Guest Blog: ‘Time for a workforce revolution?’

– Brendan Hill, Chief Executive, Concern Group

The third sector and its statutory colleagues share the same goal of aspiring to provide high-quality health and care services, at a time when demographics and finances alone provide significant challenge. There are a number of key agendas that affect us all:-

• A common goal of providing more holistic approaches to an individual’s health and wellbeing;
• Addressing the prevention and public health challenge to reduce the burden on specialist services and complex care;
• Implementing The ‘Five Year Forward View’;
• A shared understanding of the importance of the ‘Social determinants of health’;
• and the integration challenge for health and social care – i.e. integrating around individuals and their communities, rather than organisations.

As already illustrated in some of the Vanguard sites, new ways of working across professional and organisational boundaries are beginning to release the potential in local systems to focus on how to better provide and organise care around individual need. The permission to think and act differently, and having freedom to do things in a way that suits local need, will be key to success.

However, if we are serious about developing this approach across the whole system, we need to start thinking big. At least 75% of funding is usually spent on staffing services, so the type and number of staff we have, and how we remunerate them, is central.

I believe our biggest challenge (and opportunity) is to redesign our workforce around the needs of the people. A simple idea, and relatively obvious, but if we listen to what we are told, user experience would often indicate that this is not the way our workforces are currently arranged.

There is, of course, excellent care provided to many, and this should naturally be acknowledged. But this good quality care is all too often provided by dedicated staff in spite of the system they work in, as opposed to because of it.

I do not want my position to ever come across as ‘professional bashing’, as I am CEO of an organisation that has been predominantly nurse-led, which is my own professional background too. I believe we need to support and invest in our professions; refreshing their purpose, remit and skill base in order to increase their ability to serve our communities better.

With this in mind, can we now develop a serious conversation with statutory colleagues at the DH, NHS HE, PHE, ADASS, to name a few, on the following issues?

We would like to consider:-

• How might we look at the training and development requirements of existing professions, to ensure that they have ‘caught up’ regarding the importance of the social determinants of health, including a greater emphasis on promotion, prevention, and self-management?
• Can we review the professional development potential and ‘salary ceilings’ of some of our key frontline posts offering more potential for growth within their sphere of work?
• Can we ‘rearticulate’ and expand the supervisory role of the preeminent professions to support the wider workforce?
• How can the emerging non-professionally-aligned roles (including ‘navigators’ and ‘peer support’) be expanded and valued particularly with a view to develop improved cross sector workforce planning?
• How can we meet the need for flexible working, and improve the salaries and T&Cs of the lower-paid?
• How might we challenge the myth that we can tackle the chronic shortages in areas such as general practice, community nursing, psychiatry, etc, by continuing to rob other parts of the system, or chase staff that do not exist?
• How might we ultimately look at some professional roles and bandings with a view that the evolving health and care system might, in some instances, require ‘enhanced, but fewer’ of some to help fund the ‘revolution’?

Here at Concern Group we have begun to look at several key posts that we feel could be developed further in our psychological therapy, nursing and community wellbeing services with the aim of testing out some of the issues outlined above. Of course we do not operate in a vacuum and we would therefore welcome the opportunity to develop this conversation with our statutory partners, third sector colleagues, and professional bodies.

‘Workforce Revolution? A driver for change in health and social care.

If MHPF members have any comments on this blog, area of work or would like to share their views on workforce in the voluntary and community sector, please get in touch with a member of the MHPF team.