Dido Harding: ‘Soviet style’ national workforce plan is not possible

The NHS Improvement chair is currently working on a national “workforce implementation plan”. The interim report had been expected to be published early this month, but has now been delayed to next month.

Speaking at the Royal College of Physicians’ annual conference yesterday, Baroness Harding said Health Education England had been given the job of “guessing how many tractors we need to manufacture in each part of the country across maybe a thousand different variants” and “unsurprisingly, they get that wrong”.

She said the NHS had been “asking the wrong question”, by looking to plan the number of professionals for particular specialties, and instead needed to combine workforce decisions with operational and financial planning.

“It is a huge mistake to think you can divorce the most important asset you have from operational and financial performance, and we have been making that mistake nationally as well as locally,” Baroness Harding said.

“I don’t know how many cardiologists we will need in Scunthorpe in 10 years’ time. I am absolutely certain if you asked the project team in Whitehall to work the answer out, we would get the answer wrong,” Baroness Harding said. “What we need to do is build a more agile workforce.”

On workforce modelling, she said the detail needs to be worked out “again and again… because the world changes”. She repeated her view of the need to devolve workforce responsibility, as first set out in a letter to NHS leaders last month.

HEE was created in 2012 with a remit to plan staffing. In autumn 2017, the then health secretary Jeremy Hunt announced he had asked the NHS to produce its first national workforce strategy since 2000.

In an interview with HSJ earlier this month, Sir David Behan said, after joining HEE as chair, he was surprised at how fragmented workforce planning was, and stressed it needed to be considered alongside finance and service plans.

Baroness Harding said training and development needed to change for “less linear and more agile and modern careers”, including “more generalists”.

She also told delegates “sustained effort” needed to begin at the centre to change NHS culture and argued “every doctor in every clinical setting casts an enormous leadership shadow”.

She recognised there are staff shortages across a range of specialties but said the single biggest shortage that needs addressing is nurses.

She said: “Nurses are our largest employment group and we have significant vacancies today. More cross-disciplinary working will drive up the demand for more nurses still.”

NHS Providers chief executive Chris Hopson said the NHS should welcome the collaborative work and progress that has been made to develop the forthcoming interim plan, rather than “bemoan what it cannot contain at this stage”.

“We all want to see more money, more staff and solutions to long-running problems like pensions and immigration rules as quickly as possible. But given the timing of the spending review and the government’s focus on Brexit, this was never going to be possible,” Mr Hopson said.