NHS Recruitment
By Foluke Ajayi, Head of NHS Careers and Workforce Supply, NHS Employers
The NHS's greatest asset is its staff. Despite the current financial constraints, it is vital that the NHS continues to retain valuable skills and experience and recruit new staff to replace those leaving or approaching retirement.
The NHS is changing the way it delivers services with patients spending less time than before in hospital and more procedures taking place in community settings. Many clinical staff will remain working in acute trusts, although some will provide more outreach services.
This shift of care from hospital to community settings has put a greater emphasis on the need to recruit staff to primary care. Clinical staff, such as nurses and physiotherapists, need to be prepared to spend their career in a range of settings outside the acute sector including homes, surgeries, clinics, schools, care homes and community hospitals, some of which contain elements of both acute and community care.
The shift has already begun. The 2005 NHS workforce statistics show that the number of nurses working in community and primary care increased by 37 per cent from 1997. New opportunities are emerging for less experienced staff to work in general practice and in the community, while staff who have spent many years working in acute hospital settings are now looking to careers in the community. And primary care employers will need to help and encourage them to do this.
Working in the community can require different professional and interpersonal skills from staff with patients at home much more in control of their care and decisions. Clinicians may need to make decisions in less than ideal circumstances and at a physical distance from colleagues. Clinicians will also need to work with others to address the wider causes of ill-health, such as housing, social isolation and low income. And they will need to understand and influence commissioning and take responsibility for effective use of resources.
Primary care employers need to make sure they maximise the opportunities for both staff and patient services. This includes providing community student placements and marketing job opportunities through the NHS Jobs website (www.jobs.nhs.uk) and universities to address the myth that acute care experience is a prerequisite for applying for a community post. Healthcare graduates are now starting to find their first jobs in primary care instead of the traditional route through hospitals.
For staff transferring over from acute care, employers need to develop a comprehensive and personalised induction programme that recognises existing skills that staff bring with them. Programmes should include information on the area and its socio-demographic characteristics as well as maps and a directory of local services.
Staff who are new to primary care also need to be provided with information about the service environment of working in the community. They will need to know about record keeping, the types of services available and key contacts. Advice and guidance will need to be given about the physical environment, for example how to enter patients' homes and assessing and reducing risk that is outside the practitioner's control. They should also be given access to mentors who can offer regular debriefing sessions, case reviews and clinical supervision.
Employers also need to consider offering flexible employment programmes so that staff can experience more than one area of primary care.
It is essential that primary care employers work closely with colleagues in secondary care, local government and the private sector to manage change and provide continuing professional development across all sectors.
NHS primary care employers should also be making the most of the knowledge and skills framework (KSF) part of Agenda for Change. Once up and running, this can be an invaluable tool to help employers map the skills and knowledge required across the whole organisation, teams and care pathways to match demand with supply and identify workforce gaps and development needs. But before they can make the most of the KSF, employers need to make sure all their staff have been given a KSF post outline and that they have had their annual personnel development review. These reviews are designed to make sure staff are applying the skills and experience for their post as outlined in the KSF post outline, and identify any development needs. The KSF can also be used to design new roles in primary care that better meet the needs of patients instead of sticking to traditional job titles. This can also benefit staff in terms of career development.
Primary care offers many career opportunities and it is up to employers to encourage staff - both existing community staff and those who may not have previously considered primary care - to make the most of them.
Pictured - Foluke Ajayi, Head of NHS Careers and Workforce Supply, NHS Employers