How the NHS treats its workforce is now seen as central to recruiting and retaining staff.The health service is on notice to deliver.Ann McGauran reports

When it comes to ensuring a better quality of life for staff, the NHS says it is now 'moving heavily into implementation mode'. But although 'fantastic things are happening', much remains to be done.

That was the message given by David Amos, head of recruitment and retention for the NHS, to delegates attending the Improving Working Lives - Making it Happen conference last week.

The general mood at Birmingham's National Exhibition Centre seemed surprisingly chipper. The obvious national commitment to human resources seems to be going down well. For the first time, the way employers treat staff has become a core performance measure. The big money will be closely targeted to the winners.

The human resources framework was launched alongside the Improving Working Lives standard by health secretary Alan Milburn last autumn. The Birmingham audience last week was put 'on notice' to deliver. This April the target is for each trust to make a public commitment or 'pledge' to work towards delivering the Improving Working Lives standard. And by April 2003, all employers are expected to be accredited as putting the standard into practice.

They w i l l have to prov ide detailed and exacting evidence to prove their performance on a vast range of issues, including childcare strategies, local recruitment drives, career breaks, tackling the long-hours culture and encouraging equality and diversity.

At the conference, NHS chief executive Nigel Crisp handed out the first wave of awards to the first 16 trusts to reach pledge status.He said that although the health service is still a 'good and rewarding' place to work, 'we have to make sure it gets better'.

According to Mr Crisp, topping the health secretary's list is the need to 'get people in, retain them and give them good employment conditions'.A service designed around the patient was a huge and ambitious change, he said - but 'we have to get it right for staff if we are to achieve a radical transformation' for the NHS.

Mr Amos said it was 'good and right' to seek to improve working lives - with the 'single purpose' of improving patient services. Help being offered nationally includes Georgina Dwight's secondment as head of overseas recruitment (see box), the launch planned for next month of the second year of a national recruitment campaign, and the new NHS Professionals nursing agency which promises staff the benefits of an agency and the security of remaining health service employees. Successful projects locally seem to be concentrated on flexible working arrangements, nursery provision for the under-fives and some breakthroughs in international recruitment. But the national Improving Working Lives team acknowledges the importance of offering something to everyone, not just to parents of young children.

Some doubts are inevitable, given the tension between making things better for employees and wrestling with the demands of the NHS plan. One trust HR director told HSJ: 'I am in an area that has relatively few recruitment problems, but Improving Working Lives is competing with a huge agenda.

There is an increasing workload, continuous change and demanding targets.'

Last autumn the Royal College of Nursing employment relations director Stephen Griffin called employers' response to the HR strategy 'patchy'. He believes the time has come to highlight Improving Working Lives achievements as widely as possible.

'We have got a lot of work to do to make those become the norm rather than occasional practice.'

Convincing people outside the service that working for the NHS is now a better deal than it was is a 'long-haul' process, according to Association of Healthcare Human Resource Management president Sally Storey, 'but we are all passionately committed to it'.

The success of the NHS plan depends heavily on whether sufficient numbers of nurses can be attracted into the service over the next few years.

No fewer than 20,000 are needed by 2004, and 'in the short term' the government will look abroad to boost numbers.

Newly appointed director of international recruitment for the NHS Georgina Dwight is the person responsible for selling the delights of English hospital trusts to nurses across the world and keeping them happy once they get here.

She joins the Department of Health on an 18-month secondment from her post as director of nursing at Hammersmith Hospitals trust.

Her work there since 1995 has given her a unique background for the challenge of taking international recruitment forward on a national level.

Ms Dwight, who began work at the DoH last week, is obviously going to relish her role. She told HSJ: 'I think It is fantastic that international recruitment is such a key part of the recruitment and retention initiatives.'

Hammersmith Hospitals trust began recruiting from abroad in 1996. At the time it had a 35 per cent vacancy rate for nurses, and beds had to be closed - a situation she describes as 'somewhat catastrophic'. She told the board that the trust should recruit from overseas 'as an emergency measure'.

She started to take nurses from Scandinavia - particularly from Finland where there was a 35 per cent surplus of nurses. The result enabled the trust to stabilise its vacancy rate at 12 per cent and re-open beds.

The international department she set up was 'unique at the time', she says, and the trust now recruits from some 15 countries around the world.

Her boss at Hammersmith, chief executive John Cooper, said: 'Her absence will be a considerable loss to the trust. . .

She has been an outstanding role model for nurses.'

David Amos, head of recruitment and retention for the NHS, said Ms Dwight was selected because of her 'combination of having done a lot of international recruitment at Hammersmith and her general management abilities'.

Ms Dwight believes that although the number of training places is increasing, the NHS 'needs to work hard to retain its staff and to recruit qualified staff both from the UK and internationally'.

She states that her job will be to ensure that international recruitment is 'collaborative and cost-effective'. A new code of practice for trusts is due by the end of the month. It is a 'challenging agenda', but one she says she is looking forward to greatly.

She says the NHS plan brings 'all the strands' of human resources together.Her job, as she sees it, will be to look at international recruitment as one of those strands. She also thinks it is crucial for trusts recruiting from overseas to keep closely in touch with the trade unions, to 'give us a sense of staff feelings'.

Senior employment relations adviser for the RCN Josie Irwin welcomed her appointment. 'We have had concerns about levels of support for overseas nurses when they arrive here.

'An appointment at this level reflects the level of seriousness the government attaches to the role.'