Recruitment challenges: the NHS perspective


The NHS has regularly faced recruitment difficulties. However, the essential challenge remains – getting the right people with the right skills in the right place at the right time to meet service and patient needs. Getting all of these things correct at the same time is the holy grail of workforce planners, with effective workforce planning an essential pre-requisite to successful recruiting.

The right skills?
This question is central to the recruitment challenge and the answer should be based on an identification of the expectations and needs of our patients and service users. Patient expectations are changing and we need to ensure that the NHS workforce is flexible enough to meet these needs. For example, can the NHS change its emphasis towards a more preventative service which promotes wellness and health rather than addressing illness? This is a fundamental shift which will require different types of staff with different skills.
    
The recent Department of Health consultation on education and training: Liberating the NHS: Developing the healthcare workforce proposes a major change to the link between workforce planning and the commissioning of education and training for the next generation of healthcare workers. Local decisions made by a network of local providers will form the basis for education commissioning. This presents opportunities for NHS providers to address some of the local skills shortages that underpin recruitment difficulties by giving them control to commission education and skills training based on local need.
    
Advances in technology and medicine will require more staff who are able to take part in research and facilitate the utilisation of new technology into service delivery. The changes to the training and recruitment of healthcare scientist are an example of this; scientists will be given an initial broader training base before specialising in one area. Ultimately this will enable greater flexibility in skills and therefore in service delivery. A pilot of this approach to training in the genetics area proved very successful.

The right people?

A national perspective on the type of staff required in the NHS is being developed by the Centre for Workforce Intelligence (CfWI). Established in 2010, the CfWI will help health and social care organisations plan their workforce more effectively round delivering more people focused care, with an emphasis on shifting the delivery of care away from hospitals and moving the balance of staff towards the frontline.
    
The NHS has a disproportionate number of older staff of which 30,000 retire each year. This ageing workforce means that we need to attract younger staff and build their skills now so that we retain a high quality workforce for the future. Current unemployment rates in the young population (National Statistics Online – Employment), coupled with the financial incentives available for the support of apprenticeships, make this group a potential source for the future NHS workforce.         

Similarly, social responsibility challenges the NHS to look at the mix of its workforce in terms of age, gender and ethnicity.  

The NHS is seeking to increase productivity and combined with the drive for efficiency savings there is an opportunity to reshape the workforce to meet patient needs using skill mix and extended roles.
    
This can be seen in the development of roles of staff earning up to around £22,000, particularly assistant/associate practitioner roles. These roles also begin to develop career pathways which enable staff to join at a more junior level and progress through a series of clearly defined roles with the potential to enter professional training if they wish.
    
Changes to the skill mix include the development of new advanced practitioner roles where qualified staff, such as nurses, occupational therapists or physiotherapists, take on specific roles which have previously been undertaken by consultants.
    
These developments present a challenge to managers recruiting to a role and they will need to carefully assess what sort of a person they need.

The right time?

It is vital that the skilled NHS workforce is used effectively in line with service demands. The productivity agenda in the NHS expects considerable savings to be achieved by examining and changing the way we deliver services. Alongside this are the requirements to adhere to European working time directives  (EWTD) and balance individual requirements for flexible working and work life balance with meeting the needs of the service. 
           
Increasingly organisations are using e-rostering facilities to help them address this balance.
    
The temporary workforce is a vital element in enabling the NHS to respond to short term skills shortages and fluctuations in service demand.  The costs of this sort of staff have increased over the past few years and there is pressure to reduce these costs even further. Managers will need to think carefully about the most efficient and effective use of this type of staff

The right place?
Increasingly there are moves to shift the emphasis of healthcare delivery away from the acute sector into people’s homes and the community. Online facilities and technology advancements mean that consultations do not necessarily have to take place in service settings. Again this provides a challenge to the recruiting manager when considering what sort of staff are required to deliver the service.
    
Managers in the health sector need to consider these different factors when considering how they recruit. It will require greater flexibility and creativity to challenge existing professional and service norms. But with the need to drive efficiencies and the workforce consultation providing the opportunity to reshape and simplify the system, the time is right to make these changes.   
    
Patients expect to receive the highest quality care available and it is through a vigorous and adaptable approach to recruitment that we will ensure we have the right staff in the right place to deliver this for them.

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