Plan to better support NHS staff wellbeing and flexible working lacks detail, experts warn

31 Jul 2020 By Jessica Brown

Latest healthcare people strategy pledges recruitment drive and end to ‘deep-rooted’ inequalities, but commentators query how it will be implemented

All roles across NHS England and NHS Improvement will be advertised as having the option for flexible working, under the government’s latest people plan for the body.

The plan, published yesterday (30 July), laid out a raft of ‘profound changes’ following the pandemic, including plans to make the NHS more inclusive and flexible, and to better support staff wellbeing.

From September 2020, every member of the NHS should have a health and wellbeing conversation and develop a personalised plan, the 52-page document stated. As part of this, managers will be expected to discuss an employee's flexible working requirements, with flexible working also discussed in inductions for new starters and in annual appraisals.

The plan also featured an announcement that NHS England and NHS Improvement will support individual trusts to implement and use e-rostering systems, which will “allow employees to request preferred working patterns”.

All NHS organisations will now complete risk assessments for vulnerable staff, including black, Asian and minority ethnic (BAME) employees, it added, highlighting the disproportionate impact of the coronavirus on BAME employees and promising to address the ‘deep-rooted inequalities' within the NHS workforce that the Covid-19 pandemic has exposed.

By March next year, there will also be a toolkit to help improve the organisation's culture and address bullying and harassment, the plan pledged.

However, experts raised questions about the proposals, particularly around how extra wellbeing support would work in practice.

Professor Neil Greenberg, managing director of psychological health consultancy March on Stress, praised the plan’s commitment to giving staff psychological support, including 'resilience hubs’, which will provide outreach as well as assessment and coordination of referrals. “However, while the plan is strategic rather than tactical, it lacks detail as to how those who need formal mental health care will be able access it in a timely fashion,” he said.

The principle underlying the plan, according to a speech made yesterday by health secretary Matt Hancock, was having an NHS and care system “full of leaders” who were “thinking like a leader and being encouraged to use their initiative and take ownership of their decisions”. He also outlined a drive to cut bureaucracy and red tape for employees. 

The people plan also announced a 2020-21 recruitment drive aimed at recruiting 50,000 more nurses, 6,000 more doctors in general practice and 26,000 staff primary care professionals. Additionally, there will be 5,000 undergraduate places from September this year in nursing, midwifery, allied health professions and dental therapy and hygienist courses, alongside a new £10m fund for clinical placements.  

The NHS will also encourage former employees who have left or retired to return to their roles, continuing efforts from early on in the pandemic. 

This recruitment push would hopefully support the government’s renewed focus on protecting NHS employees’ mental health, Greenberg said, highlighting that “too few staff means too much work for the staff who are in the organisation”.

But he reiterated the need for more detail on implementation: “In all, the people plan makes many important promises. But as with all policies, it’s vital how they are implemented. Given the pressures caused by the pandemic, now more than ever NHS staff need to believe that senior leadership really have their back. Time will tell whether this is the case.”

The plan comes as prime minister Boris Johnson has urged workers to consider starting a career in the public sector, including as NHS workers, as part of a wider government public sector recruitment drive. The government announced 1,000 new recruits for frontline probation services this week, as part of a three-year plan to strengthen the supervision of offenders, and a plan to recruit 6,000 police officers by March 2021 and 20,000 by March 2023.

Karen Grave, president of the Public Services People Managers Association (PPMA), praised the NHS people plan for focusing on inequalities in the workplace, flexible working and leadership. But she said greater investment in training and a more joined-up approach was needed right across the public sector.

“This highlights the same challenge other parts of our public service sector face: a much lower level of investment in training than our citizens might expect. This must be addressed across the sector,” she said.

“An important next step is to look at how this plan impacts, and is impacted by, other parts of public services. Covid-19 has highlighted the fundamental structural inequity across the NHS and local government. The PPMA wants to see this addressed inclusively, with all key stakeholders engaged, especially those of us who work in support of our workforces.”

Meanwhile, Niall Dickson, chief executive of NHS Confederation, welcomed the plan’s emphasis on tackling discrimination. “Recognition of the urgent need to address the safety and experience of ethnic minority staff is key, and the fact that the service has carried out risk assessments for around 80 per cent of BAME staff is an important first step and a signal of the commitment of NHS organisations to tackle this issue,” he said.

But he added that, because the plan does not contain any details of new money, the government must provide a realistic amount of funding in its comprehensive spending review this autumn. 

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