The must read stories on on Monday

Inquiry into the invisble army

Of the NHS’s 1.2 million strong workforce, 583,837 are non-clinical staff. This includes cleaners, cooks, porters, gardeners and maintenance colleagues, as well as administrators at all levels, switchboard colleagues, IT staff, security staff, communications, finance and HR.

But still they “can seem and definitely feel rather invisible in discussions about workforce, training and policy”, says HSJ comment editor Andy Cowper.

The influence of non-clinical staff on transforming the NHS through the Carter review and STPs will be critical, which is why HSJ is examining how to get the most from this key part of the workforce – and how to give the most back to them in terms of rewarding careers.

On Monday, the HSJ/Serco Inquiry on Maximising the Contribution of NHS Non-Clinical Staff published its interim report. It’s headline conclusions so far include that Lord Carter’s efficiency agenda will not succeed if the NHS fails to engage with non-clinical staff, and there needs to be greater engagement and co-design with non-clinical staff on local STPs.

It set out three things to help the NHS realise and maximise the value and values of this vital workforce:

  1. Highlight their contributions.
  2. Work with HSJ readers on testing the ideas the interim report has sought and developed.
  3. Provide some tools for self-analysis by organisations.

The inquiry also has a number of questions it would like organisations and system leaders to answer, starting with: can anyone think of a better term for these vital workers to the NHS than “non-clinical staff”?

Secrets of the success regime

The former chair of the Essex success regime has issued a stark warning to Jim Mackey on how unrealistic targets, insufficient central support and divisive regulatory tactics are hampering local efforts to reconfigure services.

UCLPartners managing partner Professor Sir David Fish, who was interim chair of the regime for three months, also warned the NHS Improvement boss that “old style approaches” would drive “defensive behaviour” and impede joint working.

Sir David set out his concerns in a letter sent in February, seen by HSJ, and he described how local plans were being undermined by “mixed messages” and “resistance” from regulators.

When talking to other senior health service figures, he found “the story in Essex is not unusual”.

A “key observation” from Essex was that “frontline staff, myself included, feel unsupported given the journey we have been asked to undertake”, he said.

Sir David’s letter added that there was “disappointment about the apparent national nervousness and uncertainty on group models”. Local leaders were forced to get external legal advice “rather than more senior direct input from NHS Improvement”.

HSJ was told last week that Sir David stands by his critique, but he had been “very impressed” with the progress made by NHSI under Mr Mackey to change its approach.