NHS workforce decisions on hold until autumn

In an interview with HSJ, Julian Hartley, who is also chief executive of Leeds Teaching Hospital Trust, said for the plan to “say things about priorities and investments it will need to take account of the spending review” which is due to take place in the autumn. He said it would instead set out a direction of travel for workforce policy.

He also dashed hopes the workforce plan might offer proposals to tackle the current pensions crisis. The current rules mean highly-paid staff are being hit with large tax bills, which is being blamed for encouraging many senior clinicians and managers to leave their NHS roles.

But Mr Hartley said tackling the pensions issue was not within the gift of the workforce plan and stressed it was a “wider issue” that was “definitely on the radar”.

“What we are able to do is reflect, through the feedback that’s coming back to us, some of the real issues that colleagues feel about the importance of it,” he said.

He added he could not be clear on timescales as to when the final interim report would be published. He said the timing was “dependent on lots of other things” but added it was likely to be in April.

When asked how the plans predictions on vacancies compares to the Closing the Gap report published last week by a group of leading health think tanks, Mr Hartley said he could not give exact figures but stressed “nursing and midwifery in particular have come out as one of the biggest, if not the biggest, workforce challenges we face”.

“There is an urgency about nursing and midwifery we need to address,” Mr Hartley said.

He also highlighted the need to look at supporting healthcare roles alongside the expansion of nurses.

“If we think about what’s in the long-term plan and the shift from acute settings to primary and community… we will put a premium on some of those expanded and new roles,” Mr Hartley said.

He said this direction of travel will need more nurses, GPs, a wider range of allied health professionals and pharmacists, because working in a multidisciplinary way is “key”.

In the letter Mr Hartley and NHS Improvement chair Dido Harding sent to NHS leaders earlier this month, they proposed a review of the national oversight framework. Mr Hartley said, when asked what these reforms would look like, “we would want to argue for the importance of ‘people issues’ as part of that and the level of staff engagement and the importance of culture”.

“What we are trying to get to is a way of strengthening that alignment with how organisations are formally assessed with the importance of people making the NHS a better place to work,” Mr Hartley said.

He said although there are active discussions with NHSI and the Care Quality Commission, they do not have anything conclusive at this stage.

“If we can get some steers as part of the interim recommendations… we will start to flesh that out in the final plan,” he said.

Mr Hartley could not give specific figures as to how many international staff are needed and where they should come from but he said it was subject to a “deep dive” and “making sure we are doing it in the right”.

“There is a sense trusts want to make sure we are not duplicating and not competing for the same group from a particular country,” he said. “This is using international recruitment as a support for the delivery of the overall plan and try[ing to] get us in a more positive position.”

Correction: This story was updated at 13:25 on 26 March to clarify that it is the final interim report expected in April, not the final report