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NHS leaders need guidance to navigate abundance of advice, think tanks say


By Valeria Fiore
Reporter
21 March 2019

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NHS employers should receive guidance to help them navigate the extensive number of recommendations they receive on culture and leadership, three think tanks have said in a report published today.

The Nuffield Trust, The King’s Fund and the Health Foundation said in the report that a wide range of suggestions have been put forward to local NHS bosses on how they should improve their leadership, making it difficult for them to know which advice to prioritise.

The report said that the workforce implementation group should ‘undertake a prioritisation exercise’ to clarify which recommendations leaders should focus on in order to positively impact NHS culture.

‘Compassionate and inclusive leadership’ will be essential for the delivery of many of the other workforce-related recommendations set out in the report, the think tanks said.

The report said: ‘The single most malleable and powerful influence on the culture of modern organisations is leadership. It is therefore an essential part of any consideration of workforce retention issues.’

The report, Closing the gap: key areas for action on the health and care workforce, presents a series of actions for the NHS to consider as part of the forthcoming workforce implementation plan, expected to be published next month.

Becoming a better employer

According to the report, the NHS needs to become a better employer in order to retain more staff, for example by offering better opportunities for flexible working and making sure it allows equal opportunities for career progression for all employees.

Despite the fact that progress has been made on race equality since the introduction of the Workforce Race Equality Standard (WRES) in 2015, the authors said change has not always been rapid.

The report stated: ‘We recommend that the forthcoming workforce implementation plan focuses on strengthening NHS trust leadership on workforce race equality.’

Recent NHS Staff Survey data showed that BME staff confidence levels in career progression fell to its lowest level since 2014 while a WRES report published last week found that BME nurses, midwives and health visitors face a glass ceiling when moving up the pay bands.

Workforce hasn’t been a policy priority for the NHS, the report said, adding that ‘responsibility for it is fragmented’ at a national and local level.

It said: ‘The information the NHS needs to understand and plan its workforce is poor and the NHS has not invested in the leadership capability and skills needed to manage the workforce effectively.’

‘Tinkering at the margins’

The authors calculated that there needs to be a £900m increase in the annual budget ‘for training and developing health care workers in England by 2023/24’in order to address the workforce challenge.

Action to plug the gap in nursing numbers is also needed to deliver the workforce plan, the authors said. Their recommendations included expanding the number of nurses in training each year by 5,000 by 2021, allocating grants of £5,200 a year to cover the cost of living for nursing students.

However, the researchers said that in order to meet demand by 2023/24, a further 5,000 nurses a year must be ‘ethically recruited from abroad’.

Nuffield Trust director of workforce strategy Candace Imison said: ‘The imminent workforce plan needs to mark the moment we stop treating the staffing of health and social care as a second order issue.

Our recommendations might seem radical, but the time for tinkering at the margins has passed.’

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