It looks to me very like someone has run out of patience.
For months it’s been batted back and forth between NHSE, HMT and the DH+. Some sort of latter day Bermuda Triangle. A management black hole. A decision free zone.
I’m talking about the NHS workforce plan.
I don’t think there is anyone in Whitehall who doesn’t know it’s been written. Drafted several times, done the rounds of all and sundry and then ended up in quarantine in the Treasury.
Sent out for independent audit and appraisal, the Plan ticked all the boxes.
We breathed a sigh of relief when the former flag bearer of workforce planning, The Tinkerman none other than Jeremy Hunt, former Secretary of State for Health became Chancellor.
At last, the NHS had an ally at high table. From the back benches he’d pestered and tried to legislate for a workforce plan. As chair of the health select committee, he’d called for a workforce plan.
Now, he has the power to make it happen… he won’t.
He won’t because it comes at a price. As Chancellor he has to make sure there’s enough in the kitty for a pre-election give-away and to fund the Ministry of Defense.
Funding the NHS workforce, properly, comes with a huge price tag. Too much.
Exasperated… somebody has leaked the document and you don’t have to be Sherlock Holmes to figure out who.
NHSE’s current policy; the Chief Nurse and friends clocking up the air-miles to lure nurses from places like Nepal, isn’t a policy.
As far as the WHO are concerned, Nepal is a red-list country and pinching staff from there is the next best thing to an international crime.
‘… without radical action, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years'.
Anyone planning to outlive me should take note;
‘… that number could balloon to 571,000 staff by 2036 on current trends.’
My advice; don’t get old and don’t get sick.
By the way, a plan for the future of the NHS workforce and a promise of safe staffing was one of the key-points of agreement that brought the nursing strikes to a halt.
That puts Bully-Boy into a bit of a fix. Back to the barricades?
Why is a workforce plan so important?
It is a strategic document. It tells us what we have to do to have the right number of people, with the right skills, in the right places for the NHS to achieve it’s strategic goals.
That’s another problem. NHSE doesn’t really have a strategic plan. It’s all fudged up in ‘the Long Term Plan’… which says;
‘… ensure we have enough people, with the right skills and experience, so that staff have the time they need to care for patients well…’
NHSE cannot deliver The Plan because they have no plan for a workforce plan and so they continue their march up Penrose’ stairs.
There are four principle reasons a workforce plan is not a nice-to-have. It’s a must-have;
Anticipation; training takes years and is a long-range commitment. Predicting future workforce needs can help avoid the cost of reactive hiring, agencies and the like.
Optimising; understanding where shortages are likely to occur creates the opportunity for managers to optimise the staff they have, increasing skills and where to focus investment in innovations.
Mitigation; reducing the risks created by filling workforce gaps with temporary staff, often unfamiliar with the workplace and practice and the potential damage to safe services by insufficient staff able to work effectively.
Alignment; the workforce plan should align with the HR strategy, retention and recruitment, which should align with the ‘business’ strategy; how many people, with which skills, are needed to deliver what the organisation is setting out to achieve.
I’m not sure we have much of that?
We should because if we know what the issues are, we can mitigate the risk. Manage around it.
Last July, Hunt’s select committee said;
‘… [the NHS is facing] the greatest workforce crisis in their history, compounded by the absence of a credible government strategy to tackle the situation… persistent understaffing poses a serious risk to staff and patient safety in routine and emergency care…’
>> I'm hearing - Many practices can ignore demands for GPs earning over £156,000 to declare their income publicly because their contracts have not been updated to include the rule. Oops!
