Is the NHS risking a talent drain as staff are tempted away from the sector?

Is the NHS risking a talent drain

The NHS is a prime example of a people-focused organisation. While patients are its main concern, its staff are its biggest asset. They’re also its biggest expense, with up to 70% of NHS expenditure allocated to salaries.

Both permanent and interim staff leading services are facing the growing challenge of delivering and overseeing care amidst funding cuts and efficiency drives.

Brexit is also adding to pressures, with ambiguity over the future ability of workers from inside the EU to continue working within the service after March 2019. Combined with long training times for doctors of seven years, and three years for nurses, the NHS’ sustainable pipeline of staff and skills, which it depends upon, is facing fresh uncertainty.

For staff, this is throwing up new challenges and tough decisions. Reports that nurses have been leaving the public health service, due to the NHS staff pay cap – limiting pay rises to 1 per cent a year until 2019 – have been widely circulated.

And now this trend is intensifying, with senior leaders also being tempted away from the organisation, and the wider health industry. Anecdotally, I’ve seen 27 HR Directors depart the NHS for new management roles in the education sector. This is a well-trodden path as the transition to education is relatively easy to make, the sector has similar values and dynamics and can offer some diverse role opportunities, notably in larger institutions.

The reasons for this shift are complex, and surprisingly to some involve more than just pay.

Firstly, morale in the NHS has been especially subdued over the last few years, more sharply than the normal ebbs and flows within a typical organisation. Causes are multi-faceted, but certainly the financial pressures coupled with the challenging agenda regarding workforce planning will have taken their toll on some senior leaders.

On top of this, bitter public disputes over junior doctor contracts and pay have negatively affected the morale of leadership teams and managers.

Other considerations include the lack of training on offer within the NHS, as budgets are diverted elsewhere. These factors combined are transforming a management job in the public health sector an increasingly high-pressure role.

Interestingly, the sector seemingly most benefitting from this exodus of managers is education, which can offer higher day rates than healthcare.

So, what does this mean for interim managers, who form a vital part of the NHS’ management capability?

Working across the functions of board roles, HR, procurement and IT, interims are privy to the tensions within the NHS at each level of management.

At a time when morale is low within the organisation, and managers are leaving – interims will be more needed than ever to fill skills gaps, but also offer change management expertise.

Interims are renowned for ‘turn-around’ roles, which the NHS could greatly benefit from. First however, the organisation needs a boost in morale and new investment in its staff, not just at a financial level but also in terms of benefits and retention measures.

The organisation must do so if it’s to hold on to its permanent and interim senior talent in the long-term and build a sustainable and stronger health service for Britain’s future.


Hugh Taylor at 04/12/2017 11:25 said:

Sarah - thanks for an interesting and well-reasoned article, which highlights al lot of the issues facing the NHS. However, with regard to interims, the one thing you don't mention is the depressed day rates due to the salary cap, plus the 'double whammy' of IR35. In my experience, NHS Trusts seem to be assuming that all interim roles are automatically within IR35. Whilst this situation persists, I think it will be difficult for the NHS to benefit from the pool of talent available on the interim market. There are plenty of other roles elsewhere in the public sector (for instance, I am just coming to the end of a 10-month assignment at the Health & Safety Executive), and I think the NHS has a real problem trying to attract good interims in the current climate.

Sarah at 05/12/2017 15:43 said:

Thank you for your positive comments, Hugh and I am pleased you enjoyed the piece. I understand your observation regarding IR35. I think the impact of the legislation is taking time to settle down and some organisations have a good grasp of what falls within and what falls outside of IR35, but you are correct, whilst there is ambiguity around the legislation within the service, thankfully there are roles outside which you can pursue; no doubt helpful given the current climate. These things go full circle eventually. Best wishes, Sarah

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