There is an appetite for workforce change - now a tsar must lead it

Over the past months the HSJ workforce investigation, in association with HCL, has pondered over crucial questions and engaged a range of individuals and organisations in vibrant debates on the temporary workforce. Some of the ideas and insight discussed have certainly been refreshing to hear.

Most importantly, I am reassured an appetite for change exists. The tone of my previous columns has been one of optimism, and this remains the case. We face severe and complex challenges, but with the right action, I am confident significant improvement is possible.

The publication of this report should not mark the end of the process; rather it must act as a catalyst for genuine change. I hope to see the system move up a gear in future months.

Central to this will be addressing a question that, in my view, remains unanswered: who will take the lead at a national level to drive progress? In previous columns I have stressed the importance of senior management within trusts taking ownership over workforce management and creating the right culture to enact change. This remains a priority. However, work should not simply be left to trusts without guidance, support and responsibility from above.

Jigsaw puzzle

The intervention from the Department of Health and Monitor/Trust Development Authority banning the use of unapproved or off-framework nursing agencies in October and the introduction of agency caps across all staff groups in November will have an impact on agency spend. However, I am concerned that without proper controls, the unintended consequences of these crude measures may well derail any good intentions and add further workforce burdens to an already stretched NHS.

With this in mind, I want to use this latest column to call for the creation of a ‘workforce tsar’ to articulate what good looks like, and fit the numerous pieces to this hugely complex jigsaw together.

The NHS is brimming with talent - the workforce needs to be encouraged to be part of the solution

There are so many facets to implementing effective workforce management – the system needs a highly visible, dedicated team to review the complexity around consultant job-planning and facility wide rota planning and management; setting targets to reduce attrition rates and mandating the development of vibrant in-house staff banks with realistic benchmarks as goals will all go a long way to improving the management and retention of the NHS’s biggest and most valuable asset: its staff. The NHS is brimming with talent - the medical and clinical workforce need to be engaged and encouraged to be part of the solution.

Clear direction from the top, realistic goals and fewer bureaucratic burdens will go some way to solving the workforce dilemma; we can only truly tackle these issues when there is accountability and a willingness to take the initiative at all levels in the NHS, but this must filter down from the most senior decision makers.

Finally, I would like to take this opportunity to thank everyone who has contributed to the commission. I do not want us to be having the same conversations and writing the same columns in five years’ time; quite simply, we cannot afford to be having the same conversations. It is time to fix the problems for the long-term.

Claire Billenness, managing director, HCL Workforce Solutions