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networkIssue 69October 2007The newsletter of the Healthcare People Management AssociationInside2Immigration: changeson the horizonInside and out ...the HR challengesof working at Broadmoor Hospital3Lee - ding the MedwayHELP – HPMA ExpertLearning Partnerships4A new framework forpre-employmentchecks in the NHSCan employees setup in competition tothe NHS5Passing it on: Whatabout the employeesWorking Time Directive20096The only way is upHPMA Webwatch7Ask the expertsWanless on progress8Aiming for the top:helping members todevelop their skillsHealthcare People &Money: clinical keysDeborah O’DeaPresidentAlex O’GradyExecutive DirectorHPMA head officeGothic House, 3 The GreenRichmond TW9 1PLTel: 020 8334 4530Fax: 020 8334 4531Email: to right: Alex O’Grady, Kelvin Cheatle and Lynda Dyson atBroadmoor Hospital.In 1992, following the death of a black patient inseclusion, Sir Louis Blom Cooper QC described theHigh Secure (or Special) Hospitals as “great institutionswhich bore all the hallmarks of being detachedfrom contemporary healthcare standards”.Fast forward to 2005 and the HealthcareCommission’s report following an inspection ofBroadmoor Hospital about which, they commented,“We were impressed by the attitude of staff and therange of innovative treatments and therapies available,that are at the leading edge of contemporary practice”.So what changed to deliver this apparentrevolution in this world famous organisation?Whilst Blom Cooper’s withering verdict may havebeen harsh, and somewhat unfair, there is no doubtit represented the perception that Broadmoorand the other English high secure hospitals weredark, satanic places that no self-respecting healthprofessional would choose to work in. Indeed manyviewed them as prisons not hospitals.I joined Broadmoor in 1996 as their first, and at thetime of writing (!) only HR Director (Broadmoor becamepart of the much larger West London Mental HealthTrust in 2001), and the changes have been of massiveproportions. I often use the analogy of the evolutionaryclock to describe it: Broadmoor was opened in 1863,and until the late 1980s nothing much changed - allthe major revolutions in care and staffing practicehave been condensed into the past few years.So what part has the HR function played in thisrevolution? Well I like to think a very large part, andit is a good case study for how cultural change canbe achieved if the key ingredients are in place. Firstly,I have been lucky in working for two chief executives(and executive boards) who understood the need tochange culture, not just tinker with structures andsystems, and they have led from the front. They havealso both supported the HR function and I have seenat first hand how crippling it is for colleagues whodon’t enjoy this synergy – they face an uphill struggle.Secondly a root and branch review of recruitmentpractices was needed. Broadmoor used to recruit 90%of its staff from within the local community; that builthuge loyalty and strength but also brought introspectionand stagnation. The % of BME staff when I joined in1996 was 3% against a patient population of 25%;today that figure is 20% representing 20 differentnationalities and it shows in the climate of theorganisation-outward looking and truly multi-cultural.Broadmoor is one of the places to work today ifyou are passionate about psychiatry.Thirdly, working practices had to change.Broadmoor bore all the hallmarks of institutionalHR practice-inefficient shift systems, huge levels ofovertime, long term residences in staff hostels (atrock bottom prices) and the statutory “staff club”where staff “relaxed” before and after work. It wasBroadmoor from the “cradle to the grave”.The only way to achieve this change was by strongleadership but also working with staff and Unions.When I arrived at Broadmoor management andUnions were not even talking to each other andhostility bristled in the air. I had my car vandalisedon numerous occasions and mysterious phonecalls in the night followed a major disciplinary case.The Prison Officers Association (POA) were seenas out of date and threatening.Today, the POA are chairing our staff side witha seat on the Board and Simon Crawford, the ChiefExecutive, and I became the first NHS managersever to address their national conference this year(not only was addressing conference daunting, butwe were the warm up act for Tony Benn!)So long before Agenda for Change, we had to invent“partnership” as without it the organisation wouldstill be in its post Victorian time warp. The buildingsare changing, the practices have changed and the staffare... well, I think they are pretty heroic, doing adaunting job and, just like the other best staff inthe NHS, doing their very best for patients. Afterall, that’s what Broadmoor is about – it’s a hospital.Kelvin CheatleDirector of HR, West London Mental Health TrustContinued on p2

