At Healthcare Estates, Fiona Daly, NHS Improvement Lead for Sustainability and Workforce, shared some initial insights from the recent data collection that will lead into a national strategy for the Estates and Facilities workforce.
This strategy will link with the long-term investment plan for the NHS and will reflect a move to a system-wide approach that will see the NHS working across geographical regions, sharing an identity and culture, but with local accountability.
“I think that we have E&F teams that are stretched to breaking point and we need to look at how we get investment back in and structures that support what we need to deliver,” said Fiona.
Four key areas emerged from the data collection: recruitment, retention, career development and succession planning. None of these are particularly surprising as they are challenges that E&F departments already face, but for the first time they are backed with data.
The recruitment process takes too long, there is no national campaign and there appears to be a lack of qualified and skilled people in the whole arena. This leaves the NHS competing for a small set of people who are snapped up by the private sector and may be paid a premium because there aren't the skilled people coming through. “We need to get into schools and recruitment fairs, letting them know that the NHS is a really cool place to work and come and work for E&F in the NHS.”
The pay gap between the public and private sector is aggravated by standardisation of banding and job roles, which needs looking at. The pay gap contributes to problems with retention, with people leaving for the private sector. People also leave because there is a lack of career progression.
Reward and recognition are areas that are within the control of E&F managers. “How we reward, mentor and coach people is coming through as a strong factor and we need to act on that in terms of how we deal with our workforce moving forward,” Fiona confirmed.
Mentoring and coaching is also important for succession planning, which is an area that, with a few exceptions, the NHS is not good at. This means making sure the right people are in the right places to support others in their personal and professional development. For instance, what happens when someone is given a contract to manage or asked to write their first business case? No training is provided around this and often there is no-one in place to provide guidance. “You kind of learn the process as you go along. We need to look at how we can put together some structured training around those core business skills that you need to work in E&F.”
The data collection aims to identify the level of investment that is needed in training budgets so the NHS can collectively lobby for funding. It is a “sad state of affairs” that pressures of the day-to-day and dwindling staff numbers mean many Trusts find it hard to release people for training.
“We've also been looking at what makes us different. How can we promote the NHS as somewhere people really want to come and work? How do we drive forward what's changing in the NHS, for instance, all of the technology, how do we get the breadth of what we do distilled into something that people can understand?”
Using social media much more in E&F than currently is one suggestion, because this is a key component of how young people access and absorb knowledge.
Flexible working is becoming much more important. For instance, if NHS engineers in the future need to work across STPs, it is necessary to understand how this resource can be shared across the ‘patch’.
In a similar way, enabling people to share their skills beyond their own organisation is something that the NHS should be facilitating. Aligned with that, enabling people to swap in and out of careers and enabling E&F managers to work on secondment in other areas and welcoming other managers into E&F. “How do we get that cross-departmental working so we're a lot more visible within the NHS and people appreciate what we do a lot more?”
Finally, raising the profile of E&F and creating a stronger voice within the system. This means Board representation and ensuring everyone understands how important E&F is and that the opinions of those professionals are valued as highly as those of the clinicians.
The Seven Rights
The right people: with the right values, attitudes and behaviours.
The right size: the right number of people with the right skills, spending the right amount of time on achieving outcomes.
The right shape: removing duplications and inefficiencies, making it easier to share skills across the patch and ensuring people have the right level and breadth of roles to develop.
The right places: so staff have the right resources available to them wherever they work and whoever pays their wages.
The right skills: E&F covers many different disciplines so it is essential to give people the knowledge they need as well as core business skills, such as how to write a business case.
The right way: making sure the processes and models are in place so people work effectively, all travelling in the same direction at a local and national level.
The right costs: benchmarking pay and rewards to align the pay gap.
