No ‘silver bullet’ to solve NHS workforce challenges, Think Tank warns

A leading NHS Trust chair recently joined healthcare leaders to debate how data has helped break the cycle of past people management, as a route to improving productivity and performance.

In a Think Tank session hosted by Strasys, a leading analytics and innovation agency, Dame Jo Williams, Chair of Alder Hey Children’s NHS Foundation Trust, and its Chief People Officer Melissa Swindell, shared how the organisation – which treats around 350,000 children a year - identified an unexpectedly high churn rate and staff sickness leave, but has established a transformational approach that is already delivering positive results.

Melissa explained: “We found that almost one in three employees were on the move over a typical year, adversely impacting our productivity. When you consider that it costs on average about £12,000 to recruit a nurse, it really required us to think differently about what we were doing.

“We have both qualitative and quantitative data, but we'd never brought them together in a way that connected the dots. For the first time, we triangulated the data and got underneath it. Combining that data with our demographics brought out information that enabled us to look at our workforce in a different way.”

While in England the national average response to “would you recommend your organisation as a place to work?” is 61%, Alder Hey now tops acute hospital Trusts in the North West, achieving a 72% approval rating from staff.

Melissa added: “We are definitely moving in the right direction, with a 5% reduction in turnover too. This is down to us thinking differently about how we respond to the workforce and what it is that they need.”

Dame Jo Williams commented: “In healthcare, our most precious and most expensive resource is our workforce, at about 70% of our regular costs. The question is, do we really understand what they are thinking and what their needs are?

“When we looked at our data, it reduced activity to operational targets and regulatory needs. So, underlying our approach is using data in different ways to help us break the cycles of the past, make important decisions and transform our approach to people planning and caring for our workforce. This is a complex issue and we need to do everything we can to better understand that complexity.”

Heather Barnett, Chief People Officer at Liverpool University Hospitals NHS Foundation Trust, described how common challenges – staff burn out, high workloads and competing priorities – are being tackled, with its leadership team flipping how they look at strategy.

She said: “Traditionally we designed our service around our policy. We’re now thinking about consumer needs, behaviours and motivations - not only for our people but for our patients too. We can then take action in a planned and clever way, using intelligent workforce data to create interventions that keep our staff and help build the workforce we need to care for our patients.

“We must think about the productivity gains we can make to give a real considerable return on investment. This work can deliver a return of around 9%, with recurrent savings on a budget of £1.1 billion. It's a no brainer.”

Naeem Younis, Founder and CEO of Strasys, discussed using data and intelligence to think differently about balancing quality, performance, and finance in managing the workforce.

He added: “Healthcare is very much a people-to-people business. How staff communicate, work together and interact with patients, determines the quality and efficiency of care. But, according to a recent survey of NHS employees, only 61% on average said they would recommend their Trusts as a place to work. And satisfaction is even lower, with one in eight leaving the service. The default response is more people.

“But we have an extraordinarily diverse workforce. One in four come from ethnic minorities, and a further one in five are foreign nationals representing over 200 different nationalities. That's a huge variation in training perspectives, possibly cultural values and motivations. As a Trust looking to develop a people plan to improve the workforce dynamics, one size clearly does not fit all. What is required is a more nuanced, localised approach.”

Having analysed hundreds of organisations over the past few years and exploring how they develop their ‘people’ plans, Naeem recognises that activity typically falls into four areas - corporate, regulatory compliance, new ways of working and staff wellbeing.

He continued: “The focus is around staff types, numbers and bands and is very much driven by regulatory pressures. What complicates this even further is how organisations typically have lots of other plans from clinical strategies, digital and so on.

“If you take a systems thinking approach, people planning is at the core of an organisation, not a sideshow. So how can we do people planning differently where the focus is on the individual? We work with Trusts to look at how much of the £1 they spend, is spent on developing and nurturing their people.”

Dr Nadeem Moghal, Essayist, Honorary Senior Clinical Fellow at The Nuffield Trust and Chief Innovation Officer at Strasys echoed Naeem’s sentiment, highlighting the ‘triangle trap’.

“This is where organisations are focusing on investment, productivity and value”, he explained. “We are seeing increased spending, more healthcare need and growth in staff numbers - yet activity and productivity is decreasing.

“One question is how much money to spend on developing people. Our analysis finds time and again that it's about 2p in the pound – about 2% - and that’s just related to skills. We do virtually nothing to understand needs and inequalities. Therefore, it’s no surprise there's an increase in churn, which in turn impacts productivity. And more importantly, the result doesn’t just impact the individual. You end up with sub-optimal teams.

“What it comes down to is that all data must come together. We need to use data about people differently. That's workforce decision intelligence at its best.”

Strasys, a leading analytics and innovation agency, has developed a new webinar series entitled “Thinking Differently”. To find out more and sign up for future events visit: https://www.strasys.uk/events/

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