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A new plan to help retain and support the NHS workforce has today been launched – though unions are frustrated and concerned it falls short of addressing nurse shortages and pay.
NHS England and NHS Improvement has today published its latest phase of the NHS People Plan.
The ‘We are the NHS: People Plan 2020/21 – action for us all’ document follows the Interim NHS People Plan and NHS Long Term Plan that came out last year.
The government has confirmed that today’s blueprint is one of several people plans that will centre on the NHS workforce.
The latest publication focuses on addressing new challenges for the workforce presented by the coronavirus pandemic and also offers measures to improve physical and mental health support for staff.
While unions have welcomed commitments to support the workforce, they are frustrated and concerned that neither pay nor serious nurse shortages were addressed.
However, the government has assured an additional people plan, based on workforce numbers and funding, will be issued in the autumn once the forthcoming spending review has confirmed future NHS education and training budgets.
Today’s 52-page document recognised the “increasing pressure” nurses and colleagues had been under since the response to Covid-19 began, adding there “will be further challenges ahead”.
“Workload remains a pressing concern and we have all been reminded how critical it is to look after our people – and that we need to do more,” the report noted.
The report focused on six key chapters: Responding to new challenges and opportunities, Looking after our people, Belonging in the NHS, New ways of working and delivering care, Growing for the future and Supporting our NHS people for the long term.
The plan made an overall commitment to “look after” NHS staff by offering greater support for health and wellbeing.
It said new initiatives would build on existing support such as the helpline launched in April for NHS nurses and other frontline staff during Covid-19.
For example, NHS England and NHS Improvement were piloting the use of “resilience hubs”, which would work alongside occupational health programmes to improve staff mental health. As part of the initiative, staff would be assessed and if necessary, referred to appropriate treatment or support to help them stay well and in work.
The blueprint flagged that the “safety and health of our people is paramount” and urged employers across the health service to “take all necessary measures and redouble their efforts to keep people safe, or risk them leaving”.
“The government must now take rapid action to resolve the current workforce shortage”
Dame Donna Kinnair
As part of this, and in wake of Covid-19, employers should focus on infection risks and providing personal protective equipment (PPE) for the workforce, noted the plan.
Employers must also risk assess for all vulnerable staff including Black, Asian and minority ethnic (BAME) colleagues and anyone who needs additional support, and take action where needed.
They should also ensure nurses and other NHS workers had “sufficient rests and breaks from work and encourage them to take their annual leave allowance in a managed way”.
Bullying and harassment was also a key issue addressed in the new plan. It said that “by March 2021, NHS England and NHS Improvement will provide a toolkit on civility and respect for all employers, to support them in creating a positive workplace culture”.
In addition, by December 2020, an NHS violence reduction standard would be launched, “to establish a systematic approach to protecting staff”, the report noted.
All NHS organisations must also have a wellbeing guardian to examine their “activities from a health and wellbeing perspective and act as a critical friend”.
Another action included in the plan was a move to advertise all roles across NHS England and NHS Improvement as being available for flexible working patterns as of January 2021.
The plan said that for the NHS to become a “modern and model employer” it must “build on the flexible working changes that are emerging through Covid-19”. “This is crucial for retaining the talent that we have across the NHS,” it said.
“The people plan must be backed with investment for a much-deserved pay increase”
Under the new plan, there was also a commitment to boost the mental health and cancer workforce by offering training grants for 350 nurses to become cancer or chemotherapy specialists.
It also outlined plans to encourage former staff to return to practice as part of a recruitment drive in 2020/21. This followed the thousands of staff, including nurses, who had returned to the frontline to support the NHS during the pandemic. According to the plan, a recent survey of returners revealed around half were interested in continuing to work.
A new international marketing campaign will also be launched throughout the rest of 2020/21 to promote the NHS as an employer of choice for international health workers, alongside work to ensure ethical recruitment.
In terms of students, pledges were reiterated to work with universities to increase undergraduate places by 5,000 from September 2020 in nursing, midwifery, allied health professions and dental therapy and hygienist courses.
This is in addition to a new £10m fund for clinical placements for nurses, midwives and allied health professionals.
Other moves detailed in the plan included a call to every NHS trust and care commissioning group to publish progress to ensure that the workforce, at every level, was representative of the overall Black, Asian and ethnic minority workforce.
