Ali Mohammed found himself hooked on human resources after a stint in a hospital personnel department. He tells Alexis Nolan that simplicity is the key to success

Ali Mohammed found himself hooked on human resources after a stint in a hospital personnel department. He tells Alexis Nolan that simplicity is the key to success

It could all have been so different for Ali Mohammed. At 16, he was planning to leave school to follow in his father's footsteps and work in Chatham's naval base dockyard. Of some 6,000 youngsters who took the entrance exam to become one of the 30 lucky ones to get an apprenticeship, he came sixth.

A visit from a family friend - and local GP - changed the course of his life. 'He said I was quite bright and should carry on with school and then do a degree. It sounds odd but I didn't even know what a degree was,' he admits.

Ali went back to school and did his A-levels. It was a good choice; the next year the dockyard closed. University beckoned and, in the fourth year of his business studies degree, Ali was looking for a placement in the area in which he wanted to specialise - marketing. At least, that was the plan.

'I wanted to stay in Plymouth and the only local placement there was in the hospital in personnel,' he explains.

Like many others before and after, he was hooked. 'I thought: &Quot;I am going to like this&Quot;,' says Ali, 'and when I started to look for a real job after graduating it was in personnel in the health service.'

In 1988 he joined Medway District Hospital in Kent as personnel officer. In 2001, after more than a decade developing his career at four other trusts, he found himself back where he started - at what is now Medway trust - but as director of human resources.

It has not always been plain sailing. Ali has a strong sense of fair play - 'It offends me when I see injustice' - and is clearly not afraid to act. On one occasion he was appraised by a manager 'who hadn't prepared a single minute for it'.

He was graded down a couple of bands, but was told it was the same grading as a year earlier. 'At that moment, I decided to leave,' says Ali. 'What I learnt from that is the importance of talking to people in a meaningful way. If I found it so insensitive that it caused me to leave a senior job, other people would as well,' he adds.

On another occasion a boss reorganised a department 'without telling anyone' and advertised jobs externally - at the same time as instructing the rest of the organisation to advertise posts internally. 'That bugged me, so I got a job elsewhere,' says Ali. 'I can't put up with that kind of thing - poor management and leadership.'

He is pleased to report that his current boss is not in that category - people are given the space they need while being made aware of boundaries.

'That's had a big impact on the senior team,' he says, many of whom, like Ali, have now been at the trust for more than five years. During that time Ali has had an opportunity to develop in HR and has enabled him to set his sights in the longer term on becoming a chief executive. The trust has been recognised for its HR performance indicators,

Ali has twice been shortlisted for the Healthcare People Management Association's HR director of the year award and is now waiting for the results of his MSc in HR leadership from Manchester University.

Ali's philosophy is to simplify the way HR works, and he has worked out a very simple formula that helps to focus efforts and to drive results: recruitment + appraisal = retention.

'We have tried to make sure that we got structures right to start with and recruit fairly much to those. If we get recruitment right, retention will look after itself,' he says.

Like others, Medway has put considerable effort into recruiting doctors from countries such as the Philippines and South Africa. It has also looked to areas like Eastern Europe.

Where consultant positions have proved difficult to fill, Ali has worked to recruit at sub-consultant level and then develop those people to become consultants.

The home-grown workforce approach is reducing empty posts and cutting back on agency spend.

'That's involved joint working with the director of finance,' says Ali. 'We have got to work together like never before, really understanding that we have got to invest to save.'

The recruitment costs are far outweighed by savings in the agency bill.

The appraisal part of the equation is equally important to Ali. He says the trust now has 100 per cent appraisal coverage, although he admits there is still work to be done around the quality of appraisals. He has personally raised the issue with every director.

Staff turnover has come down from 17 per cent to 12 per cent. Sickness absence is also down from 8 per cent to 4.2 per cent and agency costs have been slashed.

This means that fewer than 1 per cent of nurses are hired from agencies.

Plenty of challenges remain, however. The legacy - and benefits - of the consultant contracts is one, the impact of the knowledge and skills framework on pay progression - or lack of it for some - is another.

HR is also expected to contribute£2m to an£11m savings plan this year and£4m next year.

Ali's focus is not simply on Medway. He is also aiming to reduce agency staff costs regionally. Last year, he became chair of the Kent HR directors' forum and earlier this year successfully proposed to merge the forums for Surrey, Sussex and Kent.

Now, as chair of the HR directors' network for NHS South East Coast he is aiming to drive regional workforce improvement. One forthcoming initiative is to make the South East Coast an 'agency-free zone'. Currently the region spends£101m on agency staff.

Medway is also part of a joint venture that has secured EU funding to explore the impact on the health sector of an ageing workforce over the next three, five and 10 years.

The trust is the sole UK NHS partner, working with UK private sector company Life Academy and Dutch partner Odyssee.

The programme will look at how Medway can respond to workforce planning issues through policies, practice and the use of technology to support age diversity. It will also explore the transferability of its findings to the rest of the NHS.

'It may be that other trusts will want to gain some of the lessons from what we are about to do,' says Ali.