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Promoting diversity and
equalityA DIVERSE
 VALUING
WORKFORCE   IN THE NHS

SHA Conference


David Amos
10th July 2010
2
Promoting diversity and equality
Diversity and the changes ahead


The real business case for diversity and equality


The board’s perspective
The road ahead recovery
    periods
                          Employment recoveries from previous recessions - this
                           show the previous depth and extent of the impact on
                               s
                    1.0
                                            unemployment
                          pre-recesion peak of employment (1979Q4/
                                                                 1990Q2) =100 Q1. Workforce jobs, UK, seasonally a
                                                                 djusted

                    1.0



                    1.0
              100




                    1.0
     index Q1=




                    0.9



                    0.9



                    0.9
                                               1980s                   1990s


                    0.9
                                                11

                                                      13

                                                            15

                                                                  17

                                                                        19

                                                                              21

                                                                                    23

                                                                                          25

                                                                                                27

                                                                                                      29

                                                                                                            31

                                                                                                                  33

                                                                                                                        35

                                                                                                                              37
                     1

                           3

                                 5

                                      7

                                           9
                    Q

                          Q

                                Q

                                     Q

                                          Q

                                               Q

                                                     Q

                                                           Q

                                                                 Q

                                                                       Q

                                                                             Q

                                                                                   Q

                                                                                         Q

                                                                                               Q

                                                                                                     Q

                                                                                                           Q

                                                                                                                 Q

                                                                                                                       Q

                                                                                                                             Q
4
fThe changing
                                  workforce the educated                                                                                          and
                                  qualified workforce 170-2005
                                  UK, share of total workforce with degree or equivalent (better educated) and share with just basic schooling.
                                  Source: EU KLEMS database.




                            70

                                                                                                                                          U Better educated
                                                                                                                                           K
                                                                                                                                          U N qualifications
                                                                                                                                           K o
                                                                                                                                          U better educated
                                                                                                                                           S
                            60




                            50
share of total employment




                            40




                            30




                            20




                            10




                            0
                                 _ 9 0
                                  1 7    _ 9 2
                                          1 7    _ 9 4
                                                  1 7    _ 9 6
                                                          1 7    _ 9 8
                                                                  1 7    _ 9 0
                                                                          1 8    _ 9 2
                                                                                  1 8    _ 9 4
                                                                                          1 8    _ 9 6
                                                                                                  1 8    _ 9 8
                                                                                                          1 8    _ 9 0
                                                                                                                  1 9    _ 9 2
                                                                                                                          1 9    _ 9 4
                                                                                                                                  1 9    _ 9 6
                                                                                                                                          1 9    _ 9 8
                                                                                                                                                  1 9    _ 0 0
                                                                                                                                                          2 0    _ 0 2
                                                                                                                                                                  2 0    _ 0 4
                                                                                                                                                                          2 0


                                                                                                                                            5
The new government’s policy
approach – implications for
the workforce
   Funding and efficiencies

   Employment legislation

   Pay and regulation

   Organisational changes

   Operational performance

   Devolution to the front-line healthcare professional

   Independent and third sector providers

   Welfare to work programme

   New training support and system
A real business case:
St Not Very Diverse (lower quartile) NHS Trust

3,000 staff


£150m turnover


500,000 patients treated each year one way or another


 How does it perform as a result of its approach?
St Not Very Diverse (lower quartile) NHS Trust
          Financial accounts 2009/10



Not employer of first choice     (£1m)
    Lost productivity
    Recruitment difficulties
    Advertising costs
    Lack of candidates


Legal cases                      (£0.3m)
    Legal advice and representation
    Compensation claims and settlements
St Not Very Diverse (lower quartile) NHS Trust
           Financial accounts 2005/6



Poor quality of patient services (£2m)
    Faulty communication
    Inaccurate diagnoses
    Choice goes West
    Repetition

Lack of leadership and teamwork(0.5m)
    Poor decision-making
    Duplication
    Under-performance
St Not Very Diverse (lower quartile) NHS Trust
           Financial accounts 2009/10



Total lost income and unnecessary
costs   :        (£3.8m)

   Or 6% of turnover
   Or 2000 cataract operations
   Or 150 extra staff
Getting the most from
              everyone
                   Consultants and   Senior Managers
          9

          8

          7

          6
Payband




          5

          4

          3

          2

          1




                                                       12
Dealing with tensions and risks
   The three lines of unemployment:
     • Contrasting needs and competition
   Quality skills, quality services
     • Investing in skills when cash is tight
   Investing in the future graduate
     • Reducing commissions which might be a problem later
   Learning lessons from the past
     • Should we let history repeat itself
   Balancing the short with the longer term
     • Taking on those when jobs get tighter later on (or now even)
   Taking on and letting go
     • Appointing apprentices and making others redundant
   Delayering and cherishing the first-line manager
     • Taking out back-room costs and relying on local leadership
   Encouraging engagement and taking difficult decisions
     • Getting staff to engage when they are increasingly unhappy
   Interventions which bump into each other
     • Overlapping and relabelled initiatives