Continued from p1...let’s get on with the jobLast month Kelvin invited HPMA Executive Director Alex O'Grady along to Broadmoor Hospital to meet some of thestaff and look around the facility. Alex shares some of her thoughts on the inspiring experience, “When Kelvin askedme if I would like to visit Broadmoor, I was both fascinated and a tiny bit spooked. Why? Well I think that Kelvin has hitthe nail on the head when he says that we tend to think of such institutions as prisons not hospitals. However, I wastremendously impressed with the tranquillity of the place and the commitment of staff, many of whom are internationallyrecognised leaders in the field of forensic psychiatry.“I was also struck by the way in which Kelvin and his team work as key players and leaders of service delivery.The thing that really stood out for me, and I speak as someone whose background is almost entirely in the acute sector,was the unassuming approach and lack of arrogance shown by those who are working in one of the most challenginghealthcare settings. Many acute organisations are, in my experience, proud and rightly so of their excellent services.Sometimes this is to the point where the words ‘world class’ slips into almost every sentence! At Broadmoor, a trueworld leader in its field, a quiet ‘let’s get on with the job’ attitude belies their extraordinary work.“Kelvin and his team were overall winners of our excellence awards this year and they really do deserve this recognitionof their world class HR practice.“I have often said that working in HR in the NHS is the best job in the world and Kelvin’s is certainly up there withthe best of the best!“Thank you Kelvin, for a fascinating insight into your world.”Immigration: Changes on the horizonComing months will see an overhaul of the ways in which nationals from outside theEuropean Economic Area (EEA) can come to the UK to work, study or train.Anyone responsible for recruitment needs to be aware of the changes, especially asthe penalties for employing illegal workers are to be tightened up later this year.Points Based SystemNon-EEA nationals will only be allowed to come to theUK to work or study if they score enough pointswhen assessed against criteria such as qualifications,earnings and age.The number of points needed, and the criteriaagainst which they will be awarded, will dependon the category into which the individual falls.There will be five tiers in all:● Tier 1: Highly skilled individuals and entrepreneursexpected to contribute to growth and productivity● Tier 2: Skilled workers with a job offer to fillgaps in the UK labour force● Tier 3: Limited numbers of low-skilled workersneeded to fill specific temporary labour shortages● Tier 4: Students● Tier 5: Youth mobility and temporary workers.The government has also said that skilled workerswill need to satisfy an English language test.SponsorshipThose within Tiers 2 to 5 will also need a certificateof sponsorship from the organisation with which theyintend to work or study. However, only organisationsthat appear on the Border and Immigration Agency’snew register of approved sponsors will be able toissue certificates.TimingThe new system is to be phased in over a period of ayear, with Tier 1 to be launched in early 2008, Tiers2 and 5 later in 2008 and Tier 4 in early 2009 (nodate has yet been fixed for Tier 3). In the meantime,health sector employers would be well advised to applyto join the register of approved sponsors in goodtime: the Home Office is hoping to open the registerin October 2007, at which point it will be possibleto submit applications online. Further informationis available at Yates, partner, Eversheds LLPtracyyates@eversheds.comDATES FOR YOUR DIARY● NHS Employers annual conference and exhibition 2007:Leading workforce thinking 9-11 October 2007 ICC,● Welsh HPMA branch ‘HR Benefits for You’ 9 November 2007 Cardiff● HPMA NI branch conference 6-7 March 2008 Belfast2

