Leadership in today’s NHS: delivering the impossible

The King’s Fund & NHS Providers | July 2018 | Leadership in today’s NHS: delivering the impossible

The King’s Fund & NHS Providers report the findings from their  survey of NHS trusts and foundation trusts conducted in 2017 by NHS Providers, the survey used qualitative interviews and a roundtable event with frontline leaders and national stakeholders.


Image source: kingsfund.org.uk

Among the findings from the survey:

  • Leadership vacancies are widespread, with director of operations, finance and strategy roles having particularly high vacancy rates and short tenures
  • A culture of blaming individuals for failure is making leadership roles less attractive. Organisations with the most significant performance challenges experience higher levels of leadership churn. National bodies need to do more to support leaders to take on and stay in these roles.
  • To tackle high leadership churn, national programmes should target professional roles  where concerns over the pipeline of future leaders is greatest. Regional talent
    management functions – largely absent since the abolition of strategic health authorities – should be rebuilt in the new joint NHS England and NHS Improvement regional teams (Source: The King’s Fund & NHS Providers).

The news release from  The King’s Fund  can be viewed here

The summary is available here 

The report can be read from The King’s Fund 

NHS Providers NHS trusts face worryingly high levels of senior vacancies

NHS Providers & The Kin’gs Fund Infographic 



Preparing the healthcare workforce to deliver the digital future

Health Education England | June 2018 | The Topol Review Preparing the healthcare workforce to deliver the digital future

Health Education England (HEE) has published its interim report on preparing the healthcare workforce for future developments. The review is considering four key questions:

  1.  How are technological (genomics, digital medicine, artificial intelligence (AI) and robotics) and other developments likely to change the roles and functions
    of clinical staff and their support in all professions over the next two decades?
  2. What are the implications of these changes for the skills required?
  3. For which professions or sub-specialisms are these likely to be particularly significant?
  4.  What does this mean for the selection, curricula, education, training, development and lifelong learning of current and future NHS staff?
Preparing the healthcare workforce
Image source: .hee.nhs.uk

Based on its work so far, HEE’s Review is proposing three key principles, which should govern the NHS’s future workforce strategy, these are: 
• Patients: If willing and able to do so, will be empowered by new tools to become more actively involved and engaged in their care. The patient generated data will be interpreted by algorithms enabling personalised self-management and self-care.
• Evidence: The introduction of any technology must be grounded in robust research evidence and a fit for purpose and ethical governance framework that patients, public and staff can all trust.
• Gift of time: Whenever possible, the adoption of technology should be used to give more time for care, creating an environment in which the patient-clinician relationship is enhanced.

The Interim Report June 2018- A Call for Evidence is at HEE 

How fixing the NHS’s broken pay system can deliver better outcomes for patients

An NHS bonus: how fixing the NHS’s broken pay system can deliver better outcomes for patients | Centre for Policy Studies

Image source: http://www.cps.org.uk

This report argues that by introducing greater flexibility into the system, and linking pay more closely with performance and objectives, both NHS productivity and patient outcomes could be improved. It urges the Government, and NHS managers, to make reform of the pay system an urgent priority as part of the new funding settlement.

Full report available here

Innovation in Medicine 2018: Government must double number of medical students

Royal College of Physicians | June 2018 | Innovation in Medicine 2018: Government must double number of medical students

A new policy briefing, Double or quits: calculating how many more medical students we need , from the Royal College of Physicians (RCP)  outlines new calculations for the number of doctors needed, and sets out the key issues facing workforce planning in the UK that affect current supply, future service demand and predicted losses in the workforce. The RCP  has called on the government to double the number of medical school places from 7,500 to 15,000 to meet the needs of tomorrow’s patients (Source: RCP). 

Double or nothing
Image source: rcplondon.ac.uk

The briefing paper is available to read here 
The new release is accessible from RCP




Redesigning care delivery

This case study looks at the work of Chesterfield Royal Hospital NHS Foundation Trust in using new models of care to overcome workforce supply challenges.

Image source: http://www.nhsemployers.org

Despite running proactive campaigns to recruit to nursing posts, the trust was unable to make up for the shortfall it was experiencing in the number of registered nurses in its workforce. Using the concept of building a team around the patient, based on identified skills needed to deliver best care, the trust looked at how it could make use of newly introduced band 4 roles, such as the nursing associate and the assistant practitioner.

This case study outlines how Chesterfield Royal engaged its staff to help develop the new team structure, addressed the issues this presented, and has got to a position where other wards are now looking to adopt model.

Full document available at NHS Employers


Our International Health Service

This report from Global Future looks at the difficulties the NHS is facing in attempts to attract the clinical staff it needs from the EU. The report discusses the need to ensure that the NHS is sustainable in the future by enabling it to continue to recruit staff from all over the world. 

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The NHS relies on staff from all over the world. Over a quarter of NHS doctors – including almost half in some vital specialities – and almost one in six nurses, are from overseas. But following the Brexit referendum the NHS is finding it increasingly difficult to attract the clinical staff it needs from the EU. The number of EU nurses is already falling, and the proportion of European doctors gaining a licence in the UK has fallen from 25% of the total in 2014 to just 16% in 2017.

This is making the NHS increasingly dependent on staff from outside the EU, who are being refused entry into the UK in their hundreds. Without relaxations in those restrictions and a commitment to erecting no new barriers to potential NHS staff from the EU after Brexit, the NHS will be unable to recruit the staff it needs.

Full report: Our International Health Service

UK needs a coherent approach to the recruitment of international doctors

The UK urgently needs a joined-up approach to recruitment of international doctors, according to BMJ editorial. 


An editorial in The BMJ, suggests that the UK government’s decision to review the visa regime for international doctors is “a rare glimmer of common sense in an issue that has been more usually characterised by national policy incoherence.”

However, they warn that the “underlying problems of the UK approach to international recruitment of health professionals” remains to be “acknowledged and addressed.”

These problems “owe much to a debilitating mix of conflicting policy goals and inadequate national health workforce planning and funding,” they explain. “This has led to a long-term ‘stop-go’ approach to international recruitment of doctors and other health professionals, which has often been misaligned with domestic health workforce and immigration policies.”

The article recommends more effective working between the Home Office and Department of Health to ensure that international recruitment is “fair and consistent”.

Full article: Buchan, J. & Charlesworth, A. | International rescue | BMJ  | 13th June 2018

See also: Joined-up approach needed to recruit overseas doctors | OnMedica