Published: 17/11/2005 Volume 115 No. 5982 Page 36

NHS staff are about to feel the pinch of the Gershon review's demand for savings. But as Keith Johnston explains, re-thinking your career could make you better placed to survive the cuts

Is it any coincidence that the£250m management cost savings demanded from implementation of Commissioning a Patient-led NHS equalled the monthfive deficit throughout the wider NHS?

The combination of trust recovery plans and a further round of structural reorganisation is going to have a profound effect on NHS employees across the service.

Understandably, management response in these circumstances is to put a freeze on external recruitment and seek internal redeployment to avoid the human and financial costs associated with redundancy. However, this time round such strategies will arguably have a limited effect. The sheer scale of post reductions is likely to be significant.

In addition, the secondment and redeployment bolt holes available in earlier reorganisations are no longer an option. The Gershon review, seeking£6.5bn savings by 2007-08, has already made an impact on staff numbers in the Department of Health and arm's-length bodies.

It has never been more important for NHS managers and staff to dust off and review their career-management strategies, irrespective of whether they are directly or indirectly at risk.

Models of career management abound.

However, the goodpractice. net model is particularly helpful. It sets out a range of skills, tasks and priorities that need to be considered to develop and implement a career management strategy.

It is built on clear principles:

Clarify what you want from a job, matching your values and skills and establishing a satisfying role.

Recognise and manage your attributes and unique 'brand', and use this to present yourself effectively in a competitive environment.

Build and exploit a personal network for career opportunities.

Identify and develop people skills to optimise performance.

Identify long-term objectives and use short-term goals and actions to achieve them.

In developing a career-management strategy, it is good to start the reflective process by considering the nature of careers.

Historically, concepts of career progression have taken four main forms.

The linear view revolves around making upward progress. Success is measured in terms of how high you rise in the hierarchy. The key motives underpinning the concept are the power of influence and achievement. People who prefer this career pattern focus on everhigher attainment.

In contrast, the expert career concept defines success as finding a type of work that represents your 'calling', and then progressively becoming more skilled and competent in this area. In this context, advancement means developing your expertise in a chosen discipline or field of work. Being very good at performing a particular kind of work is the bottom line.

The spiral career is characterised by a progressive broadening of knowledge, skills and talents. As a pattern of movement, it usually begins with an individual making a choice to start their career in a particular field, but then making periodic moves into new fields and new experiences of work. In this case, the prime motivators are personal growth and creativity.

Finally, there is the pattern of inconsistency found in the transitory career concept. The key motives of novelty, variety, independence and interpersonal contact combine to produce an ideal career of a smorgasbord of experiences. People who pursue transitory careers change jobs or types of work frequently - on average every two to four years - to get the widest and most diverse array of experiences possible.

They often dislike work that is routine and structured, and situations in which they are closely supervised.

Career concepts are clearly not fixed for life. At various stages different influences come to bear in determining our needs and priorities.

Keith Johnston is executive director of NHS Partners and a career coach. The next article in this series will examine the importance of personal values and career drivers in making career choices.

To find out more about careers go to www. goodmanagementhsj. co. uk/careers