NHS staffing crisis: what can employers learn?

Following a damning report into critical worker shortages in the health service, People Management explores what workforce planning lessons HR can take from the problem

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The recent headline-making Health and Social Care Committee report Workforce: recruitment, training and retention in health and social care could simply be titled The NHS staffing crisis report. It certainly reads that way.

Starting off by stating that “the National Health Service and the social care sector are facing the greatest workforce crisis in their history”, it details the crisis and slams the government for its lack of strategy to solve a plan that has been years in the making and puts a nation’s health at risk.

The 80-page analysis highlights structural failings in workforce planning, recruitment, retention, training and institutional working culture, and even a summary view of any of these operational areas is damning in its details.

Take recruitment, for example. As it stands, there are almost 100,000 current unfilled NHS vacancies, with experts cited in the report believing organisational leadership is underestimating this figure, before the NHS even begins to engage with a requirement for 475,000 extra staff by early next decade. 

The report goes on to state that there is negligible progress towards solving this staffing shortfall, concluding that a much-needed expansion of training places and adequate international recruitment isn’t happening and that incumbent employees are being held back by a lack of innovation in, and support for, both normative and lateral career moves.

And that’s just the topline on recruitment. The reports also notes issues with widespread sickness absence and mental health issues as well as the need for more flexibility and improved pay and rota management. There are also details on where improvements can be made regards the treatment of ethnic minority staff and where a blueprint for improvement might sit.

While NHS workers across the country are undoubtedly working incredibly hard under a cocktail of difficult circumstances, also concerning is the impact on patient outcomes. As the report states: “The persistent understaffing of the NHS now poses a serious risk to staff and patient safety.”

A workforce planning problem

While consideration of exhausted staff and unserved patients is rightly top of mind, experts agree that there is clear room for reflection on the role that workforce planning can play in effective organisational management.

Emma Parry, professor of human resource management at Cranfield School of Management, said the crisis is a “classic example of a lack of strategic workforce planning”, which means that it cannot deliver on its objectives.

She added this isn’t just an NHS issue. “Organisations put a lot of effort into addressing their needs for the supply of other elements – in the case of the NHS this might be pharmaceuticals or medical equipment, for example – but for some reason, they often neglect to evaluate what their people or capability needs will be in the future,” she added.

However, Sir Cary Cooper, professor of organisational psychology and health at Alliance Manchester Business School and former CIPD president, said it is clear the NHS as an organisation had been failed by different leaders [successive governments] and has not been involved in proper risk planning when it comes to people strategy. 

“That's part of what workforce planning should be about. It's looking at the risks that are likely to occur in the future…and now that’s costing them a packet [in agency and locum short-term hires],” he said.

Dr Michael Anderson, research lead of the LSE-Lancet Commission on the future of the NHS, heads up projects which make recommendations to the NHS about how best to use its resources, including rolling out technology to make employees’ lives easier and improving competency training.

He said: “The strategy aspect affects policies to improve recruitment and retention, from incentives to improve entry through bursaries, outreach into local communities, increasing places, and then opportunities to support professional development throughout careers.

“However, the political nature of the NHS creates a massive barrier to this working. To do it properly you need to plan over 10-20 years.”

Solutions and lessons

For practitioners looking at this and thinking ‘the NHS is a politicised and singular institution and thus the lessons don’t apply to my business’, Cooper emphasises that they should think again, noting that the issues should act as a warning to all.

He added: “How can any company say they are the best in the world if service users are getting a delayed service? Every organisation needs workforce planning that analyses how they recruit, retain and pay.”

Kate Bishop, chief HR officer at enterprise software company IFS, agrees, adding that a small silver lining of the crisis is that all organisations might start to consider how to improve their own workforce planning, taking into account the needs of all stakeholders from customers, to staff, and local communities.

Also noting the importance of goal-setting, timelines, data collection and technology use in this planning, she explained that “the key to success [in workforce planning] is in following through and…in the ability to balance, often competing for demands in the context of an integrated strategy that ensures the wellbeing of all stakeholders in an organisation.”

Additionally, successful workforce planning should be rolled out in a staged approach, explains Parry. She said the first stage should look at goal and vision-setting with an analysis of what capabilities are needed to fill this.

This should then look at current and future gaps and be translated into a people strategy that can deliver the vision. “This should feed into strategies around resourcing, talent management, organisation design and succession planning in order to ensure a reliable pipeline of talent within the organisation,” she added.

It is this approach that should be informing all HR thinking, adds Cooper. “We haven’t looked at restructures, how to make [the NHS] a better service and where we’re heading in the future,” he said.

An indictment which should act as a clear warning for people professionals, regardless of their industry: plan, and plan now, for both future and present need, and take into account potential risks and roadblocks.