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BUILDING A MODERN WORKFORCE. Andrew Foster Director of Human Resources Department of Health. Dublin Masterclass 14 Feb 03. INTRODUCTION. The history of the NHS in three minutes The HR in the NHS Plan - The Strategy Building Workforce Capacity - The Plan. NHS FACTS. NHS England (2001)
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BUILDING A MODERN WORKFORCE Andrew Foster Director of Human Resources Department of Health Dublin Masterclass 14 Feb 03
INTRODUCTION • The history of the NHS in three minutes • The HR in the NHS Plan - The Strategy • Building Workforce Capacity - The Plan
NHS FACTS NHS England (2001) Headcount Paybill (000's) Doctors 97,450 £ 6,191,000 Nurses, midwives 421,400 £ 7,673,000 Other 472,090 £ 6,476,000 Grand Total 990,940 £ 20,340,000
NHS LIFE CHANGING EVENTS • Bristol Paediatric Cardiac Surgery • Alder Hey Retained Organs • Winter 1999 • Endemic waiting
BUDGET 2000 • Three year 30% leap in funding • Last chance saloon • With funding must come reform • The NHS Plan
Public Service Agreement SR 2002 SPENDING REVIEW 2002
Year Spend % % real terms £bn increase increase 96/97 33.0 3.2 0.0 97/98 34.7 5.1 1.9 98/99 36.6 5.6 2.8 99/00 39.9 8.9 6.4 99/00 40.2 - - 00/01 44.2 9.8 7.4 01/02 49.4 11.9 9.3 02/03 53.7 8.8 6.1 02/03 55.8 - - 03/04 61.3 10.0 7.5 04/05 67.4 10.0 7.3 05/06 74.4 10.3 7.6 06/07 81.8 10.0 7.3 07/08 90.2 10.2 7.5 Cash Stage 1 RB Stage 2 RB SPENDING 1996 - 2008 Total Net NHS Expenditure in England RB - Resource Budgeting
WORKFORCE COMMITMENTS April 04 April 05 April 08 From 99 From 00 From 01 (NHS Plan) (Manifesto) (SR2002) Nurses +20,000 +20,000 +35,000 AHPs +6,500 +6,500 AHPs&STTs +30,000 GPs +2,000 Consultants +7,500 Doctors +10,000 +15,000
EXAM QUESTION How can good HR Management improve the patient’s experience?
Objectives of the Service
Re-engineering NHS jobs around patient Pathways Increasing staff numbers Headline objectives
Re-engineering NHS jobs around patient pathways Increasing staff numbers The Four Pillars of Delivery
The Four Pillars of Delivery Three Star Trust Skills Escalator Improving Staff Morale HRM Development NHS as a Model Employer Improving Working Lives and beyond • NHS as a • Model Career • 4 Modernisations: • Workforce Planning • Pay • Regulation • Education & Training Psychological Contract Staff and employers Staff and Government Staff and patients Building Skills, Capacity, Quality, ‘Attitude’
THE STAFF PATHWAYFour Modernisations Pay Eight paybands. Jobs expressed as responsibility, knowledge, and qualifications. New GP / Consultant contract. Learning Common core module. Occupational core module. Patient/disease specific module. Regulation Extension to all who ‘touch’ patients. Convergence of process. Workforce Planning Bottom-up, top-down and diagonal slice. Planning skills and knowledge, not titles.
THE STAFF PATHWAY Career Stage Level Pay Spine Learning Consultant Self Directing Higher Degrees Principals Workload and Roles 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-emp- Work Orientation Unemployed/ loyment Excluded
The Four Pillars of Delivery The Golden Trust The Skills Escalator Tackling Low Morale HRM Development The NHS as a Model Employer Improving Working Lives and Beyond The NHS as a Model Career Four Modernisations: Workforce Planning Pay Regulation Education & Training The Psychological Contract: Between staff and Employers Between staff and Government Between staff and patients Building Skills Capacity Quality and ‘Attitude’
Re-engineering NHS Jobs Around Patient Pathways Increasing Staff Numbers The Social Partnership Forum Oversight of formulation and delivery The Four Pillars of Delivery
The Social Partnership Forum HR Directorate External Members Modern- isation Agency StHAs WDCs SHRINEs Capacity Unit The Executive Wing Spreading the message Supporting some areas of delivery Supporting delivery at ground level Developing the HRM function
The Four Pillars of Delivery The Social Partnership Forum Oversight of formulation and delivery All supported by an evidence base
The Social Partnership Forum Oversight of formulation and delivery All supported by an evidence base Audiences
Audiences General Manage- ment HR Manage- ment StHAs WDCs Staff Unions
All supported by an evidence base Audiences Frontline Clinical Teams
Audiences Frontline Clinical Teams The Patient Experience
The NHS Plan Headline Objectives Re-engineering NHS jobs around patient pathways Increasing staff numbers Three Star Trust Skills Escalator Improving Morale HRM Development Model Employer Improving Working Lives and Beyond Model Career 4 Modernisations: Workforce Planning, Pay, Regulation, Education & Training Psychological Contract Staff and Employers Staff and Government Staff and Patients Building Capacity Skills, Quality and ‘Attitude’ The Social Partnership Forum Oversight of formulation and delivery HRD External Members Modernisation Agency StHAs, WDCs SHRINEs Capacity Unit Executive wing Spreading the message Supporting some areas of delivery Supporting delivery at ground level Developing the HRM function All supported by an Evidence Base General Management HR Management StHAs/WDCs Staff Unions Frontline Clinical Teams The Patient Experience
KEY OBJECTIVES WITHIN OUR SR2002 SETTLEMENT • Raise overall activity levels • Meet access targets • Achieve clinical priority targets • Shift from secondary to primary care
ACTIVITY LEADING TO WORKFORCE DEMAND
ACTIVITY REQUIREMENT • Projected extra FCEs required (000s): 03/04 04/0505/06 510 1,040 1,600 • Projected number of equivalent: 03/04 04/05 05/06 Nurses 287,150 294,000 300,180 GPs 28,220 28,830 29,560 Consultants 26,630 28,130 28,930 AHPs & STTs 98,900 102,570 106,350
DEMAND MINUS SUPPLY EQUALS GAP Projected gaps: 2003 2004 2005 Consultants 1,959 (7%) 2,611 (9%) 3,100 (10.6%) Nurses 25,165 (9%) 35,293 (12%) 43,599 (14%) AHPs 2,144 (2%) 3,995 (4%) 5,846 (5%) and STTs
GAP CLOSING MEASURES ‘NHS Plan Plus’ assumptions: • Skills Escalator skillmix • Increased international recruitment • Accelerated pathways to consultant • Improved retention • Increased productivity (offset against increased quality) • Effect of additional training
Skill mix (net) Increased productivity 30 Expediting 29 recruitment 28 27 Improved WTE (000’s) 26 retention 25 Faster conversion 24 23 International 22 21 recruitment 20 Conversion of AS Baseline supply Demand CONSULTANTS DEMAND AND INCREASED SUPPLY 2003 2004 2005 YEAR
SUMMARY • A massive set of challenges • Reform, expansion and delivery • Organisational objectives with a workforce solution • We have a plan • Thank you for listening