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Hello Future: adressing the NHS workforce crisis

Source: NHE March/April 2019

With the current NHS workforce crisis viewed by many as the biggest threat to the success of the NHS Long-Term Plan, Tasy Warn, director of employment services at NHS Shared Business Services (NHS SBS), describes some of the innovative solutions being developed to address the challenge.

Amidst the considerable focus on the NHS workforce within the new NHS Long-Term Plan, two somewhat sobering facts are laid bare: firstly, workforce growth has not kept up with need in the past decade. Secondly, the way staff have been supported to work has not kept up with the changing requirements of patients.

When down in black and white like this it perhaps comes as no surprise that today’s NHS workforce is often characterised by mass vacancies, overstretched and somewhat demoralised employees, and unprecedented staff numbers leaving their NHS roles.

But of course, this does not tell anything like the whole story. As the long-term plan also makes clear, the NHS is the world’s largest employer of highly-skilled professionals – people who have devoted their working lives to caring for others. In other words, you would have to look fairly hard to find a more talented, dedicated, and loyal workforce. 

The plan also introduces some of the steps being taken to address the NHS recruitment issue, although inevitably many of these will take time to bear fruit. So just what can be done to improve the situation in the short term? 

The answer, like with many of the other challenges the NHS is facing, invariably lies with the adoption of technology and better use of data. In reducing the amount of time staff spend on workforce admin, and by introducing smarter working practices, it will become easier for NHS employees to carry out their roles. Job satisfaction levels will also increase as staff get back to doing more of what attracted them to a career in the NHS in the first place – most notably helping patients. 

The workforce chapter in the long-term plan is titled ‘NHS staff will get the backing they need’ – and this is exactly the point. Giving our current workforce more sophisticated tools and access to more modern working practices will undoubtedly help NHS organisations retain their talented staff and support them to be more effective than ever.

At NHS SBS, we have just launched a new campaign called #HelloFuture. The aim is to design, develop, and implement innovative digital technologies and brand new services that benefit the NHS back office – aligning corporate services to the health secretary’s vision for a future technology-enabled NHS.

As part of this, we have worked closely with some forward-thinking trusts on initiatives that will help NHS organisations better understand and utilise their employees. These partnerships are also about equipping NHS staff with new technology, systems, and processes which remove unnecessary or time-consuming admin, and make their lives easier.

A new payroll app, for instance, which lets NHS staff view and interrogate their payslips on their mobile phone or tablet, is helping to save the NHS around 250 hours every month just by reducing the number of payroll queries from NHS employees. We built and tested MySBSPay in partnership with staff at Chelsea and Westminster Hospital NHS Foundation Trust. It was then launched towards the end of last year so that NHS employees paid via our payroll service (close to 400,000 staff at around 100 NHS organisations) could get their pay information in a more convenient and understandable format.

With the app including chatbot technology to answer common pay-related questions, we have seen a 21% reduction in monthly queries to our payroll service desk. The result is less time spent on the phone to us and significantly more time for NHS employees to spend elsewhere – the equivalent of 36 extra NHS work days every month.

We also partnered with Solent NHS Trust to develop a new independent exit interview service so that NHS organisations can better understand the reasons why staff leave their posts. Instead of a one-size-fits-all online questionnaire via the electronic staff record, employees are instead offered a comprehensive telephone interview with one of our impartial HR specialists. The anonymised process means that more valuable narrative data can be collected to inform an organisation’s workforce priorities.   

For Solent NHS Trust there was a marked increase in the number of leavers engaging with the exit interview process – 75% compared with just one in three people previously. And with the narrative ‘reasons for leaving’ uncovering trends and highlighting issues in specific areas, the trust was able to take positive action and increase nursing staff retention in line with the model hospital national average, surpassing it as of October 2018.

We've also worked with Norfolk and Norwich University Hospitals Foundation Trust to introduce a weekly payroll for bank workers, incentivising its existing employees to join the hospital’s bank instead of working through an agency. This initiative – combined with a number of other measures implemented by the trust – has been transformative. The number of bank hours work carried out by registered nurses has almost doubled over 18 months – at the same time that agency hours reduced. Indeed, the trust’s total spend on agency staff more than halved in the last financial year.

In promoting and rolling out this best practice more widely across the NHS, and by working with trusts to develop new ways of working that are valuable to them and their employees today, we aim to relieve some of the modern workforce pressures that threaten the future success of our health service.

Ultimately, our job is to help implement – as the NHS Long-Term Plan puts it – “changes that remove wasted time and irritating tasks, so that staff are able to focus on patient care.”

As part of its #HelloFuture initiative, NHS SBS is offering free, no-obligation insight reports (until the end of June 2019) to any NHS organisation, focusing on the workforce or a range of other back office areas. These can include an analysis of specific challenges, a benchmark against similar organisations, and recommendations for improvements. For more information, visit


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