building a modern workforce · director of human resources department of health dublin masterclass...
TRANSCRIPT
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BUILDING A MODERN WORKFORCE
Andrew FosterDirector 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 FACTSNHS England (2001)
Headcount Paybill (000's)Doctors 97,450 £ 6,191,000Nurses, midwives 421,400 £ 7,673,000Other 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 - 2008Year Spend % % real terms
£bn increase increase96/97 33.0 3.2 0.097/98 34.7 5.1 1.998/99 36.6 5.6 2.899/00 39.9 8.9 6.499/00 40.2 - -00/01 44.2 9.8 7.401/02 49.4 11.9 9.302/03 53.7 8.8 6.102/03 55.8 - -03/04 61.3 10.0 7.504/05 67.4 10.0 7.305/06 74.4 10.3 7.606/07 81.8 10.0 7.307/08 90.2 10.2 7.5
Cash
Stage 1 RB
Stage 2 RB
Total Net NHS Expenditure in England
RB - Resource Budgeting
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WORKFORCE COMMITMENTSApril 04 April 05 April 08From 99 From 00 From 01(NHS Plan) (Manifesto) (SR2002)
Nurses +20,000 +20,000 +35,000AHPs +6,500 +6,500AHPs&STTs +30,000GPs +2,000Consultants +7,500Doctors +10,000 +15,000
10Herding 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 patient’s experience?
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ObjectivesoftheService
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Re-engineering NHS jobs
around patient Pathways
Increasing staff
numbersHeadline objectives
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The Four Pillars of Delivery
Re-engineering NHS jobs
around patient pathways
Increasing staff
numbers
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Three Star Trust
SkillsEscalator
Improving Staff Morale
HRMDevelopment
NHS as a Model Employer
ImprovingWorking Lives and beyond
NHS as aModel Career
4 Modernisations:• Workforce Planning • Pay • Regulation • Education & Training
Psychological Contract
Staff and employers
Staff and Government
Staff and patients
BuildingSkills,
Capacity,Quality, ‘Attitude’
The Four Pillars of Delivery
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THE STAFF PATHWAYFour Modernisations
LearningCommon core module.
Occupational core module.Patient/disease specific module.
Workforce PlanningBottom-up, top-down
and diagonal slice.Planning skills and
knowledge, not titles.
PayEight paybands.
Jobs expressed asresponsibility, knowledge,
and qualifications. New GP / Consultant contract.
RegulationExtension to all
who ‘touch’ patients. Convergence of process.
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THE STAFF PATHWAYPay Spine LearningLevel Career
Stage
Regulation
Cadet Pre-emp- Work OrientationUnemployed/ loymentExcluded
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
DegreesDiplomas
Consultant Self Directing Higher DegreesPrincipals
Workload
and Roles
Car
eers
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The Golden Trust
The SkillsEscalator
Tackling Low Morale
HRMDevelopment
The NHS as aModel Employer
ImprovingWorking
Lives and Beyond
The NHS as aModel Career
FourModernisations:Workforce Planning
PayRegulation
Education & Training
The Psychological Contract:
Between staff andEmployers
Between staff andGovernment
Between staff andpatients
BuildingSkills
CapacityQuality
and‘Attitude’
The Four Pillars of Delivery
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The Four Pillars of Delivery
The Social
PartnershipForum
Oversight of formulationand delivery
Re-engineering NHS Jobs
Around Patient Pathways
Increasing Staff
Numbers
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HRDirectorate
Modern-isationAgency
ExternalMembers
CapacityUnit
StHAsWDCs
SHRINEs
TheExecutive
Wing
Supportingdelivery
at groundlevel
Supportingsome
areas of delivery
Spreadingthe
message
Developingthe
HRMfunction
The Social Partnership Forum
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The Social
Partnership Forum
Oversight of formulation and delivery
The Four Pillars of Delivery
All supportedby an
evidence base
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All supportedby an
evidence base
The SocialPartnership
Forum
Oversight of formulation and delivery
Audiences
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HR Manage-
ment
General Manage-
ment
StHAsWDCs
Staff Unions
Audiences
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AudiencesAll supported
by anevidence base
FrontlineClinicalTeams
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FrontlineClinicalTeams
AudiencesThe
PatientExperience
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All supported by an Evidence Base
Frontline Clinical Teams
The Patient Experience
Model Employer
Improving WorkingLives and Beyond
Model Career4 Modernisations:
Workforce Planning, Pay, Regulation,
Education & Training
PsychologicalContract
Staff and Employers Staff and Government
Staff and Patients
BuildingCapacity
Skills, Qualityand
‘Attitude’
Three Star Trust Skills Escalator Improving Morale HRM Development
HR Management
GeneralManagement StHAs/WDCs Staff Unions
The NHS PlanHeadline Objectives
Re-engineering NHS jobs around patient pathways Increasing staff numbers
Supporting deliveryat ground level
Supporting someareas of delivery
Spreading themessage
Developing the HRM function
Executivewing
The Social Partnership ForumOversight of formulation and delivery
ExternalMembers
ModernisationAgencyHRD StHAs, WDCs
SHRINEsCapacity
Unit
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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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2003 2004 2005 2006 2007
Year
Illus
trat
ive
activ
ity a
nd q
ualit
y im
prov
emen
ts
Specialist & Long TermConditionsOlder people, children'sservices and mental healthCHD & Cancer
Access & Waiting
ACTIVITY LEADING TOWORKFORCE DEMAND
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ACTIVITY REQUIREMENT• Projected extra FCEs required (000s):
03/04 04/05 05/06510 1,040 1,600
• Projected number of equivalent:03/04 04/05 05/06
Nurses 287,150 294,000 300,180GPs 28,220 28,830 29,560Consultants 26,630 28,130 28,930AHPs & 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
YEAR
2003 2004 2005
2021222324252627282930
WTE
(0
00’s
)
Skill mix (net)
Increased
productivity
Expediting
recruitment
Improved
retention
Faster conversion
International
recruitment
Conversion of AS
Baseline supply
Demand
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230000
240000
250000
260000
270000
280000
290000
300000
310000
2003 2004 2005YEAR
WTE
Skill mix (net)
Productivity
Shorter training for NVQ3 HCAs
International recruitment
Extra NHS Plan training
Increased participation
Baseline supply
Demand
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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Footballers