We must learn the lessons of the past and involve patients, public and especially staff for collaboration to succeed, writes Jodie Sinclair
It is generally accepted that the timescales in which sustainability and transformation plans have been prepared and published are less than perfect – especially given the scale of the geographic challenge and potentially competing priorities.
But what is becoming increasingly apparent is that if true collaboration is to occur between the relevant NHS organisations and all relevant partners, including local authorities and the independent and third sectors, all implementing organisations need to move from “buzzwords” to practical action.
Early workforce engagement is paramount, alongside the involvement of patients and the wider public, given the lessons learned from the numerous reconfigurations undertaken in the past.
Productivity and staff morale are under pressure yet again, not least due to change management fatigue, but it will be frontline and back office staff, clinicians and service line managers who will be tasked with delivering the future health and social care services for their local areas, so their understanding and buy in to the STP proposals is key.
Those operating in the public services arena are fully adept at implementing formal consultation processes to iron out many of the established legal and contractual challenges, including:
- Constraints associated with Transfer of Undertakings (Protection of Employment) Regulations;
- Managing a two tier workforce;
- Pensions issues and
- Mismatching cultures.
Early engagement starts before and extends beyond the legal framework for workforce consultation. True collaboration requires early and open initial discussions, however difficult, with staff across all organisations including staff side, the British Medical Association and trade unions generally about the future service delivery proposals and the role that the health and social care workforce has to play.
The lack of granular detail on the proposals should not deter the participating organisations from starting this dialogue, however informal. There are already many excellent examples of exploiting flexibilities within the contractual Agenda for Change Framework which could be shared more widely – not just across the NHS but also with its potential partners, to kickstart some of the discussions.
STPs create myriad opportunities for new workforce models between the NHS and independent and third sectors, using innovative corporate structures and different contracting models for consolidating back office functions, the redeployment of staff and the creation of a more agile workforce to address some of the challenges identified above.
Long term solutions for the pensions challenges identified are also being considered to keep pace with the new service delivery models.
Now is not the time to close the door on the possibilities for improved health and social care for whole populations simply because “this is how we have always done it.”
Jodie Sinclair is head of employment law at Bevan Brittan LLP
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