BUILDING A MODERN WORKFORCE

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BUILDING A MODERN WORKFORCE
Andrew Foster Director of Human
Resources Department of Health
Dublin Masterclass 14 Feb 03
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INTRODUCTION

• The history of the NHS in three minutes
• The HR in the NHS Plan - The Strategy
• Building Workforce Capacity - The Plan

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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

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NHS LIFE CHANGING EVENTS

• Bristol Paediatric Cardiac Surgery
• Alder Hey Retained Organs
• Winter 1999
• Endemic waiting

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BUDGET 2000

• Three year 30 leap in funding
• Last chance saloon
• With funding must come reform
• The NHS Plan

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THE NHS PLAN
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SPENDING REVIEW 2002
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SPENDING 1996 - 2008
Total Net NHS Expenditure in England RB -
Resource Budgeting
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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
• AHPsSTTs 30,000
• GPs 2,000
• Consultants 7,500
• Doctors 10,000 15,000

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Herding Cats
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THE HR IN THE NHS PLANLaunched July 2002
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EXAM QUESTION

• How can good
• HR Management improve
• the patients experience?

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Objectives of the Service
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Re-engineering NHS jobs around patient Pathways
Increasing staff numbers
Headline objectives
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The Four Pillars of Delivery
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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
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THE STAFF PATHWAYFour Modernisations
Learning Common core module. Occupational core
module. Patient/disease specific module.
Pay Eight paybands. Jobs expressed
as responsibility, knowledge, and qualifications.
New GP / Consultant contract.
Workforce Planning Bottom-up, top-down and
diagonal slice. Planning skills and knowledge,
not titles.
Regulation Extension to all who touch
patients. Convergence of process.
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THE STAFF PATHWAY
Career Stage
Pay Spine
Learning
Level
Consultant Self Directing Higher Degrees
Principals
Workload and Roles
R e g u l a t i o n
Expert Qualified Higher disease/patient Regi
stered 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
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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 W
orkforce Planning Pay Regulation Education
Training
The Psychological Contract Between staff
and Employers Between staff and Government Betwee
n staff and patients
Building Skills Capacity Quality and Attitude
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The Social Partnership Forum Oversight of
formulation and delivery
The Four Pillars of Delivery
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The Social Partnership Forum
HR Directorate
Modern- isation Agency
External Members
Capacity Unit
StHAs WDCs SHRINEs
The Executive Wing
Supporting delivery at ground level
Supporting some areas of delivery
Spreading the message
Developing the HRM function
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The Social Partnership Forum Oversight of
formulation and delivery
All supported by an evidence base
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All supported by an evidence base
Audiences
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Audiences
HR Manage- ment
General Manage- ment
StHAs WDCs
Staff
Unions
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Audiences
Frontline Clinical Teams
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Frontline Clinical Teams
The Patient Experience
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BUILDING WORKFORCE CAPACITY
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KEY OBJECTIVES WITHIN OUR SR2002 SETTLEMENT

• Raise overall activity levels
• Meet access targets
• Achieve clinical priority targets
• Shift from secondary to primary care

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ACTIVITY LEADING TO WORKFORCE DEMAND
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ACTIVITY REQUIREMENT

• Projected extra FCEs required (000s)
• 03/04 04/05 05/06
• 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

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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
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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

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CONSULTANTS DEMAND AND INCREASED SUPPLY
2003
2004
2005
YEAR
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NURSES DEMAND AND INCREASED SUPPLY
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SUMMARY

• A massive set of challenges
• Reform, expansion and delivery
• Organisational objectives with a workforce
  solution
• We have a plan
• Thank you for listening

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