In summary

The guidance is significantly shorter than previous years (20 pages down from 40+), more focussed (35 objectives down from 130+) and less prescriptive. This reflects the Government’s stated desire to reduce NHS micromanagement.

The guidance sets out three priority areas for 2023/24 (down from nine in 2022/23):

• to recover core productivity
• progress the aspirations in the Long Term Plan
• transform the health and care system for the future.

Workforce Objectives – what are they?

There is one specific workforce objective for 2023/24: -

“Improve retention and staff attendance through a systematic focus on all elements of the NHS People Promise”

This objective is to be achieved by:

1. increased investment by NHS England in workforce education and training
2. organisations refreshing the whole system workforce plans they developed in 2022/23, which will support: -

• Improved staff experience and retention through systematic focus on all elements of the NHS People Promise and implementation of the Growing Occupational Health Strategy, improving attendance toolkit and Stay and Thrive Programme.
• Increased productivity by fully using existing skills, adapting skills mix and accelerating the introduction of new roles (e.g. anaesthesia associates, AHP support workers, pharmacy technicians and assistants, first contact practitioners, and advanced clinical practitioners).
• Flexible working practices and flexible deployment of staff across organisational boundaries using digital solutions (e-rostering, e-job planning, Digital Staff Passport).
• Regional multi professional education and training investment plans (METIP) and ensure sufficient clinical placement capacity, including educator/trainer capacity, to enable all NHS England- funded trainees and students to maintain education and training pipelines.
• Implementation of the Kark recommendations and Fit and Proper Persons (FPP) test.

There are also a number of workforce recommendations aligned to the objective focused on “Use of Resources” which aims to meet a 2.2% efficiency target. Organisations will be expected to:

• support a productive workforce 
  • taking advantage of opportunities to deploy staff more flexibly 
  • measuring workforce growth by staff group, identifying expected productivity in line with growth
• reduce agency spend across the NHS to 3.7% of the total pay bill in 2023/24
• reduce corporate running costs.

Workforce Objectives - What has changed?

The focus of the workforce objectives this year is very much on improving retention and attendance of staff. Obviously, there are many factors at play here which are outside any individual organisation’s control – not least the pressures on services and staff that remain from the COVID-19 pandemic and the current pay dispute and industrial action.

Although NHS England expects organisations to meet the objectives by building on and refreshing the plans developed in response to the 2022/23 guidance, it is understood that organisations will not be performance measured or managed in relation to any objective, target or ambition that is not specifically set out in this year’s guidance. Significantly, this year’s guidance does not include the 2022/23 ‘ambitions’ of: -

• improving the Black, Asian and minority ethnic disparity ratio, by delivering the six high impact actions to overhaul recruitment and promotion practices
• continuing to support the health and wellbeing of our staff, including through effective health and wellbeing conversations and the mental health hubs.

What to Take Away and Next Steps

Although it is being reported that specific Equity, Diversity and Inclusion and staff wellbeing targets have been ‘dropped’, there are good arguments that this is not, in fact, the case.

Each organisation’s performance in 2023/24 will still be measured against the objective that they have improved “retention and staff attendance through a systematic focus on all elements of the 2020 NHS People Promise”, which includes having a compassionate and inclusive culture (“not tolerating any form of discrimination, bullying or violence… making the NHS a place where we all feel we belong”) and being safe and healthy (“wellbeing is our business and our priority”).

The number of specific objectives has reduced from 130+ to around 35. However, rather than reducing the ambitions for workforce, this reflects a change in approach to focus on outcomes rather than prescriptively setting out how each of the three priority areas are to be achieved.

Organisations should be mindful of this when implementing the guidance and refreshing their workforce plans for 2023/24 and beyond.

Systems and providers are asked to submit five-year joint forward plans before the end of March 2023. Further guidance on developing the joint forward plan is available and the annex of the planning guidance identifies evidence-based actions to support delivery. NHS England will separately set out the requirements for plan submission.

How Capsticks can help

Capsticks has significant experience in supporting employers in the context of workforce planning and change management processes, mitigating potential redundancy implications of efficiency plans, implementing cross-system working, and maximising workforce flexibilities, taking account of the remaining need to ensure staff wellbeing, and equality, diversity and inclusivity. If you would like access to advice, training or need further guidance on any of these issues (either generally or in relation to a specific case or in relation to the 2023/24 guidance) please contact Sian Bond, Kirsty MacDonald or Chloe Edwards.