The We are the NHS: People Plan for 2020/21 sets out a range of detailed actions to support essential transformation throughout the NHS and in partnership organisations, such as social care, local government and the voluntary and independent sectors.
The Plan was created by NHS England (NHSE), NHS Improvement (NHSI) and Health Education England (HEE). It follows the Interim People Plan, issued in June 2019, accounting for the significant impact of, and developments arising from, the COVID-19 pandemic. It details what the NHS workforce can expect from its leaders and each other for the remainder of 2020 and during 2021.
The Plan focuses on the need for the NHS and its partners to look after their people; foster a culture of inclusion; develop actions to grow and train the workforce; and develop collaborative working to deliver effective patient care.
The Plan is ambitious and detailed in its terms and scope and this article provides an overview of key elements from each section of the Plan for HR/OD professionals, highlighting important action points.
1. Responding to new challenges and opportunities
The opening section of the Plan reviews profound changes that have emerged through the NHS' response to COVID-19. It recognises that learning from the pandemic is only beginning but, where new approaches have worked well, these should be adopted systematically and, where they have not, the learning should be used to find better solutions.
Metrics to track the impact of the actions set out in the Plan were to be created by the end of September 2020, and NHSE/I will track progress via the NHS Oversight Framework.
2. Looking after our people
This is at the heart of the Plan and needs to be read in conjunction with the NHS People Promise.
The Promise encapsulates what NHS staff should be able to say about working in the NHS by 2024, by addressing feedback from NHS staff about what matters to them most and what would improve their working lives across seven key themes detailed below, and in relation to which we highlight a number of important action points for trusts:
- We are a team
- We work flexibly
- We are always learning
- We are safe and healthy
- We each have a voice that counts
- We are recognised and rewarded
- We are compassionate and inclusive
We are safe and healthy
Building on the efforts made during the pandemic to ensure NHS staff felt supported and valued, the Plan identifies a range of areas that staff care about the most related to the 'we are safe and healthy' theme for organisations to focus on. These include:
- Infection risk
- Providing PPE
- Flu vaccinations
- Risk assessments for vulnerable staff (organisations are encouraged to complete these for all staff)
- Home-working Support
- Rest and respite (including safe spaces to rest/recuperate)
- Bullying and harassment (by March 2021 NHSE/I will provide a toolkit on civility and respect)
- Violence against staff (by December 2020 an NHS violence reduction standard will be launched)
- Wellbeing guardians (each organisation should appoint one (i.e. a NED with a focus on this area)
- Support to get to work (via free car parking/other transport means/appointing cycle to work leads)
- Psychological support and treatment (NHSE/I pilot re. improving MH via resilience hubs/OH programmes)
- Physically healthy work environments
- Support to switch off from work (leaders need to model this behaviour)
We work flexibly
The Plan acknowledges that to be a modern/model employer that retains talent, the NHS needs to build on the flexible working changes made due to COVID-19. Employers are therefore encouraged to make progress in the following areas:
- Flexibility by default (from January 2021 all NHSE/I and HEE roles will be advertised as flexible)
- Normalising discussions about flexible working (dialogue should be included in inductions and appraisals)
- Providing flexibility from 'day one'
- Role modelling from the top down (NHSE/I to add KPI re. % of roles advertised at outset as flexible)
- Management support (on-line guidance/training re. flexible working to be developed by December 2020)
- Support for those with caring responsibilities (via rollout of working carers' passport)
From 2021, the NHS annual staff survey will be aligned to the NHS People Promise, to measure progress.
3. Belonging in the NHS
The Plan acknowledges that, in the main, the pressures of the pandemic, brought out the best in NHS leaders. However, it also recognises that efforts need to continue, to make the culture of the NHS universally understanding, kind and inclusive.
To realise urgent changes in culture and equality, the Plan notes that these issues need to have the same emphasis as patient-safety related concerns.
