Agenda item

To provide an update on workforce issues in NCL.

The most recent previous update to the Committee on this issue was 30^th September 2022. To view the minutes from this discussion please see Item 21 at:

https://www.minutes.haringey.gov.uk/ieListDocuments.aspx?CId=697&MId=10431&Ver=4

The report for this item was introduced by Sarah Morgan, Chief People Officer at the NCL ICB, which was an update on NCL workforce issues and progress on key challenges following the previous update to the Committee in September 2022. She explained that the NCL ICS People Strategy was published in May 2023 with three main priorities of Workforce Supply, Development and Transformation.

Sarah Morgan said that retention was a particular workforce challenge and that the three main levers used to support retention were identified as Staff Health & Wellbeing, Equality, Diversity & Inclusion and Leadership & Talent. She noted the importance of helping people into careers in the context of the cost of living crisis and a decline in social mobility but that the NHS had a low percentage of staff under the age of 25 which represented a future challenge. The ICB was therefore investing in workforce as a strategic priority with a system team focused on this work.

In terms of challenges, she acknowledged issues with industrial action, low morale and low national recruitment levels for nursing places. However, in the NCL area, Middlesex University had a good record of bringing new nurses through, reliance on agency staffing had reduced and an award had been won for the NCL ICS Graduate Guarantee Programme.

She added that the ICB was also one of ten pathfinders in England to support care leavers into NHS careers in collaboration with local authorities. This was part of a national programme established in October 2022 to support care leavers into career pathways.

Sarah Morgan then responded to questions from the Committee:

• Asked by Cllr Clarke for clarification about ‘Bank’ staff compared to agency staff, Sarah Morgan explained that Bank staff were substantive staff that would take on additional shifts on flexible contracts, whereas agency staff were supplied by a third party provider. The ICB aimed to reduce reliance on agency staff through improved recruitment and better use of Bank staff.
• Asked by Cllr Atolagbe about retention and Equality, Diversity & Inclusion issues, Sarah Morgan said that there had been a lot of work in this area including with an anti-racism approach endorsed by the ICB Board in July 2023, through targeted development and opportunities and an anti-racism pledge on midwifery and nursing standards.
• Asked by Cllr Atolagbe about the progress of the Oliver McGowan Training (to provide care to autistic people with a learning disability) Sarah Morgan said that this had started in pilot form for clinical staff working face-to-face with patients and would also include online training for all ICB staff. Cllr Revah said that patients with learning disabilities in Camden had started using ‘passports’ explaining the best ways of supporting them in various circumstances and suggested that this should be used in other Boroughs.
• Asked by Cllr Atolagbe about engagement with care leavers, Sarah Morgan explained that there were a lot of relationships which provided routes into communities which helped to support care leavers, including the Prince’s Trust and Health & Social Care Academies.
• Cllr White requested clarification on the figures for medical vacancy on page 21 of the agenda pack (an increase by 2.8% to 5.8%). Sarah Morgan agreed to provide further details in writing. (ACTION)
• Cllr White queried whether government policy on immigration (particularly restrictions relating to income levels) was impacting on workforce supply. Sarah Morgan said that there had been heavy reliance on international recruitment, particularly in social care, so this would have to be monitored as it could be problematic in the short-term. However, the ICB did not want to rely too heavily on international recruitment as this was an expensive route and this was why there was a focus on expanding domestic recruitment.
• Cllr James requested clarification on the term ‘Staff Passports’ and ‘Portfolio Careers’ on page 40 of the agenda pack. Sarah Morgan explained that Staff Passports enabled staff to move more easily between organisations in London without the need for lengthy checks on information such as skills and training. ‘Portfolio Careers’ referred to staff with more than one role and a range of skill sets.
• Cllr Cohen raised concerns about the overall workforce gap, particularly in social care, and asked whether a national social care plan was required to address this, including pay and conditions. Sarah Morgan responded that the social care model was currently fragmented and siloed and acknowledged the difficulties nationally in addressing this gap with an ever-decreasing workforce and an ageing population.
• Cllr Chakraborty asked what actions would help to address the concerns of residents in the short-term on the current difficulties of accessing primary care services. Sarah Morgan acknowledged that international recruitment was one important route, but that retention was also important as NCL had a high leaving rate. This was being addressed through initiatives such as increasing flexible working and health and wellbeing measures.
• Asked by Cllr Atolagbe about monitoring, Sarah Morgan explained that there was an annual review each year and that a dashboard of performance indicators was also being created.
• Sarah Morgan added that the ICB was engaging with the WorkWell partnership programme which aimed to provide employment support for disabled people and people with health conditions and were hopeful that they could become one of the small number of Vanguard Partnerships that would carry out pilot work.

Cllr Clarke thanked Sarah Morgan for the presentation and noted that the Committee would welcome further updates in future about the care leavers initiative and the WorkWell partnership programme. (ACTION)