Date post: | 14-Dec-2015 |
Category: |
Documents |
Upload: | jaylin-dimit |
View: | 214 times |
Download: | 0 times |
International Health Leadership Programme
STRATEGIC HUMAN RESOURCE MANAGEMENT
An NHS Study
Andrew FosterWorkforce Director
17th March 2006
International Health Leadership Programme
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
NHS SPENDING 1997 - 2008Year 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
MODELEMPLOYER
MODELCAREER
IMPROVING MORALE
PEOPLE MANAGEMENT
The three starTrust
Improving Working Lives
and beyond
The SkillsEscalator
4 Modernisations:
• Workforce Planning • Pay • Regulation
• Education & Training
Psychological Contract
Staff and employers
Staff and Government
Staff and patients
HRM Development
BuildingSkills,
Capacity,Quality, ‘Attitude’
THE FOUR PILLARS
International Health Leadership Programme
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
THE SKILLS ESCALATOR
Pay Spine LearningLevel Career Stage
Regulation
Cadet Pre-employment Work OrientationUnemployed/ Excluded
Skilled Assistant Support Higher NVQs and HigherAssistant Workers Occupational StandardsStarter Induction, NVQs
Occupational Standards
Expert Qualified Higher disease/patientRegistered Professional modulesPractitioner Staff Disease/patient modules
Degrees Diplomas
Consultant/GP Self Directing Higher DegreesSenior Manager Principals
Workload and R
oles C
aree
rs
International Health Leadership Programme
Pay
Ban
d
9
8
7
6
5
4
3
2
1
AN ESTIMATE OF THE CURRENT WORKFORCE
Consultants & Snr. Managers
International Health Leadership Programme
THE LOCAL HR AGENDA
• 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…
International Health Leadership Programme
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
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
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
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
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
HIGH IMPACT INTERVENTIONS
• Retention – turnover costs 100+% in lost efficiency
• Shared services – can make 20-40% savings
• E-recruitment – Ashford St 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 with lower patient mortality
• Staff involvement; good people management; directed training investment and strong OD – predictors of high performance
International Health Leadership Programme
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
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?