The NHS People Plan – welcome addition, but how can we practically attend to the aspirational aims outlined?

It’s always great to have a plan, and that’s exactly what this is. The NHS People Plan, has been a long-overdue asset needed to bring together decades of expertise and knowledge, into one, cohesive outlined document. It’s fantastic to finally have a nationally recognised, collaborative piece of work that highlights the importance of looking after our people.

So, what’s next? Is the question I would expect every senior leader, NHS Workforce Development, and OD lead working in the sector to ask.

The NHS People Plan represents a starting point. A sense of direction, a steer. What’s really ahead of us in practice is a set of complete and difficult challenges, that require not only funding but also a sense of how to implement them effectively.

Having worked within, and with the NHS for over 20 years, there is a sense of ‘we’ve known this for some time’, which is why a single document outlining everything in black and white from NHS England is extremely welcome. It highlights, as we all know, that if don’t you look after the people who look after others, we would all be doomed.

What’s noticeable is how Covid-19 has accelerated our approach to system-wide working, innovations, remote working, and digital technology. The People Plan naturally acknowledges this, whilst also emphasising the need to capitalise on some of the great initiatives that have been born out of the pandemic.

What’s a shame is that it has taken a deadly virus, putting our NHS at breaking point, to highlight the need for health and wellbeing support. As we know, burnout has been exacerbated, and the potential long-term trauma of staff who have been faced with war-like destruction could take years to be fully realised.

The NHS People Plan, quite rightly, connects the need to care for our people, with the need to improve patient outcomes. Both really have gone hand in hand in workforce planning for decades, and now it seems that we’re finally really recognising that we cannot do one, without the other.

Noticeably absent, there is little detail about how, when, or who will be responsible for social care workforce needs. If the pandemic has taught us anything, it’s that the care sector really is an extension of our health workforce, caring for the clinically most vulnerable, with the most specialist of care needs.

The plan explains system-wide improvements and support for integration but doesn’t practically attend to the need for a robust, detailed, and collaborative solution to develop a seamlessly integrated health and care sector fit for all, delivered by a skilled, system-wide workforce.

If we’re going to improve patient care, based on local population health needs, and develop a workforce that meets those needs, we must look at the entire health and care economy. We must more closely consider the people who work to care for the most clinically vulnerable, patients who reside in care homes, hospices, in the community, and beyond.

If we continually exclude huge swathes of the healthcare workforce and patients, we will never develop effective integrated care systems that meet the needs of local patient outcomes, and we’ll struggle to develop effective workforce plans.

Talking of the future, anyone reading the NHS People Plan should consider that this is a 1-year plan. From our 20 years’ experience as workforce development specialists, we recognise that effective workforce planning must be taken with a long-term view.

The initiatives in the NHS People Plan may take years to develop and effectively implement. As with all workforce planning approaches, we should consider the service we want in 5, 10, even 20 years, and what patient needs will be in 2030 and beyond. What workforce skills will be lost in that time, what may be more readily available, where will most of the workforce come from, how will patients interact with service providers, what will population health look like. Even, what health and wellbeing needs will the next generation of the workforce have, considering the experiences being faced, right now.

Our determination to enhance the experiences and lives of our workforce, whilst important, needs to be considered a long-term, hard cultural shift, not a quick fix to resolve the inevitable burnout from Covid-19.

Recruitment and retention, clearly a key theme in all sectors, is a focus in the plan. However, there is a lack of specificity and context on exactly how increased recruitment and retention will be achieved. Improve the lives of the staff, provide more flexible working arrangements, consider health and wellbeing a priority, but is this enough?

That doesn’t hide the inevitable, people will leave the service for other opportunities, the private sector, new careers, and things will move on. Likewise attracting new talent will become increasingly difficult if new industries emerge from the pandemic. Not to mention, the ‘B’ word.

There is an expectation of a significant vacancy blackhole appearing in just a few months, as we move to a new immigration system that unfortunately excludes hundreds of workers who are the backbone of our social care and healthcare. So, what, and where are the real practical solutions that will see the numbers grow, and the vacancies reduce?

Every region and locality will have different challenges in their population health needs and workforce challenges, whether that be an increasingly aging population, remote and wide-spread populations, lack of fundamental skills, or a need for distinct specialties in the workforce.

The numbers on a national level for Nurses and GP’s have been struggling for many years. A robust, national strategic plan is needed. Much more than admirable wellbeing initiatives and flexible working agreements, crucially, investment is key to entice workers into these fields or bring them back to the service, for good.

Without this, local workforce planning teams are also likely to fail. We need detail to accompany the NHS People Plan, to really make the future, sustainable, and highly skilled workforce we all dream of.