The Ward Round: No silver bullets

A message that rang out loud and clear from NHS Providers’ conference this week was the need for trust leadership teams to stop waiting for the government and the national regulators to tackle the workforce crisis.

For too long, NHS leaders have been obsessed with money and numbers, NHS Providers’ chief executive Chris Hopson told delegates. He called for frontline leaders to focus on the issues they can control, such as making the NHS a better place to work, working with neighbouring trusts to share staff, and promoting the NHS as a good career option.

In the long-term, the NHS needs a strong domestic pipeline of all staff, a sensible and compassionate migration policy and proper funding for training. But all these things hinge on decisions and funding from the centre and leaders must look at what can be done in the short and medium term.

Improving culture – certainly easier said than done – was raised repeatedly as an important way to boost retention and plug the hole in the leaky bucket of NHS staff.

Chief people officer Prerana Issar spoke about how the gap between the demand and supply curve of staff is affecting their ability to do their best.

She emphasised that, in reality, the daily lives of NHS staff are influenced more by “their colleague next to them”, and to a lesser extent set by a top down approach.

“For them, the reality is about the team,” she said.

Sir David Behan, chair of Health Education England, echoed this and said it was the responsibility of system leadership – and indeed national leadership – to create the space for local teams to feel supported in a highly pressured environment.

“Practice and service leadership is just an important as system leadership, in creating that feeling of wellbeing,” Sir David said.

International recruitment rethink

Speaking at the same conference, Jonathan Higman, chief executive of Yeovil District Hospitals Trust, said, in his experience, it was possible to build culture through simple and impactful things that will make people want to join and stay at the trust.

He also described how the trust took its approach to international recruitment into its own hands to boost its workforce. The trust identified it had real problems with international recruitment as there was poor retention and only a 2 per cent arrival rate from those given offers abroad to work at the trust.

To improve this, the trust used a “person-centred approach”, targeted where it was recruiting from, spent longer doing interviews, and involved senior nurses in the process.

Mr Higman has been able to measure the impact of this. He told delegates there are now no nursing vacancies on wards and the turnover has dropped for overseas nurses.

Beverly Murphy, director of nursing at South London and Maudsley Trust, also stressed how reducing staff turnover is crucial as advertising and recruiting for a new post is expensive and takes many hours.

She urged the room to speak to the unhappy people and find out how to make a difference. “Ask the workforce because they do have the answers,” she said.

Is this the right approach to recruitment?

The US has a lot to be envious about when looking over the pond at the NHS but learning can go in the opposite direction, specifically their approach to nursing recruitment.

Johns Hopkins University’s latest nursing recruitment advert – a gender neutral campaign with a focus on data, patient safety and presenting nurses as a key part of a multidisciplinary team – was in stark contrast to the recent NHS-commissioned advert.

‘Men in Nursing’ – set to the tune of ‘I’m a Man’ by The Spencer Davis Group – presents a career in nursing in a completely different way to any other NHS campaign I can think of. As Alison Leary, professor of healthcare modelling at Southbank University, said on social media: “It assigns gendered work, within gendered work.”

And it also arguably suggests to be a male nurse, you must fit a certain macho mould, which is problematic at a time when much is being done to change this pernicious way of thinking.

It’s clear what they’re trying to do – The Ward Round has previously covered the decline in male nurses and the spin put on the numbers by NHS England – but why resort to gender stereotyping? The NHS needs to dispel these weary stereotypes, rather than bolster them.