                                                                      13
Good practice - In practice

 Organisational values
 Track record in developing existing staff
 Support for the Skills’ Pledge and skills
  development
 Top level commitment to staff engagement
 Alternatives to compulsory redundancy
 Active in Local Employment Partnership
 The principles of diversity and equality put into
  practice
 Take up of latest employment and training
  initiatives
 Effective performance management and HR management
  practices
 Sufficient capability and capacity to deliver
 Innovative in HR practice and organisational
  development
                                                   14
15
David Amos
david@davidamos.net
07976424218




                      16

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Promoting diversity in the NHS workforce

  • 1. Promoting diversity and equalityA DIVERSE VALUING WORKFORCE IN THE NHS SHA Conference David Amos 10th July 2010
  • 2. 2
  • 3. Promoting diversity and equality Diversity and the changes ahead The real business case for diversity and equality The board’s perspective
  • 4. The road ahead recovery periods Employment recoveries from previous recessions - this show the previous depth and extent of the impact on s 1.0 unemployment pre-recesion peak of employment (1979Q4/ 1990Q2) =100 Q1. Workforce jobs, UK, seasonally a djusted 1.0 1.0 100 1.0 index Q1= 0.9 0.9 0.9 1980s 1990s 0.9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 1 3 5 7 9 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q 4
  • 5. fThe changing workforce the educated and qualified workforce 170-2005 UK, share of total workforce with degree or equivalent (better educated) and share with just basic schooling. Source: EU KLEMS database. 70 U Better educated K U N qualifications K o U better educated S 60 50 share of total employment 40 30 20 10 0 _ 9 0 1 7 _ 9 2 1 7 _ 9 4 1 7 _ 9 6 1 7 _ 9 8 1 7 _ 9 0 1 8 _ 9 2 1 8 _ 9 4 1 8 _ 9 6 1 8 _ 9 8 1 8 _ 9 0 1 9 _ 9 2 1 9 _ 9 4 1 9 _ 9 6 1 9 _ 9 8 1 9 _ 0 0 2 0 _ 0 2 2 0 _ 0 4 2 0 5
  • 6. The new government’s policy approach – implications for the workforce  Funding and efficiencies  Employment legislation  Pay and regulation  Organisational changes  Operational performance  Devolution to the front-line healthcare professional  Independent and third sector providers  Welfare to work programme  New training support and system
  • 7. A real business case: St Not Very Diverse (lower quartile) NHS Trust 3,000 staff £150m turnover 500,000 patients treated each year one way or another  How does it perform as a result of its approach?
  • 8. St Not Very Diverse (lower quartile) NHS Trust Financial accounts 2009/10 Not employer of first choice (£1m)  Lost productivity  Recruitment difficulties  Advertising costs  Lack of candidates Legal cases (£0.3m)  Legal advice and representation  Compensation claims and settlements
  • 9. St Not Very Diverse (lower quartile) NHS Trust Financial accounts 2005/6 Poor quality of patient services (£2m)  Faulty communication  Inaccurate diagnoses  Choice goes West  Repetition Lack of leadership and teamwork(0.5m)  Poor decision-making  Duplication  Under-performance
  • 10. St Not Very Diverse (lower quartile) NHS Trust Financial accounts 2009/10 Total lost income and unnecessary costs : (£3.8m) Or 6% of turnover Or 2000 cataract operations Or 150 extra staff
  • 11.
  • 12. Getting the most from everyone Consultants and Senior Managers 9 8 7 6 Payband 5 4 3 2 1 12
  • 13. Dealing with tensions and risks  The three lines of unemployment: • Contrasting needs and competition  Quality skills, quality services • Investing in skills when cash is tight  Investing in the future graduate • Reducing commissions which might be a problem later  Learning lessons from the past • Should we let history repeat itself  Balancing the short with the longer term • Taking on those when jobs get tighter later on (or now even)  Taking on and letting go • Appointing apprentices and making others redundant  Delayering and cherishing the first-line manager • Taking out back-room costs and relying on local leadership  Encouraging engagement and taking difficult decisions • Getting staff to engage when they are increasingly unhappy  Interventions which bump into each other • Overlapping and relabelled initiatives 13
  • 14. Good practice - In practice  Organisational values  Track record in developing existing staff  Support for the Skills’ Pledge and skills development  Top level commitment to staff engagement  Alternatives to compulsory redundancy  Active in Local Employment Partnership  The principles of diversity and equality put into practice  Take up of latest employment and training initiatives  Effective performance management and HR management practices  Sufficient capability and capacity to deliver  Innovative in HR practice and organisational development 14
  • 15. 15