Agenda item

Report of the Staffordshire and Stoke-on-Trent Integrated Care Board

The Chief People Officer provided a report and presentation outlining the workforce challenges within Stoke-on-Trent and Staffordshire ICS,  the report included the ICS People Plan and Annual Report for 2020/21.

Committee understood that  the prevalent issues impacting on workforce were demand, and acuity of patients compared to pre-covid levels. Staffing capacity and flow had been impacted by Covid spikes, and it was of concern that Covid levels were rising again. Assurance was given that health and care services were working together to address the workforce challenges and to develop the future workforce.

The following comments and responses to questions were noted:

·         Members were assured that there was wrap around support and training for volunteers and trainees working in mental health services.

·         Health and care partners were working collectively to consider retention incentives for staff, what attracted people to work in health and care and what it had to offer.

-        Attractions : a national pay framework was in place, qualifications, training, pastoral care and jobs that interest people.

-        Incentive perspective: understanding what incentivised different groups of staff i.e. Qualifications, training, flexible working/ shift patterns and financial incentives (including additional shifts or out of hours working). The retire and return initiative could also offer different roles to experienced colleagues or an opportunity to take up an educational role.

·         Financial wellbeing: ICS was working with Citizens Advice Bureau CAB to advise on accessing financial support. Psychological supportfor health and wellbeing was available as well as financial wellbeing. The biggest reason people were leaving related to work life balance and flexible working arrangements.

·         In terms of international recruitment and concern about depriving countries of skilled nursing staff: Members were assured that ethical recruitment was being observed, they were not recruiting from red list countries and international recruitment was not a long-term solution. Only 100 people last year and 90 this year were international recruitments, the ethnic minority population in Staffordshire compared to inner City neighbours was lower, it was noted that East Staffordshire had a higher number of ethnic minority communities and the system worked with workforce race equality scheme plans. Assurance was provided that the workforce was representative of the community and had outreach programmes in place.

·         The people hub was a national exemplar for recruitment using lots of different approaches.

·         Work force metrics: Days lost to sickness = 10% short term and 3% long term sickness: some were long term Covid cases however the two main reasons for long term absence were Musculo skeletal, and stress, anxiety, and depression - not all work related. There were challenges around sickness, but a robust offer for physio and psychological care was available to manage sickness absence and a range of support was in place to support staff for financial and other matters, providing pastoral wraparound provision.

·         There was a correlation between high sickness and high turnover in pinnacle NHS services. The move to support staff with placements and pastoral care to incentivise them to a career pathway was welcomed.

·         It was understood that many new recruits left in the first 10 months, with high numbers of leavers in clinical settings. Early support was important but where numbers of staff were stretched it was critical to provide day to day support to retain people in their first year. In a  clinical setting it was important to provide clinical supervision, education, resilience, and career development.

·         In terms of pace, the ICB had been in place since July 2022, its People Strand was key in reaching out with apprenticeships schemes and recruitment to ensure people were coming into roles in seldom heard communities. A People Strand progress report would be provided to a future meeting.

·         Retire and return: Early retirement and flexible retirement. It was noted that a significant number of the staff were over 50,  NHS pension rules had changed in April 2022 and more people had taken retirement since Covid. A challenge was that there were not the same numbers coming into roles as were leaving. Organisations had conducted retire and return initiatives in an ad hoc approach in the past and were now looking at alternatives and flexibility across organisations.  Current schemes such as the reservist hub looked at how flexible retirement could be accommodated across the system. 

·         Work force challenges were regularly risk assessed and being addressed through the formation of the people hub at system level. Collectively building a contingent workforce that sat above the work force which may be mobilised across boundaries to support areas of greatest need. 

·         Maternity workforce was also of concern. Building a new maternity work force while retaining the existing work force included some international recruitment, midwifery apprenticeships and maternity support workers to build the workforce. 

·         The People Plan aimed to make the NHS an attractive place to work and have career pathways for a lifelong career in health, where staff were valued, supported, and led. It was stressed that there was a need to ensure the pathways were for both health and social care.

·         Leaving interviews: A small project team had been gathering intelligence monitoring, collating, and analysing leaver data across the system to find out why people were leaving. The data would be presented to senior managers to make change and to understand how to offer alternative opportunities and retain experienced staff.

·         Industrial action: Trade unions were balloting staff across the NHS, which would impact in the winter period if it went ahead. This was a real risk. Patient safety was paramount and contingency plans were in place.

·         School engagement pilot schemes were taking place developing a range of resource and materials about NHS services for children, using both media and in person sessions, engaging with a range of professionals to interact with young people. Currently there were five pilot schools to develop information packs that could be rolled out wider when complete.

·         Mental health: Mental health issues were on the increase and was the second highest sickness reason in NHS. The psychological wellbeing hub at system level was in addition to wellbeing support from individual organisations.

·         Career pathways between Health and Social Care was an area of focus particularly around entry level apprenticeship roles and trainee nurse associates. Members welcomed the award recently received by ICS for best practice. It was understood that the apprenticeship offer was to give apprentices an insight to NHS and care roles, and awareness of the different roles developing in nursing homes from care worker to health care worker. Members were re-assured that the NHS will continue to work with social care to show different and exciting opportunities available in care role. Raising awareness and advertising roles and opportunities available.

The Chairman thanked partners for their contribution to the meeting and for the work being done to mitigate and respond to workforce pressures in the system. He welcomed the £4 million saving on redundancies in the system.

The Chairman congratulated the ICS team on its regional award for work on apprenticeships and wished them good luck for the national award.

Resolved:

1.        That the Health and Care Overview and Scrutiny Committee note the Workforce overview for the Staffordshire and Stoke-on-Trent Integrated Care System (SSOT ICS).

2.        The ICS be requested to provide an update in 6 months’ time to consider the action plans that sit under the strategy and to invite the Non-Executive Director People to attend.