On 19 May, we invited our health and care colleagues to join Elspeth Griffiths, SCW director of HR, workforce and OD and other panel members, to consider what the future looks like. Here is our round-up and top takeaways from the event.
The panellists contemplated the changes that were made during the pandemic that could be embedded in business-as-usual as we move forward. One of the key drivers has to be that we retain the best developments and gains but recognise that it’s not all been positive for everyone.
With over 150 attendees, there was some lively conversation and useful insight shared. Elspeth was joined by Kate Jarman, director of communications and corporate affairs at Milton Keynes University Hospital, Henrietta Mbeah-Bankas head of blended learning and digital literacy project lead at Health Education England and Rosalind Penny who is the director of HR and OD for Buckinghamshire, Oxfordshire, and Berkshire West ICS.
The full webinar, made in association with HSJ, can be watched on-demand (you’ll need to register if you haven’t already).
Here are our top takeaways from the discussion on the NHS workforce in a post-pandemic world.
What is flexible working?
Although the pandemic has forced a more flexible way of working, an important distinction was raised that working from home shouldn’t be confused with flexibility.
It has to be remembered that not all staff can work from home and that for some roles it's simply not an option. For some, working from home can be invasive and adds pressure due to personal, cultural, and organisational factors. At the start of lockdown, arrangements were often not ideal for all. Some staff live in studio flats, some use ironing boards as a desk and there are other situations where working from home can be difficult and pose a variety of increased risks.
Offices offer safe spaces that some homes do not. Working from home was a decision made for staff due to the pandemic and while some have embraced this forced change, others are unable to, or simply prefer to be in an office.
Through open dialogue with members of staff, blended workforce offers should be considered to accommodate individual needs and experiences. This can be a challenge for managers, particularly when the success of flexible working can often be influenced by their attitudes. On one hand, managers understand that life can interfere with working, such as childcare and home environments. Other managers may be suspicious of how time is being spent and are less forgiving with interruptions to the regular 9-5 working day.
Acknowledging that people may need to work different hours, and highlighting the distinction between being at home and working is vital. But an emphasis on the outputs rather than the inputs is an adjustment that some still need to make.
Even in optimal circumstances, switching on/off when working from your living space can be difficult. This relies upon trust from managers that staff are managing their own time effectively in their personal situations. The details of how or when work is completed are not necessarily important if the output of work is of the expected standard. It is agreed that more groundwork needs to be completed to ensure that colleagues trust in their processes and their superiors trust in them as well.
The difference between communication and engagement
Keeping open communication between NHS staff ensures people are kept connected and feel heard during the pandemic. All panellists acknowledge how quickly staff adopted Microsoft Teams for meetings and recognise that non-business meetings are just as beneficial.
‘No agenda get togethers’ is one solution for social interactions, where colleagues are invited to virtual group discussions of TV shows or simply to have a catch up over a cup of tea. Additionally, specific health and wellbeing catch-ups have proven to be popular. These provide a safe space for staff - anonymously if preferred - to ask questions and share concerns, which can be answered directly and alleviate pressures that multiple staff are likely to be feeling.
It is clear with wellbeing surveys, assessments, and regular communications that staff have mixed experiences with work changes during the pandemic.
Firstly, it is recognised that not everyone has a conducive home environment to work from.
In some organisations biases have been revealed, notably in reactions to childcare. Similarly, cultural differences can be overlooked and opportunities to help missed based on lack of understanding. An absence of cultural awareness and surfacing of assumptions and bias should be addressed.
Additionally, new starters and those off on long-term leave such as for sickness, maternity, or paternity leave, are in danger of being forgotten in this new virtual world. It is important to check in on all staff whether they are ‘at work’ or currently ‘out of office' and this keeping-in-touch will become an even more important role for managers. This changes again for those in clinical settings where they are physically present at work.
Each role requires different communication channels and support for staff. For example, clinicians have had to adapt to PPE and social distancing measures as well as new ways to care for patients. Extra support, training, and in some cases trauma counselling, has been required.
Mobilising new teams at pace
Since March 2020, NHS organisations have had to quickly change how they operate and how to accommodate staff in the transition. Overnight, whole workforces were instructed to work from home and mobilising teams required extra resources such as laptops and equipment to work from home.
Some roles lend more easily to working from home. There is a worry that this will cause a divide between roles where individual preferences don’t align with organisational needs. Clinical staff were often still expected to continue as usual to care for patients. Other clinicians volunteered for other roles to support areas that needed it.
The NHS 111 SCAS service incorporated over 1,500 GPs to support with phone assessments and CCG staff found themselves in new roles in acute sectors, incident control centres, vaccination centres or being seconded to other practices to offer support and expertise.
The development of ICSs coinciding with organisational shifts during the pandemic has accelerated change even more and encouraged people into agile roles, which has caused personal growth alongside the discovery of new skills. Those that have found themselves in new roles may question whether they return to previous positions, or if they even have a choice.
How far away are we from being digital ready?
The pandemic has created more opportunities for innovative digital solutions. The consensus is that technology should continue to be utilised where possible and invested in for growth. However, not all staff are prepared to embrace this and prefer more traditional paper-based ways of working.
There should be a minimum expectation of digital literacy for roles, outlined within job applications. Not all roles need to be digitally advanced, but a common ground would make certain processes easier, and training can be offered so everyone is on the same page. Being digital-ready is more than having the skill, staff need to have the attitude to adopt digital tools, rather than default to old ways of working.
It is important to remember that patients make up our workforce and any technology we use to aid patient care needs to be accessible to them. Keeping, and developing more digital solutions to assist in patient care, can free up time for clinicians to offer in-person support that can’t be digitally replicated. Tech can be a great tool to transform patient care if it isn’t simply replacing it or ignoring patient and staff needs and limitations.