From tackling bullying and harassment to improving training and flexible working, we must do a lot more to boost the numbers of NHS staff, writes health secretary Jeremy Hunt
Once again the Commonwealth Fund has put the NHS at the top of the international league table for the safety of care it provides to its patients. In tight times, it is incredibly impressive that we are still managing to sustain and improve the quality of our care.
But for hard-bitten managers who have to keep an eye on the bottom line, sustaining that remarkable performance into the future will mean doing everything possible to hold on to the most valuable NHS asset of all – our army of dedicated frontline professionals who make our NHS what it is, whether they are from Fulham, France or the Philippines.
Since 2012, the NHS has seen 8,000 more doctors and 9,500 more nurses swell the ranks of the NHS workforce. But we know we need more: trends in agency and locum spend, rota gaps and increasingly vocal concerns about patient safety show this is a worry for staff and managers alike. If staff turnover in the NHS had been reduced by just 1 per cent between now and 2012, then today we would have a further 12,000 nurses working in the NHS.
Because of Brexit there is a particularly important role for the government. The prime minister has put securing the position of EU nationals front and centre in the opening stages of the negotiations to leave the EU, so that we can continue to benefit from the skills, compassion and dedication EU doctors and nurses bring to work every day.
Health jobs are tough jobs, not for the faint-hearted, so it is all the more important that employers have an unbending focus on improving the working lives of their staff
Pay, too, is a government responsibility and itself an important dimension of staff retention. So we will consider carefully the independent advice from pay review bodies before making any decisions.
But if government has a role, so too do NHS managers. Health jobs are tough jobs, not for the faint-hearted, so it is all the more important that employers have an unbending focus on improving the working lives of their staff. That is why this month NHS Improvement has launched a major initiative to provide focused support to trusts with the highest staff turnover.
There is no single solution. I’ve argued previously that if we are to retain staff we need to do a lot better on flexible working. In this day and age we shouldn’t be asking people to make binary choices between family and work. Redesigning rotas and making e-rostering a win-win for staff and employers alike both raises morale and reduces dependence on expensive agency and locum staff. We also need to look at how, as people approach retirement, they can step down their hours if they want to and stay on and continue to contribute.
Another critical factor is learning and development so that staff don’t feel they are having to stick with one job for ever, but are developing their skills over a lifelong NHS career.
Engage with change
Ensuring effective teams with clear goals and emotionally intelligent management makes a huge difference. Compassionate leadership, seriously tackling bullying, harassment and violence on one hand, whilst focusing on health and well-being on the other, is often the difference between a fulfilling job and a daily grind. In particular that means providing proper mental health support to our employees – where we are making some progress but there is much more to do.
Above all, it means leaders being consistently curious about what it is really like to work on the frontline in their own organisation – something I have tried to do regularly as health secretary, leading to some of my most memorable moments on the job. It is common sense that happier staff will provide better care for patients – but with more trust in their organisation and the way that it is run, they are also more willing to engage with change and – and even lead it.
So for leaders everywhere in the NHS that means seizing the difficult challenge of improving staff motivation and retention.
Jeremy Hunt is the secretary of state for health