Published: 02/09/2004, Volume II4, No. 5921 Page 32 33

London has typically fought staff shortages with overseas recruitment. In the second HSJ monthly spotlight on regional recruitment markets, Sally Mesner reports on efforts to develop the capital's existing workforce

High staff turnover and a reliance on workers from overseas are well-known characteristics of London's healthcare workforce. But although the capital's strategic health authorities continue to work on attracting staff from abroad and on tackling the rate of turnover, their focus has increasingly turned to growing their own healthcare workforce.

'London will always train more staff than it can keep because of the quality of the training organisations we have, ' says Maxine Foster, workforce development and design lead at South West London SHA.

'But our philosophy is to stop trying to fight this 'churn effect', to make use of the time people spend in London rather than seeing staff turnover as a terrible thing. The mindset we want to instill in trusts is not to see losing staff we have trained as a failure but to accept that their working in London has been a valuable contribution to the NHS as a whole.'

The trust is instead focusing its attention on attracting local people into the NHS. 'To attract new and young people we use a local freebie paper called Job Opportunities, which is distributed at stations, supermarkets, shopping centres and waiting areas in hospitals, ' says Foster.

'We also have a generic bus stop campaign.Virtually every hospital has a bus stop outside it.

We put up posters in those shelters featuring the faces of local GPs, anaesthetists and midwives telling their stories of working as part of the healthcare team in south west London.'

The authority has also come up with innovative ways of getting its message out into the local community. A scheme to attract young mothers back to nursing and midwifery advertised returnto-practice courses on the back of till receipts in supermarkets and on school menus that children bring home.

'We also have a strategy to grow our own nurses, ' says Ms Foster.

'There are good numbers of newly qualified nurses coming through the system now. Our key-worker housing scheme has helped to retain nurses who trained in London and we are also offering good training and development opportunities.

Filling senior nurse positions is the problem we have now, so we are providing structured career development for nurses in junior posts to give them the confidence to develop into senior roles.'

North Central London SHA is also focusing on the local workforce. 'We have got a strategy, nicknamed Grow Your Own, to get local people into NHS employment, ' says Janice Sigsworth, director of workforce development. 'If people are living locally and we train them they are more likely to stay living locally.

We want a workforce that reflects our local population and to deliver sensitive healthcare around the diversity agenda.

'We have recruited GPs, nurses and radiographers from Australia and South Africa as a short-term solution to skills shortages in those areas.However, our focus is on developing a long-term plan to give opportunity to the massive pool of talent in north central London, particularly around the black and ethnic minority agenda.'

The borough of Haringey has the largest number of refugee and asylum-seeker doctors in London. 'We have set up a refugee doctor scheme, which provides an accelerated pathway to get refugee doctors qualified and working in this country, ' says Sigsworth.

North West London SHA has also set up a scheme - called Stepping Stones - which focuses on unemployed refugee doctors.

'It is a win-win situation for both the health service and the doctors themselves, ' says Sue Smith, assistant director of access and development. 'There are more than 500 refugee doctors in London, and half of them are in north west London.We are helping them back to work with English exams and interview advice as well as work-based training. They are also very representative of our local populations.'

Ms Smith emphasises the importance of recruiting BME populations. The Greater London Authority estimates the city's working population will grow by 516,000 by 2016 - 80 per cent from BME countries: 'The NHS is a major employing sector in London and therefore in a good position to attract groups at risk of social deprivation into the service.'

In the borough of Hammersmith and Fulham the authority has set up a scheme called The Op Shop, targeting 200 people from deprived communities for employment in the acute and primary care trusts.

'The kinds of people we are targeting are lone parents, people living on estates, people who have been unemployed for a long time and migrant communities, ' says Ms Smith. 'These are people who may not have otherwise considered looking for work in the health service.'

The authority is also developing a childcare skills initiative in partnership with social services in Hammersmith and Fulham. 'It focuses on the barriers to getting back to work - one of which is finding affordable and culturally sensitive childcare provision, ' says Ms Smith. 'We will train people to become registered childminders in their own homes, with the opportunity to to become midwifery assistants or nursery nurses.'

The SHAs are also working to tackle negative images of London: 'We want to explain that living in inner-city London is not that bad, ' says Jide Odusina, commun-ications manager for North West London workforce development confederation.

'We have a campaign that emphasises the professional career opportunities available in our sector because of our large teaching hospitals, good links with research and commitment to improving working lives issues.

On top of that is the shopping, night life, cultural diversity and other quality of life factors.'

One of the biggest staff shortages in London is in radiography. South West London SHA is supporting the appointment of clinical learning facilitators. 'Their role will be to work with very hard-pressed radiography departments to recruit new people but also to develop the current workforce into more advanced roles, ' says Maxine Foster.

'We are also supporting the appointment of assistant practitioners into radiography departments, which have traditionally relied on qualified staff. Supporting these assistant practitioners, who will work under the supervision of qualified radiographers, will help expand staff in radiography departments.We also hope they will become the radiographers of the future.'

London Health Commission 'London works' local recruitment programme www. londonshealth. gov. uk/regen. htm

The King's Fund publishes a range of labourforce publications www. kingsfund. org. uk

Staying power: train in London, stay in London London's five strategic health authorities are planning a joint campaign to make the capital more attractive to student nurses.

It will focus on theatres, art galleries and cultural activities as well as key-worker housing and the wealth of green spaces.

North Central London SHA is also working on ways to keep student nurses in London once they are qualified.

Janice Sigsworth, director of workforce development, exaplains: 'As well as providing supported housing schemes, we are using the host trust concept.This involves students being placed in one training circuit, working for a couple of primary care trusts and an acute trust during their training.The idea is to give them a sense of belonging, and to help them get permanent employment.'

'We are also targeting points in people's careers where they are likely to make a move out of London.

'For example, last year we held a pan-London event at London Zoo where we invited all the GP registrars in London.Once they become consultants there is a tendency for them to move on.

The event was an opportunity to get them thinking about staying, with a current GP and the Deanery speaking to them about the opportunities for consultants in London.'