In the NHS, backstage functions like human resources must adapt if they are to keep pace with the changing demands of service users, says Chris Roebuck

For anyone working in human resources in the health service, a world of opportunity is opening up; an opportunity to make the NHS world class and to develop professional skills at the same time.

In many organisations the "front end", where they meet their clients or customers, alters often to reflect changing needs, especially when driven by market or political forces. But the support functions at the "rear", including HR, are often left out of the change process. As a result, human resources can remain aligned to service a front end structure that no longer exists and can become unable able to deliver what is really needed.

Often staff in those functions are unaware of this misalignment and end up constantly firefighting and dealing with delivery problems. This then creates demotivation and potential retention and recruitment problems. Sometimes only actively sought client feedback reveals the problem. This is particularly true where there is a focus on completing a process rather than on quality of output.

A misalignment of HR from back to front clearly affects day-to-day performance. It also restricts the value the department can bring to the NHS, by limiting much of what it does to transactional activity only.

Research by Dave Ulrich and Wayne Brockbank shows that while transactional HR adds 18 per cent value to the organisation, strategic and transformational HR, such as development and performance improvement, can add 43 per cent. Client driven strategic HR is critical to support client/patient driven care.

Lord Darzi's next stage review and NHS senior management plans both require a talent and leadership system that will create a pipeline of leaders across the health service. This must support potential leader identification, development and mobility, especially in appointing more clinical leaders. It must then focus those leaders on delivering a service that meets the needs of the communities they serve.

Driving force

HR will have to be the main facilitator of this new approach, with senior line management the driving force. HR teams have a real opportunity to help the NHS become world class, but to achieve this they face many challenges. Not only will they have to continue to deliver excellent operational and transactional services, for example by making sure people get paid, but they will also take on more strategic and transformational activity, such as helping line managers to identify and develop talent.

This cannot happen until the HR function ensures it aligns with the current needs and structure of the clients it serves. There will undoubtedly be pressure from senior line management to start the delivery of strategic HR as soon as possible to deliver the new leadership, but it would be a mistake to try to deliver it in addition to the transactional HR without first ensuring alignment. Concurrent activity might occasionally be possible, but in most situations HR must review and restructure before attempting strategic delivery.

If you work in HR, the words "business partnering" may be ringing in your ears by now, assuming this is the silver bullet to solve all your problems.

Business partnering enables HR staff to move from being reactive and transactional to being proactive and delivering consultancy support to help line managers deliver high value activities such as performance management and development. It also allows HR professionals to identify high performers and it supports strategic initiatives such as succession planning, culture change and creating a development pipeline.

New partners

But beware: many organisations profess to use business partnering yet very few actually do.

Here are two suggestions, both supported by my colleague Dave Ulrich, who developed the concept. First, business partnering is what you "do", not what you are called, so just saying you are a business partner and then not doing it well destroys the credibility of both HR and business partnering. Second, before you start to implement it, make sure you know how to make it work.

The first step to partnering success is often omitted. It is taking the time to ensure everyone in HR, especially the decision makers, fully understands what the end user or patient wants. Let's be clear, this is not what your internal client wants, it is what the people the health service cares for want. Only if you understand this and how your internal client delivers this can you restructure or refine your process to support your internal client effectively.

This is not about delivering HR best practice, it is about delivering optimal HR for the needs of your clients at the time.

This goes to the heart of the relationship between line managers and HR. Business partnering will only work if managers see that HR makes their life easier by helping them deliver their objectives and get better performance from their people. To do this HR must understand and be aligned to their clients, and that is not achieved by overloading clients with extra HR activities in which they see no value.

Once aligned, your transactional delivery should be efficient and effective. You will know it is right when, in the opinion of your clients, everything you do adds practical value to them.

It is only then that time will be released through a reduction in transactional firefighting that allows strategic and transformational HR to be delivered effectively. This will be focused primarily on talent, leadership and performance improvement. Creating this structure is critical in order to deliver what Lord Darzi is seeking to achieve and is, above all, your end objective.

Next month I will show how human resources can, through talent, leadership and performance improvement, help the NHS deliver not only a pipeline of leaders but the transformation needed for world class care.

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