A new quarterly NHS staff survey would also be developed to better track workforce morale, on top of the current annual survey.
Commenting on the launch of the latest people plan, the Royal College of Nursing welcomed commitments to support retention of the workforce this year but stressed that a much-needed workforce strategy was awaited.
Chief executive and general secretary of the RCN, Dame Donna Kinnair, said: “Today’s plan sets out important commitments to support retention of the nursing workforce.
“The government must now take rapid action to resolve the current workforce shortage and address significant issues in supply of domestically educated nursing staff.”
Dame Donna said emphasis on a “flexible, inclusive workplace culture is encouraging” and stressed that bullying and harassment had “for too long been allowed to frustrate the ambitions and development of NHS staff”.
She called on the government to “take rapid action to deliver a full workforce strategy” to coincide with the NHS Long Term Plan.
“The delay in delivering a full and comprehensive workforce strategy, addressing domestic supply as well as recruitment and retention, is particularly concerning given staff shortages and the role that nursing staff continue to play in the pandemic,” she added.
“We need to see the words in this document become concrete fact across the NHS”
The RCN lead reiterated calls for a “fair and early pay rise for nursing staff”, as well as “proper funding of student nurses”.
Under current circumstances, NHS workers on the Agenda for Change contract will not eligible for a wage increase until April 2021, when the current three-year pay deal comes to an end.
However, unions are lobbying the government to push the negotiations forward.
Frontline nurses and midwives across the country have also taken it upon themselves to organise demonstrations to demand an early pay rise, with a national day of action planned on 8 August.
It comes after the government excluded nurses from its recent public-sector pay award announced last week.
Unison head of health Sara Gorton also stressed the importance of backing the new people plan with a pay increase for staff.
“Covid-19 has profoundly changed the day-to-day reality of work for all health staff,” she said.
“The NHS has a responsibility to focus on how to support employees over the coming months.”
She welcomed plans to tackle bullying, racism and inflexible shifts but stressed opportunities were still being missed to introduce an “early and significant wage rise” for NHS staff.
“The people plan must be backed with investment for a much-deserved pay increase,” said Ms Gorton.
Also commenting, Jon Skewes, executive director of external relations at the Royal College of Midwives, said: “We now need to see the words in this document become concrete fact in our maternity services and across the NHS, improving the working lives of its staff and giving the NHS the tools and resources it needs to deliver the safest and best possible care.”
He said this meant “significantly increasing our midwifery workforce and properly valuing all NHS staff with a substantial increase in pay”.
“Lessons must be learned from the response to Covid-19 to ensure that maternity services and the wider NHS are better-equipped to face future challenges,” added Mr Skewes.
Health and social care secretary Matt Hancock discussed the new plan in a question-and-answer session on the ‘Future of Healthcare’ held today at the Royal College of Physicians.
Mr Hancock explained that the newly published plan published was deliberately separated from strategies on workforce numbers and instead was focused on the “culture and leadership” changes needed.
“The people plan is emphatically about retention because it is about making the NHS a great place to work”
“The People Plan we have set out today, we have purposely separated from on the important work on how many people we need, and of course we need more and we are hiring fast…but we have purposefully set out separately the culture and leadership changes we want to see.
“Respecting the staff, at all levels, and supporting them to be the best they possibly can be is a critical insight that all good employers hold dear and act on.
“That is what is at the heart of the people plan and I sincerely hope that will help with retention.”
He added: “And of course pay is important as well…but the problem is because the high-level debate so quickly in the past has run straight to the question of pay, we don’t spend enough time stopping and asking all the other things that we should just be getting on with.
“The people plan is emphatically about retention because it is about making the NHS a great place to work.”
Mr Hancock added that this was “harder in social care because we are not the direct employers and local authorities are the formal route of accountability and indeed contracting”.
“But we try to look at this across health and social care as much as is possible despite the fact they are different areas…but nevertheless we take an overall view of supporting our people to do the best job they possibly can.”
The health and social care secretary added: “This people plan is not just a one-off. We had an interim last year, we had a publication this morning, we’ve got another one coming in the autumn, which will be more about the numbers, alongside the spending review and then there will be more because our people planning is a process, not a document.”