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Editor's blog Tuesday 3 November 2009: A smart workforce report

NHS Employers has released ‘Leading the NHS workforce through to recovery’ today at their annual conference.

The report emphasises the need for an intelligent approach to workforce management during the downturn. Its five main 'employer's checklist' principles (full list below) are:
(1)                     Start planning now. NHS trust and PCT boards need to put a workforce strategy in place that takes a long-term view of both immediate and upcoming challenges.
(2)                     Think staff engagement. Understand the issues and concerns for your workforce. Be honest and open about the scale of the challenge with staff.
(3)                     Take a whole-system approach. Eliminating waste and redesign services are delivering results. Having a well-understood approach to managing change and a strong improvement method is key to transforming services.
(4)                     Make the most of levers already in the system. National pay contracts and the NHS Pension Choice exercise offer tools and / or opportunities to drive quality improvement and save money.
(5)                     Work with partners in your wider community. Local Authorities, other public service employers, JobCenre Plus, schools, colleges and community services can benefit from collaboration, sharing resources, understanding each other’s needs and considering their social responsibility as trainers and employers.

All of these points are very sensible ones. What is unclear is how far managers will be able to undertake a 'worst-case' workforce review, given Andy Burnham's recent warning against local mini-spending reviews in his Kings Fund speech, and Mike O'Brien's heroically silly warning that he will "name and shame" trusts who do this.

Things are bad economically. The NHS is not likely to escape public sending cuts unscathed. There are difficult conversations ahead about short-time working and pay rates. In an unlikely parallel universe where I were an NHS chief executive, I would have started having these conversations many months ago.

In the press release, Sian Thomas, director of NHS Employers rightly warns that wide-scale redundancy should be an option of last resort, but also states, "The NHS must avoid this impacting on morale and increased workload pressures in order to improve patient safety and continue to improve clinical outcomes at the front line level. Indeed Chief Executives are concerned that the NHS currently lacks enough staff with the right talent and skills to lead it through recovery.”

She rightly cites the example of the block on nurse training caused under the 2006 financial recovery, leading to this year's growth in recruitment of nurses from overseas.

Likewise, it is hard to know how willing the trades unions - clinical and non-clinical - will take to the need for serious role redesign to work across institutional boundaries to deliver a step-change in care completeness and quality.

Time will tell.

The 10-point employer's checklist
Start planning now.
Lead by example.
Think staff engagement.
Undertake a workforce review.
Take a whole-system approach.
Know the type of talent you need.
Harness effective partnership working.
Make the most of levers already in the system.
Understand the balance of pay and reward.
Cooperate with partners in your wider community.