The health reforms have ushered in a difficult period for health service providers to deliver improving services, but just as challenging is the crucial reorganisation required to improve the back office functions that support frontline services. Claire MacConnell explains.

The changes to the NHS landscape present a complex and challenging environment for health services, but also to those back office functions supporting the front line. With the demise of primary care trusts and the emergence of clinical commissioning consortia and interim cluster arrangements, Cheshire HR Service has had to rethink its business model.

Cheshire HR Service was formed in 2007 as a shared HR service provider for an acute trust, commissioning and provider PCTs and specialised commissioning. It is hosted by East Cheshire NHS Trust. The anticipated loss of PCTs meant that, if nothing else was done, the organisation would revert simply to an in-house HR team for the acute trust.

While severe cost cutting right across the public sector means that there are even greater pressures for HR to be efficient and effective by rationalising and sharing, cross organisational working has in fact become harder to establish. This is especially true in the healthcare sector due to the fragmentation of service delivery and structural uncertainty. Determining what to do in house and what to commission externally is not easy in these circumstances. This presents opportunities as well as threats.

Cheshire HR Service grasped these new possibilities by investigating how it might deliver a range of HR activities to external customers, both within the NHS and the wider public sector. Working closely with Peter Reilly from the Institute for Employment Studies, we analysed the different HR functions and concluded that it could offer certain core services itself, whereas other areas would be better provided in partnership/association with external organisations.

The basis of the organisation’s offering is the shared services model, namely the provision of a core administrative activity that benefits from the greater scale achieved through collaboration than is possible with separate organisations and streamlined service, utilising new technology.

This is backed by a the central employee relations HR team, whose work is underpinned by a web enabled IT system allowing managers and staff 24 hour access to a wealth of policy information, template documents and frequently asked questions. 

If that takes care of transactional and operational HR work, in a traditional outsourced approach, strategic HR would normally be retained by the client organisation. For larger entities this will probably still be true in the health service, but some smaller trusts may prefer another health sector HR team to include this in their services. Moreover, learning and development and OD may get neglected because there is little money and even less expertise to give these inputs. For these reasons we have strategic HR and learning and development business partners to help organisations focus on workforce strategy, development and wellbeing.

Though back office functions get a very negative press, they are of course essential to enable others to deliver excellent customer service and patient care.