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STRATEGIC HUMAN RESOURCE MANAGEMENT An NHS Study

STRATEGIC HUMAN RESOURCE MANAGEMENT An NHS Study. Andrew Foster Workforce Director 17 th March 2006. HUGE AND DIVERSE WORKFORCE. 1.3 million NHS staff and 600 employers Over 600 jobs and grades 17 Trades Unions and Professional Bodies Pay bill £33bn takes 59% of spending

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STRATEGIC HUMAN RESOURCE MANAGEMENT An NHS Study

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  1. STRATEGIC HUMAN RESOURCE MANAGEMENTAn NHS Study Andrew Foster Workforce Director 17th March 2006 International Health Leadership Programme

  2. HUGE AND DIVERSE WORKFORCE • 1.3 million NHS staff and 600 employers • Over 600 jobs and grades • 17 Trades Unions and Professional Bodies • Pay bill £33bn takes 59% of spending • Minimum salary £11,494; maximum £165,263 • Around 120,000 undergraduate trainees • Training budget NHS £4.5bn • 79% of non-medical staff female • 34% of doctors (but 60% of trainees) are female • 13% black and ethnic minorities (population 9%) International Health Leadership Programme

  3. NHS SPENDING 1997 - 2008 Year Spend % %real terms £bn increase increase 97/98 34.7 5.1 1.9 98/99 36.6 5.6 2.8 99/00 40.2 8.9 6.4 00/01 44.2 9.8 7.4 01/02 49.4 11.9 9.3 02/03 55.8 8.8 6.1 03/04 61.3 10.0 7.5 04/05 67.4 10.0 7.5 05/06 74.4 10.3 7.6 06/07 81.8 10.0 7.3 07/08 90.2 10.2 7.5 International Health Leadership Programme

  4. NEED FOR A CLEAR SENSE OF DIRECTION International Health Leadership Programme

  5. THE NHS PLAN 2000-2010 International Health Leadership Programme

  6. TWO OBJECTIVES MORE STAFF WORKING DIFFERENTLY International Health Leadership Programme

  7. THE FOUR PILLARS MODEL EMPLOYER MODEL CAREER IMPROVING MORALE PEOPLE MANAGEMENT The three star Trust Improving Working Lives and beyond • The Skills • Escalator • 4 Modernisations: • Workforce Planning • Pay • Regulation • Education & Training Psychological Contract Staff and employers Staff and Government Staff and patients HRM Development Building Skills, Capacity, Quality, ‘Attitude’ International Health Leadership Programme

  8. IT MAY SEEM OBVIOUS… International Health Leadership Programme

  9. THE MODEL EMPLOYER • The moral argument • People management aids recruitment and retention • People management aids High Performance • Common sense but also around 30 major studies worldwide in last 12 years • Ulrich, Pfeffer and Huselid – improving shareholder value with ‘bundles’ of good practice • Magnet Hospitals in US and Aston University Studies UK • Recruitment and retention • Organisational outcomes • Clinical outcomes International Health Leadership Programme

  10. THE SKILLS ESCALATOR Career Stage Level Pay Spine Learning Workload and Roles Consultant/GP Self Directing Higher Degrees Senior Manager Principals R e g u l a t i o n Expert Qualified Higher disease/patient Registered Professional modules Practitioner Staff Disease/patient modules Degrees Diplomas Skilled Assistant Support Higher NVQs and Higher Assistant Workers Occupational Standards Starter Induction, NVQs Occupational Standards Careers Cadet Pre-employment Work Orientation Unemployed/ Excluded International Health Leadership Programme

  11. AN ESTIMATE OF THE CURRENT WORKFORCE Consultants & Snr. Managers Pay Band

  12. More staff Rapid workforce expansion Working differently Skills Escalator Strategy £3 billion investment in new pay systems Agenda for Change an enormous OD programme European Working Time Directive 2004 and 2009 And keeping the knitting going There are worse jobs… THE LOCAL HR AGENDA International Health Leadership Programme

  13. SO FOND OF TARGETS International Health Leadership Programme

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  15. PROGRESS CHECK… • 194,000 more staff in last three years • Doubling in applicants and 60+% more trainees • Explosion in new roles • Delegated tasks e.g. prescribing • Extended roles e.g. nurse endoscopist • Completely new roles e.g. emergency care practitioner • Positive staff survey results • Lower vacancy and sickness absence rates • Over 95% of staff on new pay systems • But workforce is just an enabler… International Health Leadership Programme

  16. IMPROVED RESULTS • 98% of casualty patients being seen and treated within 4 hours • Inpatient waiting times down from 24 to 6 months • Waiting times for heart bypass operations down to 3 months from 2 years • Deaths from breast cancer falling faster than anywhere in the world • Declining mortality rates from cancer, heart disease and suicide International Health Leadership Programme

  17. CHANGING CONTEXT • From benevolent producerism to top-down control to self-improving systems • System reform: patient choice, tariff + competition • Financial pressures and funding slowdown from 2008 • Workforce must respond to new policies • Patient-led NHS • Health protection and prevention • Shift from secondary to primary care • Integration with local government and social care • Electronic patient record International Health Leadership Programme

  18. THE TEAM HAS A NEW OWNER International Health Leadership Programme

  19. HALF-TIME TEAM TALK • Build on the successes of last 5 years • Better recruitment, retention and return • Model Employer, Skills Escalator and new roles • Reduced vacancies and sickness absence • A more confident HR function (EUWTD and Agenda for Change) • Respond to the financial environment • Integration of activity, finance and workforce planning • Shift from ‘More Staff’ to ‘Working Differently’ • Do the things that we know will work • Deal with culture and behaviour International Health Leadership Programme

  20. CULTURE AND VALUES • Challenge of personalised care, choice, competition, a ‘subsidised’ private sector, patients as ‘customers’ • Could the biggest obstacle be NHS staff? • If so what does HR do about it? • Need to both adjust and go with the grain • Staff have strong values about patients • Pre-registration and undergraduate training • Recruitment, selection and induction • Post-registration and other training • Knowledge and Skills Frameworks International Health Leadership Programme

  21. HR HAS THE TOOLS International Health Leadership Programme

  22. HIGH IMPACT INTERVENTIONS • Retention – turnover costs 100+% in lost efficiency • Shared services – can make 20-40% savings • E-recruitment – AshfordSt Peters saved 60% • Temporary Labour – East Kent saved £3.5m • Sickness absence – costs the average Trust £5.4m • Job design – Addenbrookes halved radiotherapy wait • Appraisal – associated withlower patient mortality • Staff involvement; good people management; directed training investment and strong OD – predictors of high performance International Health Leadership Programme

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  28. CONCLUSION • From “last chance saloon” to a “New NHS” • HR aligned and realigned to overall policy • HR must help shape the patient-led NHS • HR must add value to the NHS • World class NHS needs world class HR • One of the world’s biggest employers – want to be one of the world’s best employers • First half tough; second half will be tougher International Health Leadership Programme

  29. HR STRATEGY - TIME TO GET JOINED UP AGAIN International Health Leadership Programme

  30. THANK YOU International Health Leadership Programme

  31. SOME QUESTIONS • HR – separate function or core managerial skill? • Health staff – cost or asset? • Raising morale – sentimentality or good business sense? • Is there a causal link between staff satisfaction and patient satisfaction? • If so, which way does it work? • What do managers want from HR? International Health Leadership Programme

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