COVID-19: Lessons learnt

The COVID-19 pandemic has necessitated significant changes to the NHS, staffing frameworks and workforce provisions. We strongly believe considerable benefits can be had from the new ways of working and thinking that have emerged in recent weeks; returning to the way things were would present many missed opportunities.

Crucially, now is the time to act. The current reduction in demand presents a unique opportunity to transform the structure of the workforce supply chain and deliver fundamental improvements in line with the new NHS People Plan. As one of the UK’s leading healthcare suppliers, Acacium Group is perfectly placed to deliver these improvements.

Restating the key objectives of the NHS Long Term Plan

The NHS Long Term Plan was published in January 2019 and cited workforce supply as the biggest challenge facing the NHS. The plan sets out several actions the NHS must deliver to create a workforce of the future.

Objectives of the Interim People Plan

The Interim People Plan, published in June 2019, was described not as a detailed 10-year roadmap but:

“Our vision for our people and the urgent actions we all need to take this year, both to make immediate improvements but also to build a plan for our people that is fully integrated with those for financial and operational delivery.”

The plan identified five key action areas:

1. Making the NHS the best place to work

2. Improving the leadership culture

3. Tackling the nursing challenge

4. Delivering 21st century care

5. A new operating model for workforce

Immediate actions have been taken in a number of these key areas. Since the interim plan was published, NHS England Chief People Officer, Prerana Issar has been leading ongoing work to develop a national implementation strategy and the NHS People Plan was published in July 2020. The new plan builds on the Interim People Plan recognising the impact of COVID-19 and sets out what the people of the NHS can expect from their colleagues and leaders for the rest of 2020 and into 2021. Ensuring the wellbeing of NHS workers is met is a key highlight of the new NHS People Plan key which focuses on offering flexibility, delivering on equality, enabling service innovation and supporting excellent patient care. Regional ‘people boards’ are now being established to oversee local workforce strategies, in line with the plan’s vision to devolve more responsibility to regional integrated care systems when it comes to workforce planning.

COVID-19 has impacted these plans in a variety of ways. Some areas have been a resounding success and benefited greatly from the extraordinary emergency measures taken, while others have been significantly disrupted and may require a new approach.

Increasing international recruitment and tackling the nursing challenge have been particularly affected. Supply for nurses has far out-stripped demand for the first time and the increased numbers of nurses, coupled with the reduction in planned NHS activity, has meant many nurses outside those in critical care have found themselves underemployed for the first time in their careers. This phenomenon has created a financial challenge for a vast number of health professionals, as well as workforce suppliers in the UK.

It remains to be seen how the other key focus areas will be impacted in the medium to longer term.

Making it easier to support the NHS

Acacium Group recently provided a group-wide solution to support the flexible workforce strategy and mobilisation of healthcare staff for the Nightingale Hospital, London. It comprised a full recruitment process outsourcing (RPO) approach across all specialities; our dedicated account team was charged with determining the appropriate resourcing strategy and, ultimately, delivering on it.

We successfully identified and mobilised over 300 flexible staff who were all validated, trained and ready for duties across a broad range of healthcare specialities in under five weeks. Many of our learnings from this will help shape the workforce resourcing and capability strategy at a sustainability and transformation partnership (STP) level in support of their progression to integrated care systems by April 2021.

Utilising technology

The world-wide response to the pandemic has seen the accelerated use of digital technology. Whilst enhanced digital enablement has been high on the NHS agenda, there has often been a degree of caution and bureaucracy attached to the adoption of new technology.

At the outset of the pandemic, Acacium Group made several changes across the supply chain to facilitate improvements in speed to hire, applicant screening, verification and the validation process. This was particularly important in the validation of nurses applying to work in intensive care units across the NHS.

The impact of the pandemic made it very difficult and, in some cases, impossible for candidates to be released for face-to-face training and roaming field-based trainers were unable to deliver this in person. In light of the revised guidance from the Department of Health & Social Care on 16 March 2020, revisions were made to the compliance process to support the NHS at a time of significant strain. This decision was made after appropriate risk-assessment. Consequently, annual compliance checks were moved from 12 months to 18 months to allow for existing candidates to undergo the usual bloods and practical training for basic life support (BLS) and manual handling.

New candidates have been accepted without bloods if they have worked in the NHS previously and can provide previous evidence of fit-to-work

All other compliance aspects have been obtained digitally for new and existing candidates which is a more efficient process as well as a candidate preference

These measures enabled greater workforce availability which should be considered in future.

The urgency in demand also led to unprecedented collaborations and changes to the usual cascade rules which have delivered more timely and efficient results. Hirers have worked collaboratively on a preferential, and at times exclusive, basis which has proven to be far a more efficient way of expediting resourcing plans. Working with fewer suppliers on a more strategic basis and under agreed emergency measures to mitigate the impact of the virus are just some examples of lessons learnt that could be adopted and evolved in future.

None of these measures had any adverse impact on compliance, standards or patient safety. See Appendix 2 in the full report for more.

Further insight

This is the first in a series of seven articles from our ‘NHS workforce provision in a new world’ report. To access part two, where we look at restarting international recruitment, keep an eye on our LinkedIn.