Case Study

Taking a system-wide collaborative approach to people and workforce

The Black Country and West Birmingham ICS has taken a system-wide approach to delivering solutions in people and workforce planning.
Alan Duffell

15 December 2021

In a complex, multi-tiered arrangement of national priorities, local drivers, transformation and clinical priorities for the workforce agenda, the Black Country and West Birmingham ICS has taken a system-wide, collective approach to addressing its common problems and delivering solutions in people and workforce planning. Since May 2020, the ICS has worked together to meet its shared objectives despite the challenges of the pandemic, to achieve a number of positive outcomes that have improved workforce development.

Key benefits and outcomes

  • Improved workforce planning.
  • Increased job offers.
  • Reduction in vacancies.
  • Standardisation of roles in the system.
  • System-wide management of the apprenticeship levy.
  • Workforce data-sharing agreement.

What the ICS faced

The Black Country and West Birmingham ICS, like other systems, was operating in a complex arrangement of nationally mandated and local drivers, including the NHS People Plan, ICS development and a range of clinical and transformation priorities needed to develop the people and workforce strategy, including the need to establish a Black Country and West Birmingham People Board.

With four acute provider trusts, a provider collaborative, mental health and community trusts and five places, as well as CCG, primary care and local government and voluntary sector care partners, there was a great risk of duplication of strategic drivers and priorities, as well as potential competition for the same workforce and available resources.

What the ICS did

Faced with this complexity, the system worked together to map the range of drivers and address the common problems they were facing collectively as an ICS through the development of the Black Country and West Birmingham People Board.

In this complex arrangement, the ICS People Board needed to look at how best to work at the system and place level, and within the context of acute provider collaboration.

A driver diagram was developed outlining the national and local drivers and the themes for change and action, and the ICS partners agreed to look at the problems they were facing as an ICS, rather than as individual trusts.

Five areas of focus were identified, and five programme delivery groups were established to address them, each with a senior responsible officer (SRO) and agreed key deliverables:

  1. Improve workforce supply.
  2. Improve education and training and access.
  3. Improve leadership and culture (including EDI).
  4. Improve workforce support and workforce health and wellbeing.
  5. Improve workforce flexibility and consistency.

Royal Wolverhampton Trust’s chief people officer was appointed as the system workforce SRO, who chairs the People Board and partnership work. An associate director for system workforce was also appointed, as well as two programme facilitators and a workforce analyst, whose role it is to look at the system position on key workforce metrics. This has enabled the system to justify and recruit to a substantive ICS analyst role, rather than rely on HEE non-recurrent funding.

Results and benefits

The five programme delivery groups have created, shared and delivered a number of projects and actions that have improved workforce planning and collectively addressed common problems across the system:

  • The Prince’s Trust model, which was initially started in The Royal Wolverhampton NHS Trust (RWT) and has been recognised as best practice in converting Prince’s Trust placements into employment, is now being taken forward across the system
  • International recruitment programmes that were originally started in the Royal Wolverhampton NHS Trust are now expanded to other provider trusts within the ICS.
  • A system-wide apprenticeship prospectus was created to promote the apprenticeships available in the trusts, West Midlands Ambulance Service and the local authorities.
  • To ensure that the system utilises the apprenticeship levy funding they contribute, a system-wide process now allows all organisations to effectively manage and gift any funds that cannot be used by the contributory organisation, to smaller organisations within the system.
  • A system leadership programme has provided training for 120 staff across the system, developing a collective vision and purpose across the system, building relationships and planning for the future.
  • EDI leads have developed a system-wide equalities and diversity strategy to build a system workforce that is representative of the communities they serve.
  • All trusts have signed up to a COVID-19 digital scheme to improve the validation of staff who needed to move between trusts to meet peaks in demand and emergency deployment of staff between organisation.
  • With a high level of vacancies in healthcare support worker and care support roles across the system, a partnership programme of system-wide virtual recruitment has taken place with both NHS and social care, to ensure that vacancies are filled in both areas. This has resulted in 350 job offers across the system and successful reduction of vacancy numbers.
  • Seven roles have been identified where standardisation might deliver the greatest benefits to the system with regard to promoting flexibility and system-wide working. The work reviewed the job descriptions, pay banding, job titles and accountabilities for each of the seven roles across system partner organisations.

The ICS leadership team is committed supporting Black Lives Matter (BLM) and to leading the Black Country to become an anti-racist system and to look at their personal roles and accountability to achieve this ambition. The people board is also carrying out personal development to look at racism in organisations and communities, white fragility and white privilege, and what becoming an anti-racist system will look like. The BLM programmes include listening events; a survey on the workforce’s experiences of racism and inequality; education on systemic racism; and reverse mentoring.

Overcoming obstacles

The ICS has faced, and is still facing, many challenges along the way. Workforce planning is difficult without system data and modelling, and short-term, non-recurrent HEE funding makes long-term planning difficult. Individual organisations have their own internal pressures/challenges, which can limit their capacity and ability to engage, while it was also a challenge to grapple with the overall size of the workforce agenda/challenge and all the national/regional/local asks.

To address these challenges, the ICS established a substantive workforce support team and a workforce data-sharing agreement. An internal team supported the SROs and their project groups, and larger projects were broken up into phases that could be funded separately over a number of years.

Access to ICS-level workforce data, as used by NHSEI and HEE, continues to be a struggle, as does leadership of the system agenda. There is a need to challenge each other not to bid individually for project funds or initiatives in single organisations, where previously organisations would be competing for resources. However, the ICS is seeing a change in mindset from competition for resources, to sharing and adapting the resources as a system.

Next steps

  • To adopt an electronic temporary staff management solution for all staff groups across the system and align bank process and rates.
  • To develop a system-wide approach to job evaluation training and agree on standardised pay levels for key roles, which will support wider system-level strategies for recruitment, retention and mobility.
  • An effective ally training programme will be rolled out in 2021/22.
  • Improving ICS workforce metrics that start to project a future position rather than a current position.
  • Reviewing the project group structure to also reflect the needs of the national NHS People Plan.

Takeaway tips

  • Collaboration is harder than competition. It takes time to build trust, so systems need to invest time in relationship building and creating a safe environment to challenge historically based organisational competition.
  • Develop an inclusive people board with clinical representation (nursing and allied health professionals in particular) along with local authorities and VCSE organisations.
  • Map out the range of challenges and interrelationships to establish a clear focus of what is needed.
  • Establish regular meetings with SROs and HRDs between the People Board meetings, to have open discussions on any key issues or concerns.
  • Identify the common issues or challenges facing all the organisations within the ICS and use that as the basis of future work.

Further information

For more detail on the work in this case study, please contact Alan Duffell, chief people officer at The Royal Wolverhampton NHS Trust: