More money for a more productive NHS?
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Keir Starmer launced his ‘Plan for Change’ last week. He highlighted ‘The NHS - Losing the trust of the British public; Record dissatisfaction; Unable to provide the timely care and dignity that Britain relies on…’ He vowed to ‘make our public services and economy work for working people’. He said there will be a £25bn investment in the NHS which will lead to ‘waiting lists in our NHS cut; the 18 week target, from referral to treatment – finally met’. This would be ‘a symbol of an NHS back on its feet, facing the future, dignity and care restored to millions’.
His assessment of what is required to rescue the NHS was accurate; however he continued by stating that ‘Productivity in the public sector is 2.6% lower than this time last year, 8.5% down compared with just before the pandemic’ and indicated ‘I am not going to subsidise it with ever rising taxes on the British people’. His words were represented in the media as ‘no more money for the NHS without increased productivity’.
What is productivity in the NHS?
Productivity in industry refers to outputs like the number of cars made in a day, the number of transactions processed in a bank per staff member - in other words how much you can get for the investment you make. In the NHS Productivity refers to care given with available resources - financial, staff, facilities and equipment. It includes consultations, operations, and investigations. NHS England has set a target of a 1.2% increase in productivity over each of then next 5 years
Before the pandemic, NHS productivity was growing faster than in the wider economy, but the intensity of emergency care for the seriously ill patients with Covid, and the need for additional infection control measures for non-Covid work, reduced the NHS to essentially an emergency service. Elective work was stockpiled for later, and waiting lists which were already long, lengthened further. Overall, therefore, the pandemic caused significant disruptions in care, reducing productivity levels below pre-pandemic figures.
Post Pandemic the decline in productivity has been intensified by increased staff burnout and higher sickness absence rates.
Why is productivity lower after the Pandemic?
NHS staff, who are not generally well paid, have nevertheless always been prepared to work above and beyond their contracted hours. Many have routinely worked additional unpaid hours at the end of a shift rather than see operations and clinic cancelled. However, increasing levels of burnout and disillusion have reduced their willingness to stay and perform unpaid additional work. The NHS has consequently been unable to recover to pre-Covid productivity levels and this is undoubtedly having an effect on patient care.
Motivation and commitment have reduced for several reasons; increased workload, longer waiting lists, work related stress, feeling undervalued and unrecognised, poor working environment and resources, inadequate pay during a cost of living crisis and staffing shortages being a few. Facing public pressure and disapproval, it is reported that 1 in 7 staff are currently trying to leave the NHS.
Readers of my posts will be aware of my commitment to Executive Coaching. It addresses the challenges of disillusion and lack of motivation. Coaching creates a supportive leadership culture that values its staff so they feel valued and empowered. It improves communication, by addressing concerns and promoting engagement. Coaching assists with stress management giving staff appropriate tools to manage their inevitable workplace stresses. It improves personal development by focusing on individual strengths and areas for growth, to become more effective and contented in their roles, rather than seek employment elsewhere.
Productivity can only improve if NHS staff recover their motivation and commitment to the service. So it is unfair to blame Staff for the apparent decrease in NHS productivity when the previously high pre-Covid levels were boosted by Staff resilience and a desire to protect the service, by working flexibly and often without pay to finish the job rather than delay treatments. Perhaps the NHS is now getting what it actually pays for, rather than an additional bonus provided by its excellent committed staff working beyond their contracted time?
The solution for increasing productivity is to actively re-engage the NHS with its staff. In fact without dealing with the epidemic of stress, burnout, dissolution and lack of career focus in the NHS we are never going to return to pre-Covid levels of productivity, no matter what financial investment is made.
What is the way forward?
NHS Trusts should be actively promoting Coaching for staff in Senior Clinical or Management positions, using well trained and accredited Coaches with an appropriate Executive Coaching qualification. Where issues are likely to be sensitive, the availability of Coaches external to the organisation is essential especially where the optimal solutions for the organisation and the individual may be different. Trained and accredited Executive Coaches, external to Trusts, are already available and willing to work with NHS staff.
If you feel that any of this applies to you, and you are unwilling to wait for your Trust to get around to finding you a Coach, please be aware that many Executive Coaches working in Healthcare offer a free no-obligation conversation so that you can determine if Coaching is what you need.
If you think I might be able to help, please use the link here to book a free discovery call. I will link you to someone else if I am not the right person for you.