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

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

3 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 Total990,940 £ 20,340,000

4 NHS LIFE CHANGING EVENTS Bristol Paediatric Cardiac Surgery Alder Hey Retained Organs Winter 1999 Endemic waiting

5 BUDGET 2000 Three year 30% leap in funding Last chance saloon With funding must come reform The NHS Plan

6 THE NHS PLAN

7 SPENDING REVIEW 2002

8 SPENDING YearSpend % % real terms £bn increase increase 96/ / / / / / / / / / / / / / Cash Stage 1 RB Stage 2 RB Total Net NHS Expenditure in England RB - Resource Budgeting

9 WORKFORCE COMMITMENTS April 04 April 05 April 08 From 99 From 00 From 01 (NHS Plan) (Manifesto) (SR2002) Nurses +20, , ,000 AHPs+6,500 +6,500 AHPs&STTs +30,000 GPs+2,000 Consultants+7,500 Doctors +10, ,000

10 Herding Cats

11 THE HR IN THE NHS PLAN Launched July 2002

12 EXAM QUESTION How can good HR Management improve the patient’s experience?

13 Objectives of the Service

14 Re-engineering NHS jobs around patient Pathways Increasing staff numbers Headline objectives

15 The Four Pillars of Delivery Re-engineering NHS jobs around patient pathways Increasing staff numbers

16 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 Four Pillars of Delivery

17 THE STAFF PATHWAY Four Modernisations Learning Common core module. Occupational core module. Patient/disease specific module. Workforce Planning Bottom-up, top-down and diagonal slice. Planning skills and knowledge, not titles. Pay Eight paybands. Jobs expressed as responsibility, knowledge, and qualifications. New GP / Consultant contract. Regulation Extension to all who ‘touch’ patients. Convergence of process.

18 THE STAFF PATHWAY Pay SpineLearningLevel Career Stage RegulationRegulation Cadet Pre-emp- Work Orientation Unemployed/ loyment Excluded Skilled Assistant Support Higher NVQs and Higher Assistant Workers Occupational Standards Starter Induction, NVQs Occupational Standards Expert Qualified Higher disease/patient Registered Professional modules Practitioner Staff Disease/patient modules Degrees Diplomas Consultant Self Directing Higher Degrees Principals Workloadand Roles Careers

19 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’ The Four Pillars of Delivery

20 The Four Pillars of Delivery The Social Partnership Forum Oversight of formulation and delivery Re-engineering NHS Jobs Around Patient Pathways Increasing Staff Numbers

21 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 The Social Partnership Forum

22 The Social Partnership Forum Oversight of formulation and delivery The Four Pillars of Delivery All supported by an evidence base

23 All supported by an evidence base The Social Partnership Forum Oversight of formulation and delivery Audiences

24 HR Manage- ment General Manage- ment StHAs WDCs Staff Unions Audiences

25 Audiences All supported by an evidence base Frontline Clinical Teams

26 Frontline Clinical Teams Audiences The Patient Experience

27 All supported by an Evidence Base Frontline Clinical Teams The Patient Experience 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’ Three Star TrustSkills EscalatorImproving MoraleHRM Development HR Management General Management StHAs/WDCsStaffUnions The NHS Plan Headline Objectives Re-engineering NHS jobs around patient pathways Increasing staff numbers Supporting delivery at ground level Supporting some areas of delivery Spreading the message Developing the HRM function Executive wing The Social Partnership Forum Oversight of formulation and delivery External Members Modernisation Agency HRD StHAs, WDCs SHRINEs Capacity Unit

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29 BUILDING WORKFORCE CAPACITY

30 KEY OBJECTIVES WITHIN OUR SR2002 SETTLEMENT Raise overall activity levels Meet access targets Achieve clinical priority targets Shift from secondary to primary care

31 ACTIVITY LEADING TO WORKFORCE DEMAND

32 ACTIVITY REQUIREMENT Projected extra FCEs required (000s): 03/0404/0505/ ,040 1,600 Projected number of equivalent: 03/0404/0505/06 Nurses287,150294,000300,180 GPs 28,220 28,830 29,560 Consultants 26,630 28,130 28,930 AHPs & STTs 98,900102,570106,350

33 DEMAND MINUS SUPPLY EQUALS GAP Projected gaps: Consultants1,959 (7%)2,611 (9%) 3,100 (10.6%) Nurses25,165 (9%)35,293 (12%) 43,599 (14%) AHPs 2,144 (2%)3,995 (4%) 5,846 (5%) and STTs

34 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

35 CONSULTANTS DEMAND AND INCREASED SUPPLY YEAR WTE (000’s) Skill mix (net) Increased productivity Expediting recruitment Improved retention Faster conversion International recruitment Conversion of AS Baseline supply Demand

36 NURSES: DEMAND AND INCREASED SUPPLY

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

38 Footballers