Responsibility for NHS workforce to be devolved locally

Workforce implementation plan chair Dido Harding and national executive lead Julian Hartley said in a letter sent to chief executives yesterday that they would look to devolve more responsibility for workforce issues to sustainability and transformation partnerships and integrated care systems.

There will also be a review of how national bodies regulate trusts, with the letter making clear positive leadership in the NHS was not “consistently demonstrated across the system in national bodies, providers or commissioners” and there was a need to acknowledge this and “improve our leadership culture and capacity”.

The letter said the actions it set out could be taken this financial year “within existing budgets”, but it did not say how much money would be allocated.

It said flexible working needed to be increased “significantly” through the use of technology and a change in HR practices to improve retention.

The letter confirmed the plan will be published in early April and will include a 2019-20 “action plan”, with a “more detailed version of how our workforce will transform over the next ten years”.

Workforce has become a major area of concern for NHS providers and policymakers in recent years with the service facing vacancies of more than 100,000. The NHS long-term plan failed to offer any solutions with the issue pushed back to the spending review later this year.

The letter from Baroness Harding and Mr Hartley asked for responses to key questions and proposed actions from chief executives by 15 March.

The key themes and actions within the letter were:

 Roles and responsibilities for workforce in local areas:

• The workforce plan will devolve more workforce responsibility to local systems
• It will also clarify the roles of national bodies and align those that have a shared workforce strategy
• It will help systems to identify skills gaps and help systems address these
• It wants to create a single, workforce dataset available to national and local bodies and also address the gaps in the data, beginning with primary care

Improving leadership culture:

• The support given to challenged organisations by NHSI/E will be reviewed so it reflects “inclusive and passionate leadership”
• Regional talent boards will be rolled out
• Consultation on common job descriptions, competency, values and behaviour frameworks for board level roles following reports by Tom Kark QC and Sir Ron Kerr
• The well-led framework used by NHSI and the CQC will be reviewed along with the way NHSI/E regulates trusts
• A new leadership compact setting out the values, behaviours and competencies expected of senior leaders

Nursing and midwifery workforce:

• There will be an additional 5,000 clinical places for nursing students in the September 2019 intake
• It pledged to better engage with universities to ensure there are enough places for nurses and midwives
• There will be a new campaign to target school leavers and attract them to nursing
• The plan will support nurses better between education and employment and said it will look at expanding Health Education England’s ‘Repair’ initiative, which aims to reduce attrition from courses
• There will also be a review of return to practice processes

New ways of working and new roles:

• The workforce plan will include a review of areas for CPD investment and there was a recognition this is crucial for morale and retention
• Organisations and systems will be supported to maximise the use of the apprenticeship levy
• The plan wants to equip the workforce for the digital age and leaders will be given the tools to develop skills
• An “easy to use” learning hub will be developed and will include content on “everything from robotics to genomics”
• Four new multi-professional credentials are proposed and will be developed by the National Academy of Advancing Practice

Ability to recruit and retain staff:

• The letter said it aimed to expand the NHS Improvement retention programme to all trusts and proposed developing an equivalent programme for primary care
• It suggested streamlined induction and training process and enabling employees to work across different employers and settings with their qualifications
• It pledged to review the impact of pensions policy on retention and look at how to resolve this