It’s time to invest in our support staff

Source: NHE July/August 2018

Dean Royles, director and strategic workforce advisor at Skills for Health and co-author of ‘An Introduction to Human Resources Management,’ argues that, as the NHS turns 70, we must recognise the hard work and achievements of support staff.

The NHS is 70 and, despite the current challenges and pressures faced by many parts of the NHS system, there is much to celebrate. We are enormously privileged to have universal healthcare, free (largely) at the point of need and provided on clinical need, not on the ability to pay. 

According to the World Health Organization (WHO), at least half the world’s population still do not have full coverage of essential health services and over 800 million people spend at least 10% of their household budgets to pay for healthcare. The WHO’s aim is to achieve universal health coverage by 2030. This is a remarkable ambition. We can foresee a time when essential healthcare doesn’t feel like a privilege, but becomes an unalienable right. 

The NHS can also boast in the achievements of a system working at the limits of science where, daily, those that work in the NHS hear of staff achieving the seemingly impossible to save lives, improve health and increase the quality of life for thousands. The NHS has been at the forefront of research, has Nobel Prize winners, and is regularly ranked amongst the best in the world.

Irrespective of your personal views, we can all agree that, as an institution, the NHS is surely recognised as one of our greatest innovations. Born at a time of adversity and honed by millions of staff and patients over the last 70 years, the NHS is constantly striving and changing to achieve more. The future of technology looks exciting, with increased use of genomics, artificial intelligence and machine learning heralding more personalisation and precision healthcare. 

There is a danger, though. It is often said, when we embark on change, that aspiring to be great can become an enemy of the good – because of a focus on being perfect, we don’t make changes that would be good enough. 

In the NHS, our danger is rather that we let good become the enemy of the great. Recognising the good services provided can result in a complacency about the need to change and consistently improve. As we embark on the next chapter of the journey, with the potential offered through increasingly sophisticated technology and promised government funding, we can acknowledge the significant achievements of staff, their dedication and commitment to go above and beyond what is expected. 

But we will do them a huge disservice if we fail to appreciate the opportunity of getting from good to great. A good NHS is a fantastic legacy after 70 years. A truly great NHS provides a sustainable future beyond the imaginations of those who doubt the possibility.

This ability to move from good to great is particularly evident in our support staff. Around 30% of the NHS workforce provide support to clinical staff. These staff have an enormous amount of patient contact time and yet it is clear we underappreciate them and underinvest in their training, development and education. 

The government has asked NHS leaders for a 10-year plan. I believe there are three things organisations can do to ensure that support staff are not only the backbone of the NHS, but become the jewel in the crown. 

Develop a workforce strategy 

Identify targets for progressing people through the support grades and beyond, set and enhance training and development budgets, hold conferences to highlight their contributions, and celebrate their achievements – Our Health Heroes is a great example (pictured). 

Aim to have all staff educated to level 2 and beyond. Spot talent and encourage development. In my experience, many support staff are just as bright, just as intelligent and just as dedicated as registered staff; they have just not always had the same opportunities to develop. This is a staff group where we can make true equality of opportunity a reality. Skills for Health has some good materials on its website.

Invest in apprenticeships

There has been plenty in the press about the complexity of the apprenticeship levy, much of it valid. 

However, this is money available to invest in training and development. If organisations aren’t using up their levy, despite the complexities, then develop a plan now, today, to ensure the NHS draws down the money. 

Spend it on helping support staff achieve qualifications. It is good for the organisation, but can be life-changing for those we invest in – and life-saving for those receiving care from them. How much more of a business case do we need than that?

See support staff as an important part of the future workforce pipeline

Workforce supply will continue to be a problem for some time despite additional investment. The ongoing impact of a period of austerity and Brexit will play their part. Artificial intelligence and digital solutions will change the way we work, the roles we need and the optimum skill mix. This is a time of opportunity to make the skills escalator a reality. 

When we look ahead to the next 70 years, by valuing and investing in the workforce, today and tomorrow, we can see the opportunity to develop a well-loved service to a truly exceptional service able to endure the inevitable political rollercoasters to come. 


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