networkLee - ding the MedwayOn 20 September, Cheryl Lee was appointed HRDirector at Medway NHS Trust. It’s an amazingachievement for someone who’s only 28, and wehope that it will give inspiration to members.At the end of her second day in post, Network askedCheryl how she felt about her new position, “I wasreally pleased to accept the role of Director of HRat Medway NHS Trust. I’ve been working at Medwayfor 3 years already, I know the size of the agendaand I feel that my personality and values fit wellwith our aspirations.“My previous line managers have been inspirational,constantly challenging my comfort zone and they’vehad a huge influence on my values and workingpractices. I’m glad that I’m still in touch with bothAli Mohammed, Director of HR at Brighton and Sussexand Pauline Fryer, Director of HR at RotherhamPCT, they offer me a listening ear, great advice andthe confidence to deliver.”Ali Mohammed, also branch chair of the SouthEast HPMA Branch, was delighted to hear of Cheryl’ssucess, “A per chance meeting at a bar in Boston (!)led to Cheryl and I meeting. Weeks later she wasworking for me as Assistant Director of HR at MedwayNHS Trust. I think what makes Cheryl exceptional isher ability to move seamlessly between the strategicand operational. Her grasp of the technical HRemployee relations issues is second to none. She hasan amazing work ethic and truly relates everythingto the business needs of the NHS. Add to this,a charming personality and a winning smile andmanagers are ‘eating out of her hands’.“I fully expect her to go on to the highest levelsof people management in whichever sector shechooses. The NHS would be wise to hang onto her.”HELP - HPMA Expert Learning PartnershipsThis Autumn HPMA are launchinga new mentoring and buddy schemefor members.The scheme aims to help members find mentors,mentees or buddies, but also to support membersin these new professional learning relationships.Based around our existing branch network, wewant to strengthen cross-organisational links andcontinue to develop the HPMA community acrossour branch network.If you would like to be a mentor, find a mentoror find a buddy (professional colleague at a similarcareer stage to yourself) with the HPMA scheme,you simply need to complete an application formwith your details.Good mentoring relationships begin with goodmatches so we will also ask you to include a fewwords outlining what you hope to gain from yournew mentor or buddy relationship.Capitalising on the knowledge and skills withinour branches, great efforts will be made to matchmentors, mentees and buddies with complementaryaspirations. The HPMA mentoring and buddyscheme aims to introduce members to rewardingnew relationships that really add value to theirworking lives.Some do’s and don’ts● Do be clear about your motives for helpingyour mentee or buddy. If you’re not sureyourself, your partner will get mixed messagesfrom you.● Do look after your mentee’s or buddy’s needs,but consider your own as well. Be certain aboutwhat you want from the relationship and whatyou’re willing to give.● Do be prepared for the relationship to end.The successful mentor-mentee cycle requiresthat the mentee moves on and the relationshipeither ends or takes a different form.● Don’t give up right away if your mentee orbuddy resists your help at first. S/he may notrecognise the value of what you have to offer.Persistence – to a point – may help.● Don’t have a pre-conceived plan for the finaloutcome of your relationship● Both parties should be prepared to learn● Do aim to empower your mentee or your buddy● Don’t just offer lip service● Do establish the confidentiality of yourrelationship● Initially do provide a structure to your sessions,and as the relationship develops, so formalitycan lessen.You can find more information onthe HPMA website or take a lookat the following helpful mentor to be a better you want to be a a to be an effective and mentoringExecutive Director Alex O’Gradywill be launching the HELPscheme at the NHS Employersconference and exhibition (9 –11October, ICC Birmingham), visitthe HPMA stand and sign up.3

