Trust chiefs decry ‘concentration on targets’ at DHSC

Julian Hartley, chief executive of Leeds Teaching Hospitals Trust and former national workforce implementation plan lead, commenting on HSJ’s story, said: “Too one-sided a concentration on high level trajectories and targets can distort the positive leadership behaviours which the NHS at local and national level needs to deliver greater retention.”

He added: “The national culture within which we all work as leaders matters here and Prerana [Issar, NHSE’s chief people officer] has already done much to improve this. We need to support her and the key themes set out in the people plan.”

The comments were posted below HSJ’s report of a leaked email sent from the DHSC’s workforce director Gavin Larner to Ms Issar setting out “particular concerns” about the “retention delivery plan” for the target.

The concerns related to ongoing work on delivering Boris Johnson’s “Nurse 50K” pledge to increase nursing numbers by 50,000 over five years. Sources close to the discussions told HSJ the DHSC had ramped up its involvement in the NHS’ staffing plans in recent weeks. 

In the email, Mr Larner told Ms Issar a retention delivery plan submitted did not contain “trajectories or milestones”, unlike other plans received.

Navina Evans, chief executive of East London Foundation Trust, who has been leading a workstream for the People Plan, also commented on the article. She stressed improving retention and recruitment was a “top priority”.

“I know from the many people we have consulted with during the development of the People Plan and from excellent examples of initiatives to make a difference that a significant change in culture and behaviour, including within [arm’s-length bodies], and DHSC will go a significant way to help,” said Dr Evans.

However, a reader commenting anonymously said workforce issues would not be solved by “blind enthusiasm”.

“[Mr Larner] is rightly doing his job to hold NHSE to account for delivery of a key government pledge,” the person said.

A DHSC spokeswoman said in response to the leaked email: “We are working closely with the NHS to deliver on our commitment for 50,000 more nurses by 2025, including quality assuring plans.

“The upcoming NHS People Plan will set out further actions to boost recruitment and retention.”

An NHSE/I spokesman said: “Trusts’ retention rates have improved over the past year partly as a result of improved staff satisfaction with pay and working conditions as reported in yesterday’s annual staff survey, and partly as a result of NHS Improvement’s retention collaboratives.

“Further gains are possible, and the People Plan which will follow the Budget will set out the path to 50,000 extra nurses, based on evidence of what is — and is not — feasible and practical, including on retention.”

21 February midday: Updated introduction to better reflect the chief executives’ comments.