training primary care letter Baroness Dido Harding

DiDo is now head-honcho workforce. Repairing the neglect of recruitment, training and investment before the NHS collapses under its own weight.

Her first public task is a letter. Here it is. Groan…

Various themes and vacuous questions about the future of the workforce, and putative actions that will take us well into next year and beyond.

The letter, dated 6th March, requires a reply by 15 March. Nine days, six working days, 48 working hours to get the Boards together, HR people briefed, have a time-out meeting, write a considered reply and send it back.

Of course, on top of everything else, there is sooo much time to reply to dinky-do questions such as;

• Do you agree we should review the support provided to challenged organisations by NHSI/E to ensure it reflects inclusive and compassionate leadership

• How about; establishment of a board level leadership development model; and a digital workforce planning exercise

There’s other stuff like;

‘To deliver 21st century care for our patients, we will need a transformed workforce…’

Given the urgent, pressing, mission-critical workforce problems the NHS is facing, this document is Harry Potter when we need Jack Reacher. It’s Grimm when we need Grisham. It makes a laundry list look worthwhile.

How this all fits with Prerana Issar the new DH+ Chief People Officer (what a dumb title), who may want an entirely different approach… I dunno

Let’s roll-up our sleeves…

First, we have to ask the question; is workforce strategic planning the right approach? All previous attempts have failed.

We can’t wait for strategy. We don’t have enough nurses and don’t have enough ideas what to do about it, tomorrow.

For sure; take care of the front line, fund it properly and make it fun to work there and most of the other problems will go away.

The NHS is always desperate to avoid over supply, because they think they have to employ all the people they train. They don’t.

So-what if we have an oversupply of engineers and architects… but not nurses or doctors. Why? There’s a global shortage and importing staff is getting more difficult.

There is an emergency we have to cope with… now. Not April or next year. Right now. Some hospitals, maybe the majority, are kidding themselves if they think they have safe staffing. They don’t.

We don’t need a transformed workforce. We just need enough, properly trained, well-treated people, enjoying doing a great job.

Leadership? The Leadership Academy has been churning out people with MBA’s for years but, apparently, we still need leaders? Something’s not working. Close the Academy, start a Staff College.

We don’t need a digital training programme. We just need to buy things that work as easily as FaceBook, WhatsApp or as straightforward as ordering from Amazon or Tesco’s.

If the interface isn’t that simple, don’t buy it.

What else, immediately?

• Stop turning good people away. Talk to the 10k people who applied to be a Doc but couldn’t get on a training place and the 20k who couldn’t get on a nurse course and offer them alternative routes in, or other health related careers or the apprenticeship schemes.

• Stop people leaving! Mandatory, independent exit-interviews, with returns to the centre for analysis, every day. Analyse why people leave and fix it.

• Stop the national return-to-work programme. It’s painfully clunky. Let Trusts manage it locally, Get all returners on the wards doing something useful. Risk manage and train from there.

• Showcase the good Trusts. The ones who keep people, low sickness-records, find out why they are good.

• Buy a rota planning software license for the whole of the NHS. Something that works and allows flexible rostering and the aggregation of data for national analysis and a full picture.

• Stop Trusts from buying-in agency until they have a bank and flexible employment opportunities for people who can’t work a three day, 12hrs, back-2-back pattern.

• Make every Trust have a crèche.

• Stop the pension penalties fiasco that makes people leave.

Consider every nurse who leaves as a failure of us all. This is urgent.

In the longer run…

• Create a single national curriculum for nurse training and let the Trusts go from there.

• Include a basic prescribing module in all clinical training; OTs, physio’s chiropodists, radiographers, paramedics… everybody.

• Help everyone to work to the limits of their competence and improve productivity from there.

Strategies never work. A workforce data model is fluid more nimble, more tactical and will work better than sending out letters.

We don’t have time for Hans Christian Andersen. We need hands-on crisis avoidance.
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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.