Medicine 2019—The People’s Plan

  • UK Medical News
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By Rachel Pugh

The NHS should be the ultimate people business, according to its Chair of Improvement Baroness Dido Harding, but instead, she has been shocked at the ‘rottenness’ she has seen in many parts of the NHS and says it needs to change.

Baroness Harding, formerly CEO of the telecommunications company TalkTalk, expressed her shock at the degree of bullying and discrimination she had encountered in the NHS since she joined 18 months and made her appeal for NHS staff to join her in making a cultural change towards a more people-friendly organisation.

Charged with the task of delivering a People’s Plan, containing the workforce changes necessary to underpin the NHS Long Term plan over the next 10 years, Baroness Harding said: “As an outsider, to me the NHS is the ultimate people business and I can’t get my head round how people are not at the core of what we do in the NHS. That is what our People’s Plan is all about putting right.”

“Staff are under too much pressure; they do not feel valued enough. I was shocked to see how rotten the culture is in parts of the NHS where bullying and discrimination are rife. And it’s gone on far too long. We have to find different ways of working.”

She is working on an interim plan and promised a final plan at the end of the year. Her vision for the healthcare system is one that delivers better outcomes for patients and is:

  • More personalised and patient centred.
  • More focused on preventing ill health.
  • More likely to be delivered in community settings including people’s own homes.
  • More enabled by technology.
  • Delivered by multi-professional teams from different organisations, collaborating and coordinating care.

Demand for more health and social care and the need for a larger workforce are the inevitable consequence of result of people living longer but with more co-morbidities. So, a ‘more of the same’ approach to workforce is not an option.

Baroness Harding said: “We need different people in different professions working in different ways, for the sake of patients, staff and taxpayers.”

Patients had made it clear they did not want to have to repeat themselves to a constantly changing line-up of stressed clinicians. Staff have been clear that they feel under pressure and undervalued. Taxpayers were also calling for changes to the way the health service is financed.

The People’s Plan aims to tackle workforce issues differently, by incorporating 5 key principles:

  1. Make the NHS the best place to work, probably the single most important aspect.
  2. Inclusive and compassionate leadership with change from the centre.
  3. Honest assessment of shortages, with nursing as the most high-priority requirement and a need to get 5000 more student nursing clinical placements by September.
  4. Cross-disciplinary and 21st century working, with less linear and more agile careers, with people adapting as technology moves on.
  5. Collaborative and continued work on the people agenda.

Baroness Harding said: “The NHS has had a Soviet style tractor production plan view of workforce planning, giving the DHE the job of guessing what would be required across the country across 100 different tractor variants in 10 years time. We’re asking the wrong question. We need to be integrating people planning with our operational and financial planning because people are the most important asset we have in the NHS.”

“This is not a crash diet it is a new way of life for all of us. People planning cannot be a one-off exercise and changing cultures takes time and sustained effort. Every doctor in every clinical setting casts a big leadership shadow with people you work with. How you behave from the most junior person in the room to the one with most prestige affects how everyone in the room behaves.

So, we are genuinely in this together if we want to make the NHS the best place to be.”