Published: 17/03/2005, Volume II5, No. 5947 Page 32 33

With a population explosion on the horizon, Adrian O'Dowd finds out how trusts in the South East plan to keep staff from the lure of London's bright lights and weighted salaries.

Planning for change is the secret to successful recruitment, according to NHS workforce planners in the South East. The constant battle is to keep one step ahead of shifts in patient population and their needs and wants.

Employers in the South East outside London face a constant battle to attract staff that may be tempted to go and work in the capital. 'Recruitment is hard work, but improving, ' says Neil Sellen, director of pay modernisation for the Essex workforce development confederation.

'We are just outside London and there are problems with that being a bit of a magnet for staff.

'One big problem area for us was GPs and we have put in place a number of measures to recruit from overseas that have borne fruit.' For example, 40 GPs have joined us from Spain and Italy in the past two years.

A large population growth is predicted for the South East over the next decade and Mr Sellen says the NHS has to cater for that, a pattern mapped out in a discussion document produced by the confederation last November.

The population of Essex has grown by 5 per cent since 1991 to 1.6 million, and is expected to grow at a rate of 7 per cent over the next decade.

One way of handling the growth is to look at the kind of extra staff needed.

Essex is planning a major expansion in associate practitioners - those on a higher pay banding than healthcare assistants or therapy assistants, with an NVQ3 qualification or equivalent.

The confederation wants 200 associate practitioners in post by April 2006 and 2,000 by 2010.

The challenges facing Surrey and Sussex strategic health authority include a particular shortage of healthcare assistants, the impending loss of a skilled but ageing workforce - 14 per cent of its workforce is now aged over 54 - and high housing costs.

SHA director of strategic human resources and workforce development Charlotte Thomas says: 'The cost of housing in Surrey and Sussex is having a major effect on recruitment and retention, with house prices nearly double the national average.' To tackle this, the SHA has developed a strategy to make the most of the key worker scheme and starter home initiatives - subsidy schemes where the government provides financial aid to lower-paid professionals wanting to buy, rent or join a shared-ownership scheme.

By June of last year, 421 NHS staff in Surrey and over 200 in Sussex had purchased properties using starter home initiative funding.

The SHA, working with the local county councils and education providers, has also set up a modern apprenticeship scheme aimed at younger people, which started in East Sussex in January. It is also keen to develop partnerships between the NHS and schools.

Charlotte adds: 'Surrey police have increased their recruitment numbers after providing continual contact throughout school life, finishing with well-organised work experience opportunities where they follow up children who have shown an interest.

We must not get left behind in the competition for the future workforce.' One of its trusts, Ashford and St Peter's Hospitals, won an HSJ award in 2003 for its recruitment efforts, including a oneweek programme for youngsters to spend a week touring various departments and meeting a range of health professionals.

Bedfordshire and Hertfordshire SHA director of workforce development Sarah Childerstone says: 'The closer we are to London, the more difficult recruitment becomes. The difference in housing costs in London and Hertfordshire is very little.' Bedfordshire and Hertfordshire is also set for major development, with plans for 70,000 new homes over the next 30 years in and around Milton Keynes.

Sarah says: 'The development will put increasing pressure on our services. We are thinking about not just recruiting the same staff we have had, but being more radical in terms of thinking about a different type of workforce with roles such as advanced and assistant practitioners.' The workforce development confederation is keen to get a better understanding of why people leave their jobs: 'We are conscious that the quality of information from exit interviews is not as robust as it should be.

'Increasingly, our workforce is better informed and more demanding of us as employers. They are looking for clarity, continuing professional development and career pathways.' Recruitment has been improving, according to Dartford and Gravesham trust human resources director Colin Moore, but he adds: 'From a nursing perspective, we have had a challenge because we are about to open a treatment centre in July.' The trust is now recruiting 30 nurses from Dubai and has made the process smoother by developing its own threemonth adaptation programme for overseas nurses, fully accredited by the Nursing and Midwifery Council.

Colin is not unduly worried about the 'trickle' of staff who leave to work in London, but is mindful that the trust is just eight miles from the London allowance boundary within which nurses can earn a maximum£5,328 extra on their salary.

'We do keep an eye on that. We are working very hard at being seen as a desirable local employer. If people are happy at work and feel they are involved and being invested in, why would they look elsewhere?' Kent and Medway SHA interim director of workforce David Scott is equally aware of the need to stay one step ahead. 'The proposals to expand Kent's population in Thames Gateway and Ashford, bringing more than 20,000 new homes, set us quite a challenge.' David says the SHA is establishing its health and education strategic partnership - the initiative to develop more effective local strategic planning between health, social care, and education.

'The key is to engage the higher education institutions in developing with us a range of new curricula for the kinds of doctors, nurses and allied health professionals with new ways of working, who'll meet the needs of our future population.'