NHS organisations will therefore need to take action in the following areas:
- Recruitment/promotion (by Oct 2020 employers must ensure their practices are appropriately diverse and include accountability for outcomes, diversity targets and that bias in processes is addressed)
- Health and wellbeing conversations (by Sept 2020 managers must discuss equality, diversity and inclusion with their staff and develop personalised plans for them. H&W conversations should take place at least annually)
- Leadership diversity
- Tackling the disciplinary gap
- Governance (by December 2021 governance arrangements should be reviewed to ensure staff networks contribute to/inform decision-making)
- Accountability (by March 2021 NHSE/I will publish competency frameworks for every Board level position in provider and commissioner organisations)
- Regulation/Oversight (over 2020/21 the CQC's 'well-led' measure will place emphasis on measurable progress on equality, diversity and inclusion)
- Building Confidence to Speak-up
It is undoubtedly true that inclusive leadership is essential to creating an inclusive culture effectively and a new approach to leadership in the NHS will be codified in a 'leadership compact' to be published soon.
4. New ways of working and delivering care
The plan recognises COVID-19 compelled the NHS workforce to adapt and work flexibly, often outside their usual scope of practice with successful working arrangements arising from good communications, trust and the need to make rapid decisions.
To continue the momentum in transforming ways of working, NHS employers will need to focus on staff working and learning collaboratively in multi-professional teams across clinical and non-clinical areas. NHS employers will therefore need to focus on the following areas:
- Supporting deployment and redeployment
- Upskilling (in particular, developing skills/expanding capabilities to create flexibility, boost morale and support career progression)
- Technology-enhanced learning
- Development of generalist skills
- Expanding multi-disciplinary teams to the primary care sector (by the end of 2020/21 HEE will support this expansion via primary care training hubs)
Increasing longer-term volunteering opportunities (by training volunteers, developing routes into employment and using the NHS Ambassadors programme)
5. Growing for the future
The Plan addresses the need for the NHS to build on the momentum of the high-profile public support received through the COVID-19 pandemic and consequent interest in NHS careers, to grow the NHS workforce.
Steps are to be taken by the centre to address workforce shortages in key service and professional areas, and work needs to be done within NHS organisations to recruit both domestically and internationally at pace and scale alongside careful workforce planning analysis to implement appropriate development strategies. As such, a priority focus for HR teams in 2020/21 will be on the following areas:
- Increasing local recruitment
- Growing apprenticeship and volunteering opportunities
- More effective use of staff banks that have higher numbers of registered bank staff
- Encouraging/supporting former staff to return to the NHS (noting available pension flexibilities)
- Increasing international recruitment via local hubs and coordinated marketing.
- Designing varied roles that make the best use of skills/experience and offer flexibility.
- Taking active steps to engage with staff approaching retirement to retain valuable service.
- Developing movement across localities including via the digital staff passport.
6. Supporting our NHS People for the long term
The final section of the Plan reinforces the need to keep behavioural and cultural change at the top of the workforce agenda, building in the momentum and transformation that has already taken place. The Plan calls for NHS organisations to engage with their people to develop system people plans aligned to system implementation plans being developed for the next phase of the response to COVID-19.
The Plan is wide-ranging and ambitious in its scope to capture and utilise the important knowledge and skills developed in the NHS' response to the COVID-19 pandemic and harness that learning to create a larger, effective, agile workforce working in a supportive, compassionate and inclusive environment. There is much work to be done now and in the coming months by the HR and OD teams in NHS organisations - in particular, to implement the Plan successfully.
The pivotal role that NHS HR and OD teams will play in driving the Plan forward cannot be underestimated. It will involve creativity and development across a myriad of different and difficult areas, such as recruitment and retention; creating and embedding a compassionate, safe and inclusive culture; and driving the development of a more agile, adaptive and flexible workforce that uses new ways of working across teams and different organisations supported by technology.
Hill Dickinson can assist NHS HR&OD professionals with the challenges and opportunities the Plan present. We can also provide training on key aspects of the Plan, including on recruitment (particularly in the context of the challenges presented by COVID); flexible working and creating an inclusive/safe culture.
Originally Published by Hill Dickinson, November 2020
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