NHS Reset is an NHS Confederation campaign to help shape what the health and care system should look like in the aftermath of the pandemic.
In this blog, part of a series of comment pieces from NHS Confederation members and partners, Clare Panniker shares her reflections on how the workforce has had to change rapidly during COVID-19 and offers insights as to how we use this change to reset the NHS.
In the past few months, the way the NHS does things, in relation to our workforce, has changed. The demands of tackling COVID-19 have led to new and innovative approaches – introduced at a pace not previously thought possible. These have resulted in improvements in staff recruitment, deployment and education and training. The way services are regulated has changed for the better and there has been a big step towards system working. The pandemic has also seen the introduction of a wealth of national resources to support the health and wellbeing of NHS staff, which sit alongside the extensive local efforts to support teams.
Some of these measures are temporary and should only be in place during the pandemic. Other changes will continue to be helpful in the longer term. We must do all we can to keep and build on these. An example is the more streamlined approach to recruitment, especially in the use of digital technology, which has reduced the time to hire and improved the experience of candidates and recruiters.
Retired staff who chose to return to the service at our time of need have been of great help in bolstering intensive care units. Their valuable contribution has been crucial. Returning staff can help on an ongoing basis, by continuing to work in COVID-19 priority areas such as social care. They can also help ensure we have a sufficient number of staff to reintroduce services, postponed at the beginning of the outbreak, and to enable staff working through the pandemic to get well-earned rest and recuperation.
Volunteers have also had a crucial role in supporting health and social care during the pandemic. The goodwill and commitment of all those who have got involved is wonderful. If individuals continue to be so generous with their time, then we should seek to embed volunteer roles into new ways of working.
The response to the pandemic has reinforced the importance of a team approach to delivery of services, which recognises and maximises the contribution all staff groups can bring. We have seen virtual and flexible working linked to new models of service delivery and examples of system working, with health and social care staff working across multiple employers to deliver effective care pathways. As we reset the NHS, these examples need to become the norm, with staff being able to move across organisational boundaries to provide a more joined-up service for patients. This should be done with staff and through discussions with their representatives.
NHS England and NHS Improvement and the Care Quality Commission need to take account of the way decisions have been made and services are delivered. Changes to the permissions culture between national, regional and local systems have shown how we can rapidly deliver improvements. This freedom must allow us to introduce new services at an appropriate pace and not be restricted by overly burdensome and unnecessary assurance processes.
As the reality is that we will be managing COVID-19 patients for a considerable time, with the need for planned ‘flex’ to manage any resurgence in the virus, we will need far more certainty about the funding available to support these changes, before finalising service plans.
The financial question also looms over the arrangements we have made for staff to park for free and to have access to free food and refreshments. This has been an important acknowledgment of the efforts of our people and echoes the core offer envisaged in the People Plan. These steps, however, have a cost and there needs to be discussions nationally to see if they can be resourced in the longer term.
Staff health and wellbeing have rightly been given prominence and national funding during the pandemic, but the most important aspect has been giving staff the time to access the support. This means we need to find a new language and assessment of what good looks like in terms of productivity, which takes account of wellbeing. Investment in staff health and wellbeing will need to be sustained for years to come, with consideration of where best support should be delivered – nationally, system or locally.
The same is true when it comes to continuing professional development. The underlying gaps in the clinical workforce pre-COVID-19 still need to be addressed and we have to build collectively upon the positive profile careers the NHS now has. Delivering additional training during and beyond the transition must be built into service delivery capacity.
The pandemic has taken an awful toll in loss of life among health and social care staff and the population as a whole. This is particularly true for our black and minority ethnic colleagues. It is incumbent on all leaders to ensure they take urgent and sustained action that address any unfairness present in our workplaces.
Clare Panniker is chief executive of Mid and South Essex NHS Foundation Trust and chair of the NHS Employers Policy Board.
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