The key to solving the NHS’s changing needs is a robust recruitment and retention plan.

The changing needs of the NHS can only be met if we have a robust recruitment and retention plan that is able to meet those needs. This is easier said than done given this has implications for the existing structure, culture and the regulatory framework underpinning the recruitment and retention processes. By way of context, the NHS is a 1.3 million-strong workforce and the NHS People Plan focuses on looking after this workforce, belonging in the NHS, new ways of working and growing the workforce for the future.

The unanticipated demand on the NHS as a consequence of Covid alongside the backlog of the patients who have not accessed the care or interventions that the NHS would normally have delivered, but which was disrupted by Covid, impacted service delivery. Any attempt to address this issue must be viewed holistically alongside retention as much as recruitment of staff to have a sustainable, long-term, fit-for-purpose workforce.

Within this context and with the advent of the Integrated Care Systems, improved care for patients outside of the hospital setting will be achieved through collaboration and intentional sharing of resources, aligned to the NHS long term plan, published in January 2019, that envisions service delivery. expansion and workforce changes. The existing workforce shortages and absence of the promised workforce to deliver the aspirations of these plans will no doubt test the outcomes, and hence the focus must remain on improving the employer value proposition on an ongoing basis, at every stage of the employment life cycle and particularly so at the recruitment and retention stages. The continued focus on staff engagement and morale as a driver and enabler of frontline innovation and productive working, promoting a compassionate and inclusive culture, will go a long way in making the new employees feel welcomed and keeping the existing employees engaged and in employment when they have a choice to leave.

At the basic level, the plans to restore elective activity, addressing both the surgical backlog and new infection prevention and control requirements, are not just logistical or structural exercises. Key factors in implementing these plans are, for example, the accuracy of current job descriptions, banding and development opportunities. In addition, the expansion plans espoused by the NHS long term plan have meant the NHS is running a high vacancy rate, within the ambit of increased demand and static capacity to deliver. High vacancy rates mean existing staff are under more pressure to meet rising patient demand, and are often overworked.

It is important that existing practices relating to recruitment and retention are modernized to support rapid deployment of talent and new ways of working. Virtual recruitment, use of video platforms (such as MS Teams, Zoom and Skype) that provide a positive candidate experience, pre, during and post interview have become a regular practice now. Reducing the time to hire from vacancy authorization to final contract for domestic recruitment and a longer period for international recruitment will not only keep the candidates engaged but eager to join, and will ensure they don’t lose interest if there are delays. The introduction of NHS staff passports enabled workers to move quickly and avoided repeated and time-consuming mandatory training. In order for staff to move to areas where backlogs are the highest, the passport process needs to be further streamlined and adopted at pace.

Digital transformation has an important part to play in addressing many of the challenges, from attracting staff to making their working lives easier, a wide range of technologies are available for both clinical and non-clinical staff and may impact attraction and retention of talent, enable. and streamline ways of working, and support and develop workforce agility. Robotic process automation is being used by trusts and enables NHS and social care staff to spend as much time with patients as possible, using virtual workers (robots) to perform and automate repetitive administrative tasks, and the use of manual processes is eliminated. It has the potential to provide immediate productivity gains, near zero error rates, reduced operational costs, and the opportunity to increase the quality of contact with potential employees. The benefits might include smaller vacancies through faster time to hire, reduced reliance on bank and agency staff, increased staff satisfaction with their onboarding experience and a reduction in headcount (reducing both the recruitment department’s cost and bank and agency staff spend).

The use of allied healthcare professionals to their full licensing capability is now becoming part of workforce planning as part of new ways of working, so these professionals can work at an enhanced, advanced or consultant level of practice, addressing some of the rota gaps in the establishment. Access, support and increasing the use of flexible working is one of the commitments in the ‘People Promise’ and ensures predictable and flexible working patterns for staff and, if they do need to take time off, to support them to do so. This strategy can promote increased wellbeing and retention by enabling an improved work-life balance, reducing the risk of illness and increasing productivity.

There are no easy solutions when the demands are growing, capacity to deliver is limited and support is required for systems as they manoeuvre their way to ensure implementation of the plans. The impending merger of Health Education England and NHSEI raises hopes of ensuring effective national workforce planning and consolidating systems, expertise and resources available to deliver best care and demonstrating value of the proposals in the NHS long term plan.

Shilpi Sahai is an HR professional working in the NHS.

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