News and Comment from Roy Lilley.

Another year in sight and the urgency to deal with three things, no less pressing.  Apparently, 2018 is the year of the dog but if it is anything else, it has to be;

‘The Year of The Three Things’.

You know what they are. People, People and People.

First, the people.  

The NHS struggles to do what the likes of Marks & Sparks and Top-Shop, Lidl’s and Waitrose do instinctively.  They segment their markets and tailor their offerings to the people.

The NHS has one front-door and everyone piles though it.

Commuters need a different primary care to yer-granny.  People with long-term conditions need a different approach to folk needing a short-term fix and I’d guess 70% of outpatient appointments could be safely done over the phone, FaceTime or Skype.

Second; the people.

The NHS, maybe the biggest employer in the country but arguably, the worst at looking after its people.  The majority of colleagues, women.  Somehow we manage to create the most macho working environment it is possible to imagine.  Inflexible, punishing rota that no airline pilot nor lorry driver would attempt.  

Most Trust HR departments would struggle to spell crèche, never mind run one.  

Millennials don’t see a job-for-life.  They see a job, and-a-life.  

Return to work in the NHS?  Don’t even think about it.  It makes mountain climbing look easy.

Third; the people.

We have to figure out the people; who’s going to work with us, what we want them to do and how many.  That’s Health Education England’s job.  From the start HEE were dealt a bad hand and played it badly.  

No sooner they started, they were nearly finished-off by budget cuts.  Then, got themselves involved in ill-judged exchanges during the junior doctors’ strike, costing them creditably and any scintilla of hope, they are independent.  We all know they are the DH in drag.  It doesn’t matter.  

Issues with their own staff redundancies and daft forays into ‘guidance’ have done for their reputation.  

Now they have a task that will define them.  They are charged with developing a workforce strategy.  The first for the NHS.  It’s success or otherwise will make or break the HEE and probably finish off the NHS if they make a mess of it.

Reading their ‘future of the workforce’ consultation document is a complicated business.  You’re seemingly invited to start here but I couldn’t make the links take me to the actual ‘draft strategy’.  Perhaps I’m dim?  Eventually, I found this link on the HEE web-site.  

You’ll know you’ve found the right document; it has a picture of a man with a tube up his nose?  Presumably a document, not to be sniffed at…

Read the proposals and navigate your way to eight questions.  You are asked to give narrative answers, which, I think, could stretch semantic interrogation to its limits.  There is a potential for responses to be ‘editorialised’.

There are pages and pages of vanity blurb and statements of the obvious.  On page 18 HEE claim to have ‘greater clarity on future service models‘… really?  They are the only one’s that have!

It’s an important point.  Design the work, train the workforce to deliver the right outcome.  

Not, redesign the work make the workforce fit and wonder why you don’t get the right outcome.

On the same page; ‘6 Principles‘ that start with a disingenuous, oblique reference to the Brexit fiasco.  Point 3 might be a harbinger for the end of Agenda for Change?

Fast forward to the graph on page 27.  HEE say they have started using ‘waterfall’ diagrams to describe components of movements in and out.  The numbers made me weep. 

You have to plough to page 33 to figure out what their plans are; new graduates, returns to work, retention, more places, new roles… the usual… everything.

Page 67; social care.  It’s a minimum wage, zero-hours car-crash… 82% female, half working part-time, around 347,000 leaving last year, with 88,000 vacancies.

Just for fun, isn’t there a howler-error in the picture on page 98; have a look.  Otherwise this is a well informed, mile-wide, mile-deep, well presented, beautifully laid-out document, packed full of facts and figures to enliven the dullest PowerPoint.

Does it convince you?  Employment depends on housing, transport, kids schools, other job opportunities, as well as ambition, education, life chances, hope, happiness and vocation.  There is much more to workforce planning than the needs of the health sector.

You don’t need the facts, you work with them every day.  

Skip to page 134, read the questions and see if you are smart enough to find the links to where you can have your say.  It’s important you do, so I’ll make it easy. Go here.

What are the answers? I keep saying, dare I say again; protect the front-line, fund it properly, make it fun to work there and your problems will disappear. 


 Contact Roy – please use this e-address


Know something I don’t – email me in confidence.

Leaving the NHS, changing jobs – you don’t have to say goodbye to us! You can update your Email Address from the link you’ll find right at the bottom of the page, and we’ll keep mailing.