take into account: 

… an ageing workforce, global shortages; insufficient, appropriately qualified people coming into the workplace from school; geographic distribution of staff and enticing mobility; lack of organisational loyalty, a younger workforce wants a job and a life; a digital-first workplace and the new skills needed; regulatory pressures that puts-off staff and discourages joiners.

This leak is not going to change for the better even with November data.

Dig into it and you’ll see; to bolster the numbers, 10,200 people are camouflaged as ‘skill-mix between nursing associates and registered nurses’.  We know there’s been a 14% growth in nursing associates and unregulated staff.

This is a kite-flying leak and tells me; austerity has crippled the workforce, it’s too late to get back to normal and we will all have to get used to a new normal.

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.