The Plan contained aspirations, relevant beyond its 2020/21 lifespan, around how NHS organisations could do more to affect their local economy and the socio-economic factors that lead to the health outcomes and health inequalities. The Plan focused mainly on recruitment, with calls for organisations to look at their routes into the NHS by expanding the number and range of apprenticeships on offer, providing more direct routes into permanent employment for volunteers and by working more closely with schools, colleges and universities to attract people towards NHS careers, particularly in more deprived areas.
These recruitment initiatives look like they will have the most effect on entry into the NHS jobs market and the movement of individuals from low-skilled work into professional employment, as well as the professional development of those already in NHS roles. While these initiatives are clearly steps forward for the many areas where the NHS is one of the only large-scale organisations offering stable professional employment, the challenges to the economy created by the Covid-19 pandemic have reinforced the importance of a continued focus on the recruitment initiatives contained in the Plan. During the pandemic, there has been a substantial increase in unemployment and furloughing among people working in the lowest-paid and least-secure parts of the labour market, people in roles in the retail or hospitality sectors, for example, and particularly younger people.
It’s long been established that employment is one of the most important things in determining our socio-economic status and wellbeing. There is a huge challenge in helping people who have lost their jobs back into employment, as well as getting younger people who have never had a job into employment before they experience long-term unemployment and the issues that can bring for wellbeing. There is an opportunity for the NHS to help address this as it tackles longstanding staff shortages by identifying new ways to bring people into careers in the NHS, for example, through apprenticeships, volunteering and developmental clinical roles and provide them with new skills within the health system through continuing professional development.
The sorts of changes in recruitment and development outlined in the People Plan will not have an impact on inequalities in the short term, but the potential benefits of expanding the NHS workforce by changing the ways people can develop their careers are tangible in the here and now. Health Education England and the Department for Health and Social Care have been able to secure funding from HM Treasury to support the expansion in nursing places seen over the past 12 months in part because they pledged to direct that funding towards areas the government had targeted for ‘levelling up’, such as the East of England and South West. There are plenty of examples of individual areas taking a proactive approach to this, progressing schemes around recruitment and developing people from a more diverse set of economic backgrounds, as both we and the Health Foundation highlighted last year.
Many of these things are also true for social care, which has an even larger workforce than the NHS, yet consistently struggles with recruitment. A sustainable social care sector will be core to the success of the move towards place-based care. There are opportunities for NHS organisations to work with local government in spreading employment opportunities in social care as well as health care. Part of the need for a long-term settlement for social care is to provide people working in the sector with better, more sustainable working conditions that encourage people to continue their careers in the sector.
The People Plan can be seen as a first step in a long journey - there remain some significant gaps: there is still no long-term workforce strategy for the health and social care sector to plan around and draw from as the period covered by the People Plan draws to a close. Hopefully the next NHS People Plan will offer a long-term vision for the NHS as an employer, enabling local organisations to make more of the opportunities outlined in this blog. Without sustainable funding for recruitment and professional development backed up by a clear plan for how to spend those funds, the NHS cannot offer the level of stable, long-term employment deprived areas and the NHS needs.