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Sally Campbell

arvato UK


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Rethinking HR delivery in the NHS


Persistent cost pressures and HR functions facing continual scrutiny on efficiency means that NHS organisations are having to fundamentally rethink how they provide HR services. But new HR initiatives are emerging for departments needing to create efficiencies in the back office without sacrificing quality.

Although the £2bn a year of NHS additional funding announced in the Autumn Statement will go some way towards meeting the £8bn cash shortfall identified by its Chief Executive, Simon Stevens, cost-cutting and doing more for less remain top of the agenda for NHS organisations.

To address the growing efficiency targets, Trusts are having to protect front line care by reducing budget expenditure in back office operations, such as HR. The service is a critical function for NHS organisations nationally, and current challenges dictate that HR requires a strategic and tactical transformation in the way it is both organised and delivered.

Transforming HR in the NHS

Even before the publication of the 2004 Gershon Review of efficiency in the NHS, Trusts were looking at increasing back-office efficiency. However, recent developments have placed a greater urgency on driving change further and faster.

HR has been at the top of the agenda for NHS transformation since the Francis Review identified a link between employee wellbeing and patient care. Critical emphasis is now placed on enabling HR teams to focus on the bigger strategic issues.

Additionally some Trusts face the challenge of acting as host employer for employees spread over a wide geographic area. This can make the effective roll out of HR policies and procedures both logistically difficult and resource-demanding.

In reaction, this has led to an increase in the adoption of shared services and outsourcing as NHS organisations look to pool resources to deliver back-office services, such as payroll and administration. Such initiatives can create immediate cost savings as well as long-term efficiencies through significant economies of scale. By simplifying and standardising processes to reduce duplication and to support both managers and employees to self-serve, the administrative burden is eased, allowing teams to concentrate on business critical operations.

Improving services moving forward

NHS organisations are now adapting and introducing innovative approaches in attempts to free-up HR teams from their administrative workload. East Cheshire NHS Trust responded by developing a central online platform, HR Direct, which has had a significant contribution in streamlining the Trust’s HR function. For example, its implementation led to a 25% drop in the number of calls to the East Cheshire HR helpdesk by simply enabling line managers to more easily resolve day-to-day queries themselves.

The online one-stop-shop portal is accessible for all managers and employees 24 hours a day, hosting all HR policies, procedures – from induction materials, employee welfare and development policies to information on pay and terms and conditions – and a library of frequently answered questions (FAQs). Staff can also update their information online without the need to consult with a HR helpdesk, which has enabled line managers in the Trust to manage their staff far more effectively.

This success has seen the online service rolled out across nine other NHS organisations nationally, serving as a user base for more than 34,000 employees.

The most recent implementation at the St Helens and Knowsley Teaching Hospital Trust will allow the central team to streamline a particularly complex HR operation – the management of all employment matters for 2,500 junior doctors in training on behalf of over 150 organisations across Cheshire and Merseyside. This presents a logistical problem for delivering an efficient HR service, but by providing a 24 hour service which can be accessed remotely, St Helen’s and Knowsley, like East Cheshire, will now be able to increase their focus on more strategic responsibilities. This alleviated administrative burden will help improve employees’ overall well-being and ultimately patient care.

With continuing cost pressures expected in the coming years, further budget cuts and ever-more challenging efficiency targets can certainly be expected across all NHS organisations. The development of new systems which streamline back-office work and encourage the sharing of expertise and learning between Trusts nationally can unlock savings and improve services. Continued successful implementation will allow more HR teams to focus on the bigger challenges their stakeholders are facing. 

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Sally Campbell


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