Alignment and collaboration across health and care systems

Our systems will be the key units in planning for recovery. They should support local health and care employers, as well as wider partners, with a concerted focus on people and workforce issues. This begins with greater alignment across workforce, operational and financial planning, with a bigger role for systems in understanding the numbers and skills of their workforce, and deploying them effectively to meet service requirements and local  health needs.

Systems will have a central role in helping design new models of care and major service changes, to deliver better population health outcomes. They will need to work with HEE regional teams to understand the workforce requirements, any gap between demand and supply, and what needs to be done to address this.

Systems will also need to support the focus on retaining our people, including returners, as well as driving rapid, large-scale recruitment into a range of entry-level roles across the NHS. It will be critical to ensure a collaborative approach to recruitment, supporting primary and community care, as well as social care, to secure the skills and people they need.

The NHS has worked in partnership with social care during the pandemic so far, to provide support and to share workforce where possible.  This was underpinned by the government’s care homes support plan as well as joint work at national and local level to support staff to return to the health and care sector, although only a small number were deployed into care homes. In order to ensure that social care has the support it needs in preparation for winter and future outbreaks, the NHS and social care should continue to work in close partnership at every level. In particular all systems should review their local workforce position with providers and implement arrangements for their areas to increase resilience and capability.

In a wider context, the NHS can play a significant role in local economic recovery and improving social and economic outcomes, including reducing inequalities. Health and care systems, in particular, can build on the role of NHS organisations and large social care employers as anchor institutions, to bring those furthest from employment into meaningful work and to target recruitment, volunteering and apprenticeship opportunities in areas of greater deprivation, for example.

Workforce planning and transformation

  • Systems planning: Systems must strengthen their approach to workforce planning to use the skills of our people and teams more effectively and efficiently. This includes playing a greater role in planning, fully integrating this with service and clinical strategies and financial plans, and reviewing these plans in-year in response to changes to demand or services. In developing their plans, systems may find it helpful to consider key workforce planning questions.
  • Support for planning: Systems should work with HEE and NHS England and NHS Improvement regional teams to further develop competency-based workforce modelling and planning for the remainder of 2020/21, including assessing any existing skill gap and agreeing system-wide actions to address it. During 2020/21, HEE will develop an online package to train systems in using the HEE Star model for workforce transformation. This training will equip workforce leads with the capability to lead complex workforce conversations across care pathways, provider organisations and systems.
  • Data collection: In 2020/21, NHS England and NHS Improvement and HEE will begin urgent work to improve workforce data collection at employer, system and national level.
  • Transformation tools: In 2020/21, NHS England and NHS Improvement and HEE will refresh tools to support workforce planning and transformation and establish communities of practice for workforce analytics and modelling, workforce design and workforce planning.

Recruiting and deploying staff across organisations and geographies

  • Recruitment: Systems should make better use of routes into NHS careers (including volunteering, apprenticeships and direct-entry clinical roles) as well as supporting recruitment into non-clinical roles. Systems should also make much greater use of secondments and rotational roles across primary and secondary care to improve integration and retention.
  • Recruiting across communities: Systems should actively work alongside schools, colleges, universities and local communities to attract a more diverse range of people into health and care careers.
  • Staff banks: When recruiting temporary staff, systems, trusts and Primary Care Networks should prioritise the use of bank staff before more expensive agency and locum options, and reduce the use of ‘off framework’ agency shifts during 2020/21. Through its Bank Programme, NHS England and NHS Improvement will work with employers and systems to establish and grow collaborative staff banks. During 2020/21 this programme will work in partnership with systems to improve existing staff banks’ performance on fill rates and staff experience, aiming by 31 March 2021 to increase the number of staff registered with banks.
  • Movement across organisations: Systems should develop workforce sharing agreements locally, to enable rapid deployment of our people across localities where appropriate or where possible. NHS England and NHS Improvement has developed guidelines to make it easier, enabling the sharing of information such as HR records and statutory and mandatory training.
  • Digital staff passport: Systems are supporting the trial of the COVID-19 digital staff passport during winter 2020, which simplifies the high volume of temporary staff movement between NHS organisations, saves time by providing a verified record of identity and employment, and allows colleagues to carry their credentials and professional registration on their smartphone.