I’ve hinted at it but it’s time to say something.
I’m not alone. NHS Provider’s, Captain Mainwaring, signalled as much. He told Sky News on Sunday that he was;
‘… incredibly frustrated… that Mr Javid refused to sign up to a long-term plan for NHS recruitment, when it was… blindingly obvious… that it was needed to fill gaps in the workforce…’
There is a lesson in basic politics here.
Politicians won’t sign into law a requirement for ministers to have an annual workforce plan. They won’t, because they won’t bind future Parliaments, particularly, to a pledge that has such huge financial ramifications.
So, what happens now?
It looks to me the central issue is the relationship between No19, the NHSE/I and the competence of the Board.
Alas, it doesn’t strike me as being much cop and it’s likely to get worse.
A new chair Richard Meddings, has been appointed. He knows nothing, diddly-squat, about the NHS and social care and looking at his career, I’d bet the farm, he enjoyed the benefits of private medical care.
The Select Committee have reservations about his appointment but they are powerless to stop it.
He was FD at Standard Charter and left after a period of high losses, a rights issue and a cancelled dividend for the bank.
There is not one line in his impressive, corporate CV that I can see, has any connection to public service, or civil society.
The rest of the Board? With the notable exception of Ara Darzi, all corporates.
The former COO at NHSE, is now chief executive and has hardly hit the ground running.
Right or wrong, the impression she gives is, when No19 says jump, she asks ‘…how high off-the-ground’.
The NHS looks to me like it’s being run from the DH, badly and the DH is being run by No10, badly.
The problem is this…
… none of these people are bad people. I’m sure they want to do the right thing and service is seductive… but…
…none of them have the experience or the gravitational pull, to be able to drag the NHS out of the hole we are watching it slide into.
There is nothing in their collective experience that has prepared them for the task they are facing.
Capt Mainwaring is right, the key issue is workforce.
At this critical time there is no plan for the future of the workforce. How can any Board, serious about its governance and business, accept this?
Without a workforce plan the recovery plan, with probably a hidden 5 million yet to come forward for treatment, is worthless.
The plans to bring social and health care together, with an estimated 100,000 care vacancies, are pointless.
Why is the Board, its leadership, executives and non-executives, why are they silent on the biggest challenge the NHS is facing and indeed the biggest problem all health systems are facing.
Is there a foolish assumption that we are in some way impervious to the international forces buffeting workforce? There is a global bow-wave of post covid demand and a dearth of qualified people to deal with it.
Writing in the £walled Telegraph, reported in the Indy, No 19 said;
‘… the NHS aimed to recruit 10,000 more nurses from overseas and 5,000 more healthcare support workers by the end of March, to increase capacity.’
That is in 44 days time… it takes at least four weeks to get a standard DBS check never mind all the rest of the palaver.
As the Nuffield’s Claudia Leone, points out, don’t forget;
- ‘…accommodation
- flights
- language lessons
- the Objective Structured Clinical Examination
- tuition programme
- fees specific to non-EEA nurses
- alongside other expenses of inducting and mentoring nurses from abroad…
… and as the competition for nurse supply gets tougher… paying the health surcharge and even visa fees, where applicable.’
I have seen nothing in the NHSE/I board papers, nor any member that gets anywhere near saying;
‘… all bets are off until we know where the staff are coming from’.
The NHS, the people in it, the frontline, the back office, everyone, has to believe the Board has their back. Alas, it looks more like the Board just backed off.
They must challenge, stupid meddling promises about recovery, recruitment and social care that cannot be kept and will lead the public to believe the NHS has failed.
It has not and is not but it is being failed. The choice for the NHSE Board, is simple; bravery or political bravado.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