A new framework for pre-employmentchecks in the NHSThere have been recent developments in theregulatory framework, tools and guidance availableto employers to ensure their mechanisms forcarrying out pre-employment checks. Thesedevelopments are summarised below;● The Border and Immigration Agency( have developed newservices to enable employers to make a saferand better informed decision when consideringapplications from migrant workers. These takethe form of an Employer Helpline at 0845 0106677 and an on-line interactive guide A newEmployer Checking Service will be piloted overthe coming months offering a range of differingchecking services for employers, ensuring thatemployers are better able to interpret passportsand keeping employers informed of outstandingapplications or appeals currently with the Borderand Immigration Agency. It is envisaged thatthe Checking Service will eventually incorporateidentity checking as part of its service.● The fast track PoCA (Protection of Children ActList) service will be withdrawn from 1 October.Now that the CRB (Criminal Records Bureau)are achieving their targets for both Standardand Enhanced Disclosures the original need forthe service no longer exists. What this meansfor employers is that from now on an applicantmay not commence employment in a regulatedchildcare position until the full CRB disclosurehas been received.● On 1 July 2007, Parliament approved two newamendments to the Exceptions Order of theRehabilitation of Offenders Act 1974. The twoamendments include staff who are giving adviceto children over the telephone or via electroniccommunication such as email and text messagingand those staff who have access to ContactPoint – a new national database containing basicinformation about children in England. Thesecategories of staff will now require enhancedCRB disclosures.● Finally, a new scheme run by the newIndependent Safeguarding Authority (ISA) is inthe process of being established with statutorypowers to protect children and vulnerable adultsfrom risk of harm. The scheme will be run bythe CRB and will be phased in over a numberof years from Autumn 2008. NHS Employers iscurrently in the process of co-ordinatingemployer responses to a national consultationon the new scheme. Interested employersshould view the full consultation document onthe DfES website those HR practitioners involved in co-ordinatingrecruitment in the NHS it is important to keepabreast of these developments and you can do soby regularly reviewing the NHS Employers websiteat Gregory, Consult GEE NHSCan employees set up in competition to the NHS?4chamberlain dunnEmployingNurses & MidwivesThe online report on employment trends and dataEmployingDoctors & DentistsThe online report on employment trends and dataEmployingAHPs & Health ScientistsThe online report on employment trends and dataEmployingHealthcare ProfessionalsThe online report on employment trends and dataWith the healthcare market becoming increasinglycompetitive, NHS organisations, foundation trusts,private providers, clinicians and GPs can find themselvescompeting for healthcare work.In the September issue of Employing HealthcareProfessionals, Andrew Rowland of Capsticks exploresthe particular problem arising when NHS practitionersfind themselves, through their private interests,competing with their employer for work. The BMAhave recently issued advice to its members entitledPractitioners Working in Competition with NHSEmployers which clarifies what is possible withinthe consultants’ contract – at least from the doctor’spoint of view.Mr Rowland concludes that the contract and theduty of fidelity can act to prevent practitioner fromsetting up in competition to or working in competitionwith their NHS employers. He points out, however,that establishing whether the duty of fidelity hasbeen breached is difficult. His recommendation isthat healthcare organisations seek to agree localprotocols to delineate clearly the extent to whichpractitioners may work for other organisations.Employing Healthcare Professionals is publishedfour times a year and is available free of charge tosubscribers to any of our other newsletters:Employing Doctors & Dentists, Employing Nurses &Midwives and Employing Allied Health Professionals.To sign up for regular free news updates and forsubscription details of all our healthcare employmentreports go to Each reportis now available for purchase separately at £19.95.Alison DunnEditor in chief, Chamberlain Dunn employmentreports

networkPassing it on: What about the employees?Dear Ali,In the relatively short time I have been in human resources I have repeatedly heard about the need for the profession to moveaway from the ‘tea and tissues’ role it may have taken in the past. I for one believe in and agree with the more strategic andbusiness focused direction our profession is taking, since the impact we currently make, and can have in the future, is huge.However, I have at times wondered where this leaves us in regard to our role of supporting staff when they need an outletfor their frustration and workplace worries. I know occupational health are there to help with this and the unions can beinvaluable in their role of supporting staff but I still wonder what role we should play.My impressions are that staff still think of us when problems arise, but our role in supporting managers, being perceived as‘enforcers’ and taking a much more strategic role places a big negative wedge between us and the majority of staff not inmanagement positions. Attitudes and actions that seem to look down on general staff have seemed to me to be indicative of this.At times this leaves me in conflict (and possibly others) as to how I should respond to their cries for help (slightly dramaticbut you get the gist)! Am I a staffside rep in the making, a bit too much of a softy (polite answers only please readers) or justaware of an inherent conflict as human resources develops as a profession?Your thoughts would be welcome on this month’s caring thoughts!RegardsBill Davies, Senior HR Advisor, Imperial College Healthcare NHS TrustBill Davies, NHS HRmanagement graduateDear BillAh, it’s good to see that the H still exists in HR… There is absolutely no conflict between being firm, fair and decent topeople. They say that in addition to love, a child needs discipline almost as much to develop properly (not disciplinary in theHR sense of course!). People managers could learn a lot from child psychologists and teachers of parenting skills.I’m glad you raised the issue of being seen as ‘enforcers’. In my own mind it conjures up the wrong mental image.Perhaps a more appropriate word may be ‘enablers’ or ‘upholders of standards’. I honestly wouldn’t advocate ever usingthese words in practice if you want to be taken seriously, but it may worth thinking of them as a working philosophy.In addition, the role we can play is to have our ear to the ground. Any manager worth their salt walks the turf. Weshould too. Maintenance engineers check their machines regularly for signs of wear and tear. Now before you get thewrong idea, all I’m saying is that by HR people getting out and about a bit, they can take the pulse of their organisationsdirectly while checking that policy initiatives and corporate messages are getting through to the frontline.That’s not ‘tea and tissues’, that’s good people management and excellent HR practice. All the best from the sunny southcoast in Brighton.Best wishesAli Mohammed, Director of HR, Brighton & Sussex University Hospital NHS TrustAli Mohammed, HPMASouth East Branch ChairWorking Time Directive 2009In 2009 the maximum hours that junior medicalstaff in the NHS work will be reduced from 58 to 48under European law. This is a major challenge forthe health service and will require new ways ofworking to be adopted. NHS National WorkforceProjects has been appointed as the lead organisationto help support the NHS in finding and implementingsolutions to Working Time Directive 2009.Meeting the 48 hour week is a challenge fororganisations, but for some, progress has been madequite quickly. With less than two years to go until themaximum working hours for junior medical staff is reduced,it is crucial that trusts who have already met therequirement share their learning with the wider NHS.As part of the work to develop solutions forWTD 2009, NHS National Workforce Projects hascommissioned a range of pilots that explore newways of working and their impact on the compliancewith the directive.There have been three main groups of pilots lookingat co-operative solutions, team working, handover andescalation and 24:7 working. There are also other oneoffpilots looking at other important areas of work.The aim is that the pilots will take in a wide varietyof organisations to look at solutions which aretransferable across the NHS and that will provideuseful learning to as many other trusts and healthcommunities as possible.NHS National Workforce Projects is pleased topresent a showcasing event to disseminate keylearning and offer practical hands-on advice fromthe NWP pilot sites that have reached early compliancewith the WTD 2009 requirement.This one day national conference, taking place at theHilton Metropole Hotel and Conference Centre, London,will accommodate 200 delegates and is aimed atoperational and general managers. Delegates willtake home five key tips from each of the interactivesessions and representation from each of the earlycompliant sites will be present on the day, allowingyou to ask the trusts involved, direct questionsabout their projects.Pilots taking part will include Stockport NHSFoundation Trust, Homerton University HospitalsNHS Foundation Trust, Dorset County Hospital NHSFoundation Trust, Guy’s and St Thomas’ NHSFoundation Trust, Countess of Chester Hospital NHSFoundation Trust, Scarborough Health Communityand South Devon Healthcare NHS Trust.To register please

The only way is upJog HundlePartner, for Mills & Reeve LLPjog.hundle@mills-reeve.comA growth areaThe latest Tribunal statistics show that nearly 1,000 agediscrimination claims were lodged in the six months toMarch 2007. That’s well in excess of the number ofsexual orientation or religious discrimination claims lodgedin a full year. On present trends, it won’t be long beforeage discrimination claims reach the level of disability orrace discrimination complaints, where a combinedtotal of around 9,000 claims were lodged last year.Retirement claims dominateAlthough the Age Equality Regulations took effecta year ago, it has only been in the last few monthsthat reports of full tribunal hearings have emerged.All three that have been formally reported so farconcern compulsory retirement, and two of themconcern the complicated transitional provisions thatceased to apply in April. They are a reminder – if onewere needed – of the importance of complying with thenotice requirements when dealing with compulsoryretirements. Giving the employee the correct noticeat the correct time and responding correctly toany request not to retire is vitally important, or thebenefit of the retirement exemption will be lost.In the meantime, Heyday’s challenge to thedefault retirement age has continued to progressslowly through the system. Heyday, an organisationlinked to Age Concern, is arguing that the defaultretirement age – the exemption to allow compulsoryretirement at 65 – infringes the EU Directive that isthe parent of the age discrimination legislation inall member states. The formal questions that theEuropean Court of Justice will be asked to considerhave recently been formulated, but a decision isnot expected until 2009.Public sector claims pile upAlthough many commentators do not rate Heyday’schances as very good, particularly since a preliminaryruling in a similar Spanish case, it is hard to say thatit is bound to fail. This means that employees bringingclaims (at least in the public sector) can argue thatthere is a chance their employer will not be able torely on the retirement exemption. That is why Heyday’slawyers have asked the President of the EmploymentTribunals to direct that all such claims should beput on hold until the ECJ announces its decision.The President faces a difficult decision. If claimsare allowed to pile up, a mountain of paperwork willbe created which may well turn out to be unnecessary.On the other hand, if the ECJ decides in favour ofHeyday, it hardly seems fair to dismiss claims thathave no chance of being resurrected – because ofthe rules on time limits – at a later date.HPMA Webwatch6Once again HPMA’s webwatch brings you usefulwebsites and online resources. Don’t forget we wouldreally like to see members sharing their own sites andresources. So if you have a suggestion or nominationto share, please contact is this month’s eclectic mix:It is vital for any HR professional to establish, developand maintain effective communication with a widerange of colleagues within their organisation. TheWork Foundation report, IC:UK 2006/7 looks atresearch on internal communication – a primarymechanism for delivering efficiency and effectiveness.Download at in Practice is a journal designed toaddress the role and responsibilities of primary caregeneral practice managers. The journal promotesbest-practice in practice management and providesexpert comment on and analysis of issues facingpractice managers. The free ezine service whichcomplements the journal highlights news and offersmanagement tips. Follow this link for tips on how tochair a meeting sucessfully (please note you willhave to register to access this free content).Since 1984, WFC Resources (formerly Work &Family Connection) has beenworking to help employers create a workplace that’sboth supportive and effective. A global clearinghousefor work-life professionals. Produces monthlywork-life news and trend digests. Subscribers haveaccess to the searchable 10 year archive of globalwork-life news. Includes lots of free informationincluding ‘Tip of the Month’. See many people networking professionally is adaunting prospect, but as we are now into conferenceseason it’s a reality. Take a look at networking trainersKintish’s website some useful tips.

networkAsk the expertsIf you have any questions you would like to pose tothe experts whether they be about legal issues suchas restructuring, organisational issues or even careersadvice please e-mail These questionswill be responded to in Network and on the HPMAwebsite anonymously.QUESTION: Where length of continuous service is themain criteria used in identifying which category of staffgets full protection of pay in the event of an organisationalchange, would this constitute a breach of theage discrimination legislation due to the fact thatyounger members of staff will not be able to meet thecriteria i.e. if 5 - 10 years of continuous service is required.Anna King and Rachael Heenan, health employmentspecialists at Beachcroft LLP replies:As you have rightly identified, there is a potential breachof the age discrimination legislation as youngeremployees are less likely to be able to meet this criteria.There is an exception in the Age DiscriminationRegulations entitling an employer to award benefits byreference to an employee’s length of service providedWanless on progressSeven seconds is the greater part of a sprinter’s business.Some, who do not follow the recruitment manual tothe letter, believe that it is possible to judge a candidateat interview within seven seconds. Judgements arebeing made all the time – the test is whether there issufficient evidence to justify the action that follows.Enough time has now passed to make initialjudgements on Sir Derek Wanless’ original forecastsand the impact of the subsequent massive fundingincreases. The NHS has got six years older since thepublication of his interim report on the long termprospects for the health and well being of thepopulation. Getting staffing right was central to theNHS Plan which preceded it – and benefited from theBudget which raised taxes which followed it.Many methods exist for generating data to assistthose wishing to assess progress to date. The PickerInstitute has recently picked apart four years’ worthof patient satisfaction surveys. The 2007 staff attitudesurvey is underway – making nerve-wracking readingfor HR directors next February. The experience of patientscan be divided into a range of different aspects ofcare – most of which are directly driven by how staffbehave and perform. For example, effectiveness oftreatment; involvement in decision-making; emotionalsupport; and engagement with family and carers.The political party conference season has revealedsuggestions designed to create a better NHS workforce.that benefit is referable to a period of 5 years’ serviceor less. In the circumstances you describe, however,this exception will not be applicable because you arereferring to a longer period of up to 10 years.In that situation, employers will only be able to treatemployees differently if it “reasonably appears” to theemployer that the award of the benefit fulfils a “businessneed”. You may be able to justify the benefit beinglinked to length of service on the basis that it rewardsloyalty or the experience of employees who havebeen with the organisation for some time and whoare key to the organisation. In this case, the risk of asuccessful age discrimination claim would be minimal.In order to properly protect the organisation againstpotential claims, you need to document the businessreasons for pay protection being linked to length ofservice i.e. because it rewards loyalty, experienceor retains key staff. You will then have a paper traildemonstrating that it “reasonably appeared” to theorganisation that the benefit fulfilled a business need.If you have any further queries on this issue pleasecontact Anna King orRachael Heenan there is plenty of praise around for front-line staff– the views on what state the NHS is in vary markedly.Public confidence and trust in healthcare professionalsremains high – and on the whole people feel that staffcommunicate well – although a third of in-patientsfelt that they had received conflicting information.The Conservatives have pitched their remedyon trusting the professionals – including the creationof employer-based clinical reference groups topromote dialogue with managers. They want betterworkforce planning, especially in medical education.The Government has called for a more personalisedservice, security protection for staff and a greaterrole for matrons.Wanless himself has also painted a self-portrait –thanks to the King’s Fund – to judge how things are going.Whilst heralding the increase in staffing, usefullysummarised in the chapter on resources, he raisesalarms that suggest that planned productivity gainsand improved lifestyle behaviours are not on trajectory.The review challenges a prevailing view that the majorityof the funding growth has gone into more staffrather than take home pay and better conditions.To the relief of many, he does not call for reformof reward as long as managers acknowledge thestructures which now exist to motivate people andto get better value for money. The levers exist locally– managers just need to learn how to use them.Boards could do a lot worse than use the review’srecommendations as a measure against which tojudge their plans and predictions for the future.The HPMA hasintroduced a newfeature into Network;Ask the Experts.This will give ourmembership theopportunity to poseany HR and legalquestions to healthsector employmentspecialists atBeachcroft LLPand our panel ofHR professionals.David Amos, HPMA LondonBranch Chair7

networkAiming for the top: helping membersto develop their skillsInitial feedback from the HPMA HR Developmentworking group has highlighted strong support forthe programme, coupled with a real concern thatmany HR professionals are just not considering thestep up to HR Director.Stage 3 – deputy HR director to HR director - hasdrawn the most comment, with a number of colleaguesconfirming that an aspirant NHS HR Director todaymust possess many skills outside the remit of CIPD.Perhaps catalysed by the growing number of foundationtrusts, there is a greater expectation that an effectiveHR service, and therefore the Director of HR, requiresa broader understanding of how health servicesoperate, and how to lead a successful organisation.There is an expectation that HR services mustsupport productivity and efficiency improvementsthroughout the organisation. HR professionals atstage 3 must acquire core skills that extend acrosstraditional HR boundaries if they are to join thenext generation of leaders within the NHS.If you would like to jointhe HPMA HRDevelopment workinggroup pleasecontact your local branchchair or email LaurenCrawford working group members from the Birmingham and Black Country branch identified core skills for senior management:Leadership and changemanagement● Empowering others todeliver● High level interpersonal skills● Team development● Manage complex decisionsthat are integrated acrossthe full range of operationaland corporate services aswell as HR.● Effective organisationaldevelopment (changemanagement theory andpractice)● Business/service improvementmethodologies andapproaches e.g. leanFinancial stewardship● Commercial decisionmaking – cost/benefitanalysis and development● Cost awareness● Knowledge of assetutilisation and cash flow● Understanding of paycosts against income● Understanding financialstatements and reportsand critically the differentapproach to financialmanagement betweenNHS Trusts and FTsStrategy & business casedevelopment● Market awareness● How to usebenchmarkingappropriately● Integrated thinking –service activity, HR,finance, IT, estates etc● Service redesign/workforce redesign● Strategic workforceplanning (i.e. beyondthe numbers)● Identifying income●●●generation opportunitiesMarketingstrategies/approachesto market awarenessOrganisationalstrategic planningprocessesand techniquesDeveloping HR andworkforce strategiesthat are aligned toorganisational strategy.Effective performancemanagement● Holding to account forservice viability● Corporate decisionmaking●●●Effective appraisal andfeedbackDelivering theimplementation ofstrategic plansUnderstandingperformancemanagement systemsAnalysis of informationsystems and criticalthinking● Interpretation ofinformation and usingemerging intelligence● Workforce productivity& efficiency● Service line reporting● Key performanceindicatorsOperating at board level● What makeseffective/ineffectiveboards● Differing roles andresponsibilities of boardmembers (particularlyexec v non exec)● Top level structures forFTs, i.e. relationship etcbetween Board ofDirectors and Board ofGovernorsProgramme participantsshould gain exposure toactual board working andwe should build in:● participation in boardcommittees in current●organisationvisits to boards in otherorganisations● the politics and behavioursrequired to be effectiveboard members.On the bigger picture● Awareness and exposureto the bigger politics.● Understanding/interpretingcurrent national/government approach topublic sector and healthsector policy.● Appreciating newtechnologies /systems -opportunities & challenges(visioning).● Understanding Europe -law and labour.Personal skills● Having coping strategies,handling the politics(small p).● Skills for mentoring/supporting others.Healthcare People & Money: clinical keysRegular readers will be aware of the Welsh pilotprogramme under the HPMA People and Moneyworkstream banner. The NHS Productivitymeasurement project has been developed byHPMA members in Wales with support from PriceWaterhouse Coopers and Saratoga.No doubt like other productivity forums, the pilotgroup has found that clinical measures will be criticalfor meaningful productivity measures in this sector.And it has become obvious that HPMA’s plannedrollout to English trusts will need additional pilotsfor clinical measures applicable to mental health,primary care and ambulance trusts.However the latest update from HPMA leadTracy Myhill is encouraging: HR Directors from theWelsh pilot trusts have fed back this week, confidentthat they can produce all of the proposedproductivity measures subject to minor clarifications.This means that the long awaited questionnairewill be released in early October.Look out for upcomingissues of Network for earlyfindings from the firsttrance questionnaires.8

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