international health leadership programme strategic human resource management an nhs study andrew...

International Health Leadership Programme

STRATEGIC HUMAN RESOURCE MANAGEMENT

An NHS Study

Andrew FosterWorkforce Director

17th March 2006


HUGE AND DIVERSE WORKFORCE

• 1.3 million NHS staff and 600 employers• Over 600 jobs and grades• 17 Trades Unions and Professional Bodies• Pay bill £33bn takes 59% of spending• Minimum salary £11,494; maximum £165,263• Around 120,000 undergraduate trainees• Training budget NHS £4.5bn• 79% of non-medical staff female • 34% of doctors (but 60% of trainees) are female• 13% black and ethnic minorities (population 9%)


NHS SPENDING 1997 - 2008Year Spend %

%real terms £bn increase increase

97/98 34.7 5.1 1.9

98/99 36.6 5.6 2.8

99/00 40.2 8.9 6.4

00/01 44.2 9.8 7.4

01/02 49.4 11.9 9.3

02/03 55.8 8.8 6.1

03/04 61.3 10.0 7.5

04/05 67.4 10.0 7.5

05/06 74.4 10.3 7.6

06/07 81.8 10.0 7.3

07/08 90.2 10.2 7.5


NEED FORA CLEAR

SENSE OFDIRECTION


THE NHS PLAN 2000-2010


MORESTAFF

WORKINGDIFFERENTLY

TWO OBJECTIVES


MODELEMPLOYER

MODELCAREER

IMPROVING MORALE

PEOPLE MANAGEMENT

The three starTrust

Improving Working Lives

and beyond

The SkillsEscalator

4 Modernisations:

• Workforce Planning • Pay • Regulation

• Education & Training

Psychological Contract

Staff and employers

Staff and Government

Staff and patients

HRM Development

BuildingSkills,

Capacity,Quality, ‘Attitude’

THE FOUR PILLARS


IT MAY SEEM OBVIOUS…


THE MODEL EMPLOYER• The moral argument• People management aids recruitment and retention• People management aids High Performance• Common sense but also around 30 major studies

worldwide in last 12 years• Ulrich, Pfeffer and Huselid – improving shareholder

value with ‘bundles’ of good practice• Magnet Hospitals in US and Aston University Studies

UK– Recruitment and retention– Organisational outcomes– Clinical outcomes


THE SKILLS ESCALATOR

Pay Spine LearningLevel Career Stage

Regulation

Cadet Pre-employment Work OrientationUnemployed/ Excluded

Skilled Assistant Support Higher NVQs and HigherAssistant Workers Occupational StandardsStarter Induction, NVQs

Occupational Standards

Expert Qualified Higher disease/patientRegistered Professional modulesPractitioner Staff Disease/patient modules

Degrees Diplomas

Consultant/GP Self Directing Higher DegreesSenior Manager Principals

Workload and R

oles C

aree

rs


Pay

Ban

d

9

8

7

6

5

4

3

2

1

AN ESTIMATE OF THE CURRENT WORKFORCE

Consultants & Snr. Managers


THE LOCAL HR AGENDA

• More staff– Rapid workforce expansion

• Working differently– Skills Escalator Strategy

– £3 billion investment in new pay systems

– Agenda for Change an enormous OD programme

– European Working Time Directive 2004 and 2009

• And keeping the knitting going

• There are worse jobs…


SOFOND

OFTARGETS


PROGRESS CHECK…

• 194,000 more staff in last three years• Doubling in applicants and 60+% more trainees• Explosion in new roles

– Delegated tasks e.g. prescribing– Extended roles e.g. nurse endoscopist– Completely new roles e.g. emergency care practitioner

• Positive staff survey results • Lower vacancy and sickness absence rates• Over 95% of staff on new pay systems• But workforce is just an enabler…


IMPROVED RESULTS

• 98% of casualty patients being seen and treated within 4 hours

• Inpatient waiting times down from 24 to 6 months

• Waiting times for heart bypass operations down to 3 months from 2 years

• Deaths from breast cancer falling faster than anywhere in the world

• Declining mortality rates from cancer, heart disease and suicide


CHANGING CONTEXT

• From benevolent producerism to top-down control to self-improving systems

• System reform: patient choice, tariff + competition

• Financial pressures and funding slowdown from 2008

• Workforce must respond to new policies– Patient-led NHS– Health protection and prevention– Shift from secondary to primary care– Integration with local government and social care– Electronic patient record


THE TEAM HAS A NEW OWNER


HALF-TIME TEAM TALK • Build on the successes of last 5 years

– Better recruitment, retention and return

– Model Employer, Skills Escalator and new roles

– Reduced vacancies and sickness absence

– A more confident HR function (EUWTD and Agenda for Change)

• Respond to the financial environment– Integration of activity, finance and workforce planning

– Shift from ‘More Staff’ to ‘Working Differently’

– Do the things that we know will work

• Deal with culture and behaviour


CULTURE AND VALUES

• Challenge of personalised care, choice, competition, a ‘subsidised’ private sector, patients as ‘customers’

• Could the biggest obstacle be NHS staff?

• If so what does HR do about it?

• Need to both adjust and go with the grain– Staff have strong values about patients

– Pre-registration and undergraduate training

– Recruitment, selection and induction

– Post-registration and other training

– Knowledge and Skills Frameworks


HR HAS THE TOOLS


HIGH IMPACT INTERVENTIONS

• Retention – turnover costs 100+% in lost efficiency

• Shared services – can make 20-40% savings

• E-recruitment – Ashford St Peters saved 60%

• Temporary Labour – East Kent saved £3.5m

• Sickness absence – costs the average Trust £5.4m

• Job design – Addenbrookes halved radiotherapy wait

• Appraisal – associated with lower patient mortality

• Staff involvement; good people management; directed training investment and strong OD – predictors of high performance


CONCLUSION• From “last chance saloon” to a “New NHS”• HR aligned and realigned to overall policy• HR must help shape the patient-led NHS• HR must add value to the NHS • World class NHS needs world class HR • One of the world’s biggest employers –

want to be one of the world’s best employers

• First half tough; second half will be tougher


HR STRATEGY

- TIME TO

GETJOINED UP

AGAIN


THANK YOU


SOME QUESTIONS

• HR – separate function or core managerial skill?

• Health staff – cost or asset?• Raising morale – sentimentality or good

business sense?• Is there a causal link between staff

satisfaction and patient satisfaction? • If so, which way does it work?• What do managers want from HR?

international health leadership programme strategic human resource management an nhs study andrew...

Documents

obvious slide

objectives slide

nhs staff

worse jobs slide

roles careers slide

employers staff

government staff

clear sense of direction