The NHS People Plan cannot be regarded as ‘the finished article’ without supplementary investment from the Government to tackle the workforce crisis, health bodies have said.
The 2020/21 report, which was published today (30 July) and follows last year’s interim plan, outlines a strategy for employers to increase support for NHS staff, particularly in response to Covid-19 pressures.
It pledges a number of measures for tackling staff shortages and discrimination – but sector bodies have warned that the plan lacks the necessary funding to implement it.
NHS Confederation called on the Government to provide a ‘comprehensive and realistic multi-year settlement’ in the spending review this autumn, to support the ambitions of the report.
Health thinktank The King’s Fund said the report ‘falls short’ of the workforce strategy the NHS needs and its promises would be ‘worth little without a credible implementation plan’.
NHS Employers added that ‘further investment’ in educational places was needed to ensure there are enough staff to care for patients in the future.
Growing the workforce
The plan details how the NHS should build on the ‘unprecedented interest’ in healthcare careers seen during the pandemic, which it said had ‘already translated into higher numbers of applications to education and training’.
The report said the NHS should especially aim to train and recruit into entry-level clinical roles, apprenticeships and non-clinical roles, as well as professions with the highest demand.
Health Education England said it aims to boost the mental health and cancer workforce by offering training grants for 350 nurses to become cancer or chemotherapy specialists, and increasing training places for clinical psychology and child and adolescent psychotherapy by 25%.
It also said it is working with universities ‘to increase over 5,000 undergraduate places from September 2020 in nursing, midwifery, allied health professions and dental therapy and hygienist courses’.
Mental health and physical wellbeing
In response to physical and mental pressures staff have faced during the pandemic, the People Plan asks NHS employers to ensure all staff have access to psychological support services.
It also encouraged organisations to appoint a wellbeing guardian, for example a Primary Care Network (PCN) clinical director, to look at its activities ‘from a health and wellbeing perspective’.
Employers should also focus on improving working conditions by providing adequate and appropriate PPE, flu vaccinations, risk assessments for vulnerable staff and tackle any violence or bullying, the report said.
The plan also said the NHS should build on the flexible working changes that are beginning to emerge, to become a ‘modern and model employer’.
This includes employers being open to all clinical and non-clinical permanent roles being flexible, it added, with PCNs and GP practices specifically encouraged to do so with salaried GPs. It also said ‘banks’ of GPs, who would work flexibly across local areas, should be established.
‘Between 2011 and 2018 more than 56,000 people left NHS employment citing work-life balance as the reason. We cannot afford to lose any more of our people,’ the report said.
‘Open and inclusive’ NHS
In light of recent movements for social justice, the report said ‘it has never been more urgent for our leaders to take action and create an organisational culture where everyone feels they belong, in particular to improve the experience of our people from black, Asian and minority ethnic (BAME) backgrounds.’
By October this year, employers should ‘overhaul’ their recruitment and promotion practices to ensure their staff reflect the diversity of their community, by creating accountability for outcomes, agreeing diversity targets, and addressing bias in systems, it added.
It also calls for the ethnicity gap to be closed in relation to disciplinary processes, with the expectation that 51% of organisations will have achieved this by the end of the year.
According to the report, the introduction of the Workforce Racial Equality Standard (WRES) has led to ‘progress across a number of areas; for example, increases in the proportion of BAME very senior managers.’
Government investment must follow
Niall Dickson, chief executive of the NHS Confederation, welcomed the report’s focus on ‘looking after staff’ and its emphasis on tackling discrimination, but said the plan did not ‘contain new money and so we must regard it as an instalment, not the finished article’.
He said: ‘The Government must fulfil its pledge to provide a comprehensive and realistic multi-year settlement in the Comprehensive Spending Review in the Autumn – a settlement which supports the ambitions in the Plan to tackle a workforce crisis which, every day, places intolerable strains on staff up and down England.’
Suzie Bailey, director of leadership and organisational development at The King’s Fund, said the report was ‘another interim stop-gap’ and delays to Government spending decisions meant it lacked the long-term investment needed to recruit staff and address shortages.
She added: ‘Even before the pandemic, the UK health and care workforce was in a state of crisis, with high levels of work-related stress, reports of overworked staff looking to leave their jobs, and a shortage of around 40,000 nurses.
‘Although today’s plan includes some welcome measures to support the health and wellbeing of staff and tackle discrimination, warm words will be worth little without a credible implementation plan.’
‘Real and lasting change’
Danny Mortimer, chief executive of NHS Employers, said there were ‘no quick solutions to the years of disinvestment in the NHS workforce’.
He added: ‘Our sector needs support from elsewhere in Government – further investment in educational places is in the gift of the Treasury, apprenticeship flexibility with the secretary of state for education and a wiser long-term migration policy (particularly for colleagues in social care) is still achievable for the home secretary’.
Prerana Issar, NHS chief people officer, said: ‘This plan aims to make real and lasting change in our NHS to benefit our hardworking staff. It includes practical actions based on what our people tell us matters to them, including a more equal, inclusive and flexible organisation.’