With regard to the NHS workforce crisis, it’s clear that we’re in ‘Save the Patient’ territory now.
Only, the patient here is, in fact, NHS staff.
Take care of our staff and they will take care of our patients – no argument there.
But without a wholesale shift from the NHS to looking after our frontline colleagues, prioritising their needs and well-being, we can’t expect them to look after patients the way they, and we, would like. The ‘end-game’ in this annual deterioration in staff morale (and willingness to work in a system that is so clearly broken) is the collapse of the incredible service levels that have been sustained for so long, albeit by a decreasing workforce year-on-year.
In this context, engaging and empowering staff to make them feel valued, respected, motivated and listened to at work is not an optional extra. It is literally at the heart of the survival of our NHS.
And this is not something that can be done by NHSI, SI, QI, CPI, or any other ‘I’ for that matter - unless of course the ‘I’ is the Trust CEO and every Executive Lead.
For it is the responsibility of the C-suite in an organisation to lead, own, devolve, and spread the creation of an environment where staff can prosper, free from the intolerable burden of trying to hit myriad targets that are unachievable with a workforce on its knees; free from having to prioritise everything but patient-facing time and care to administer to the multitude of other demands on them; free from having to work without enough support from absent colleagues or a management system that can’t plug the gaps; and free from a system that precludes widespread honesty and integrity around safety issues, and fosters a climate of fear to speak out. The whole well-intended creation of the Freedom to Speak Up Guardian in itself belies the size of the challenge we have to fix: if a staff member’s only recourse to raising a safety concern is to go to an individual who they feel ‘safe’ approaching, the culture and the leadership has already failed.
Unless we fundamentally shift what we measure - moving away from national targets and financially-driven goals - to measuring numbers of staff staying, and then, in time, numbers of staff returning to the NHS, the situation can only get worse. It is the role of local leaders to create a climate in which staff can thrive and do their best for patients. Top of the list of To Do’s is to ask staff how safe, effective, caring, responsive and well-led their service or specialty is. No-one knows better than the staff themselves what it’s like at the coal-face. Let their views and ideas be the drivers for change.
It’s time to stop doing what’s not working, and to pull the people lever like never before, putting the NHS’ most prized assets, its staff, at the centre of all we do.
Every other known lever has been pulled, expensively and expansively, for decades now - IT, process, operations, finance, infrastructure - with no substantial and sustainable turnaround in ‘direction of travel’.
If we succeed in understanding what gets in the way for staff today, and listen to what they need in order to deliver safer care tomorrow, in an environment that supports them, miracles happen - actual, incredible, fundamental changes for the benefit of staff, patients, the public, and the System.
The opportunity to get the ball rolling is here right now. And the proof? Ask these ‘game-changer’ leaders…