Recruiting and retaining a talented workforce

With the public sector freeze on pay, a squeeze on recruitment, and new limits on skilled migrants entering the UK, health service managers will be wondering how to keep their brightest staff and fill the knowledge gaps left when senior staff depart. They may also be looking at how to find top talent to help them innovate and manage change.
The planned phasing out of primary care trusts (PCTs) and strategic health authorities (SHA), as proposed in the government’s recent white paper, will also be a talent issue. NHS Confederation acting director Nigel Edwards said the transition to GP commissioning will need to be carefully managed. “It will be essential to avoid a talent drain from primary care trusts; now is the time for strong leadership at a local level,” he said.
Strong leadership and staff engagement are the two key elements I believe the NHS needs in order to recruit and retain a motivated and talented workforce in these challenging times.


At NHS Employers’ annual conference and exhibition last year, Heather Rabbatts, former executive deputy chairman of Millwall Holdings Plc and Millwall FC, and one of Britain’s most influential women, summed it up nicely, speaking passionately about the importance of communication and respect when leading organisations through difficult periods of change.

According to Heather, the art of leadership and management essentially involves three elements:
• Simplicity in what you’re trying to convey and what you want people to do.
• A sense of tactics and an ability to read the game, adapting to changing circumstances.
• Communication and motivation.

The coalition government has made it clear that they want to see clinicians and frontline staff empowered to make the changes needed in the NHS and there is good evidence that engaged staff have a lot to contribute to improving productivity and spearheading innovation. This means the NHS will need to step up its game in these areas, but we have a solid base to build on.

 A recent report from the Institute of Leadership and Management (ILM) on leading change in the public sector suggests that, contrary to their stereotype, public sector managers are ready for change and motivated to find ways to reduce spend, while maintaining quality of services. However, they are worried about team morale, quality of organisational leadership and communication. The ILM concludes: “Senior managers in the public sector need to spend time and energy connecting with the people they lead, communicating with them and making themselves as visible as they can.”

NHS managers quizzed at the NHS Confederation’s annual conference in June put maintaining staff morale at the top of the list of concerns that keep them awake at night. It was also one of the top concerns identified in the ILM study.

Staff engagement is intrinsically linked to morale and NHS Staff Survey results show us that NHS organisations with high scores in staff engagement tend to have better quality outcomes, overall good performance on HR practices and better results in the patient survey. So staff engagement is a critical ingredient for an effective health service and will become even more important as the focus narrows on outcomes over processes and empowering staff at the frontline.

NHS Employers has placed an increasing focus on helping employers to improve staff engagement over the last few years. Our March webinar on staff engagement during tough times emphasised that the NHS had good levels of staff engagement, but there was more that could be done to harness the energy of engaged staff to jointly tackle challenges in the health service.

In particular, staff engagement efforts need to be ongoing and sustained. While various engagement models and techniques could be used, a common theme in good staff engagement is the involvement of staff in key decisions facing the organisation such as reconfiguration of services, dealing with deficits and productivity improvements.

NHS Employers’ top tips for staff engagement include:
• Make a case for staff engagement on the grounds of impact on patient care and organisational performance.
• Show commitment from the top.
• Make staff engagement a critical catalyst for progress on productivity and quality, not a separate timeline.
• Support first level line superiors to create an engaging style of leaders.
• Seek to involve staff in the critical challenges that are facing your organisation.
• Use information for the staff survey to identify the scope of the staff engagement challenge and benchmark your performance and progress.
• Review and improve communication methods and, in particular, be seen to respond to staff concerns even if they cannot be acted upon.

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A recent report from the Chartered Institute of Personnel Development (CIPD) looks at what good talent management feels like and how organisations can leverage this to get the most out of their top talent. They suggest that business leaders should:

• Agree the business goals and strategic intent behind their talent programme and ensure this is communicated.
• Demonstrate visible leadership and commitment from the business.
• Encourage and support line managers to take their role in supporting individuals on the programme.
• Review the nature and composition of your talent programme to ensure the right mix of formal training and other development opportunities (eg, networking and mentoring).
• Consider how you can make the most of the people on the programme, such as stretch assignments or mentoring.

Burton Hospitals Foundation Trust is several steps ahead in terms of growing its own talent for the future. Its approach to succession planning involves hiring young talent with strong management potential and developing them through the trust’s own internal graduate scheme.

The trust identified a gap in the available successors for core middle management posts and wanted to find people with the right attitudes, abilities and beliefs to lead the trust in the future. While it had always supported the national graduate scheme, it felt that a more locally focused scheme would mean that the talent developed would stay with the trust beyond the length of the scheme.

Not only is the scheme cost-effective, it is beginning to make inroads in terms of changing the trust’s culture and introducing new ways of working.

Roger Smith, associate director of human resources, told us: “We were keen on finding people with the ability to manage people. We want people who can bring out the talent and best in others so that instead of having one person who does things well, we’ll have one person who can support, develop and challenge ten people to perform.”

Graduates are recruited through a challenging assessment centre and interview process before being appointed by the trust. Each year, the previous year’s recruits become mentors for the next cohort of graduates and this approach has now been adopted as one of the cornerstones of Burton’s people strategy.

Across the trust, low absence rates and below average turnover are testament to the effort made to develop talent internally and keep hold of it. The trust also recognises the value of diversity in the talent mix, working hard to accommodate disabled members of staff, making workplace adjustments to enable them to contribute to the work of the trust.

Event Diary

Following the 2017 Naylor Report into NHS estates, it has been estimated that estate upkeep costs have reached approximately £10bn in annual funding for 2019/2020.

More recently, ERIC (Estates Returns Information Collection) data collection has contained some deeply alarming news about the condition of NHS buildings and equipment.

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