Agenda item

To provide an update on workforce issues in NCL.

The most recent previous update to the Committee on this issue was on 29^th January 2024. To view the minutes from this discussion please see Item 46 at:

https://www.minutes.haringey.gov.uk/ieListDocuments.aspx?CId=697&MId=10545&Ver=4

Report to follow.

The Chief People Officer to the NCL ICB introduced the report.

In addition to the report, the Committee learned that:

·         It was a challenging year for people managers. Industrial action and a spike in respiratory illnesses nationally had put strain on the workforce.

·         With regards to medical and dental clinical and nursing roles, vacancies had dropped and there was good sustainability in the workforce currently.

·         The WorkWell project had enabled better joint working between medical departments. Patients who needed support where automatically being referred to a Health and Wellbeing Coach for extra support.

·         The Shaw Trust had supported 3,000 residents into work.

·         There was work to support care leavers and care experienced young people into employment with the NHS. Forty care leavers had been engaged. The project was funded by Drive Forward and NHS England would be supporting 25 extra places.

The floor was opened to questions.

The Chair enquired for further information on Health and Social Care Hubs. The Chief People Officer explained that the General London Assembly had funded five Health and Social Care academies across London to support the least represented in the workforce in London. In addition, work was carried out with every employment hub to support those in care.

The Chair pointed out that although 40 care leavers had been supported only 10 had been offered employment at the end of the year- she questioned whether this was value for money. The Chief People Officer responded by stating that the Care Leavers Programme is funded by the third sector. She explained that intensive support into work was needed for those in care, as many had mental health issues, and were transitioning from a life in care into work. She added that Line Managers needed support to help keep Care Leavers in work – the ICB had created training programmes to address this.

The Chair then asked further about access to the extra micro funding to help care leavers into work -such as free prescriptions, help with transport costs and interview costs. The Chief People Officer explained that councils and multiagency groups were responsible for these.

Cllr Atolagbe enquired how long this extra support was given to care leavers. The Chief People Officer explained that the line manager training should support care leavers throughout employment, however the intensive mentoring programmes for those entering employment was twelve-weeks. She added that there was a challenge around the availability for entry level jobs in the NHS, which is why 10 employment placements was considered a success. 

Cllr Atolagbe referred to the metrics in the WorkWell report. She enquired as to why there was a ‘Did not start’ category (on page 58). The Chief People Officer responded that some did not qualify for the programme. For example, those who worked but did not live in North Central London would not qualify. She added that residents would also have to commit to time with the Work and Health Coach - who would support them in or back into work if needed.

Cllr Chakraborty highlighted the positive steps that had been made in decreasing vacancy rates. He enquired what policies work well to reduce these rates. The Chief People Officer responded that the main driver for filling vacancies was reducing bank and agency staff. Managers enjoyed the flexibility (especially in terms of budget) when employing agency staff however there was a balance between this flexibility and providing and monitoring more substantive roles. Performance in these more substantive roles, was also key, as the ultimate aim would be to reduce the work force through increasing productivity as budgets were tight. Cllr Chakraborty responded that productivity was only part of the puzzle, he asked whether the ICB had sufficient platforms to talk to government about policies that effect domestic supply. The Chief People Officer responded that there was still heavy reliance on international recruitment especially for areas such as mental health and advanced medical practice. Steps to grow domestic supply was hampered by the curriculum in higher education in the UK, as changes to the curriculum can take up to five years . She added that work with NHS Change had identified this. She also added that there were very high rates of anxiety and mental health issues amongst young people in London, which led to low rates of employment. Also, the NHS was not seen as an attractive career choice by many.

Cllr White commented that there was a disconnect as to what the Committee scrutinised in terms of policies and strategies and what was experienced everyday by the NHS. Cllr White asked how the Committee could scrutinise the theory that reducing staff would increase productivities and not lead to reduction in services. The Chief People Officer replied that there was a shift in providing care - from a Hospital to a Neighbourhood Model, where changes to funding meant more projects and care being provided in community settings, more focus on prevention and more focus on digital services. This would ensure that reducing staff did not mean a reduction in services. She added that  since the COVID pandemic, the UK particularly had seen more direct links of the determinants of health as wealth. She stated in this sense the UK was the opposite to Europe.

Cllr White suggested that next year, the Committee should consider more in-depth  information about productivity and the shift to the Neighbourhood Model. The report should focus more on what is meant by ‘productivity’ and what the effects are on the wider outcomes - namely have patients quality of life improved in anyway as a result of this. ACTION

Cllr Atolagbe enquired about the metrics in the report. The Chief People Officer clarified that the metrics dashboard was actually indicative as it was under development. She clarified that some metrics especially on the Workforce Race Equality Standard, and Workforce Disabilities Equalities Standard was only measured during a time period, once a year.

The Chair requested that next year more information about the Neighbourhood Model be presented as part of the Workforce presentation and in addition other service delivery partners should be involved. This was in order to understand how the shift to the Neighbourhood Model would affect the outcomes to patient in greater depth. She stated that this should be given a minimum of an hour on the agenda to allow for greater scrutiny.  ACTION

Cllr Chakraborty added that more information was needed on what was being done to make the NHS more attractive to job seekers. He acknowledged the increase of training of domestic talent but highlighted that conditions had to be attractive for people to stay. He asked for more information around working conditions, and what could be offered to those graduating as an incentive as it was acknowledged that the pay was not competitive. ACTION

The Chair added that information be provided on the kind of mentoring that could be offered to help those at entry level grow within the organisation and across the public sector. ACTION 

Ms Morgan suggested bringing this information back to the Committee when the  NCL ICB ten year plan had been approved. She added that she felt there was much more that could be offered by the ICB to become an attractive employer to young people especially when it came to flexibility.