About NHS East of England
NHS East of England was established on 1 July 2006 as the Strategic Health Authority for the east of England, covering Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk.
NHS East of England is the regional headquarters of the NHS and provides strategic leadership to all NHS organisations across the six counties. It is ultimately accountable to the Secretary of State for Health. It is also responsible for ensuring that the £8.1 billion spent on healthcare in the region delivers the best services and value for money for both patients and the taxpayer.
NHS East of England aims to deliver a better patient experience, improve people's health and reduce unfairness in health.
Contents
Key drivers behind the project
Key challenges
A new approach
The newly qualified profile pool
Employment incentive scheme
Embedding partnership working
The outcome
Future and next steps
Professor Mike Cook (right in the photo)
Professor Mike Cook spearheaded the project on behalf of NHS East of England and raised the profile of this best practice initiative, nationally. His 20-year background in higher education, including position of dean at Anglia Ruskin University, contributed towards the stakeholder group’s understanding of those challenges facing higher education institutes and undergraduates. He was a key sponsor of bringing education challenges into workforce planning for this project.
Sean McLoughlin (left in the photo)
Sean McLoughlin, project lead for the Strategic Health Authority has been a key driver behind the project, striving to make significant improvements in employment prospects and in restoring the imbalance of excess supply of physiotherapists against reduced demand. Sean has vast experience of working in the health sector, having worked in a number of clinical and managerial posts and is an executive director of a local NHS Trust.
Physiotherapy makes a significant contribution towards health priorities and plays a vital role in preventing long-term health problems. It keeps people in work, keeps the elderly and others independent in their communities and improves public health.
In 2006/7 it became evident that the number of newly qualified physiotherapy graduates looking for their first post-qualification jobs far exceeded the number of roles available within the NHS. This was a nationwide issue and prevalent in the East of England where almost a quarter of all newly-qualified physiotherapists were unable to secure graduate posts in 2007. Graduate physiotherapists were identified as those facing the toughest challenge, alongside the nursing profession.
Sean McLoughlin commented: “In the east of England region, almost a quarter of all newly-qualified physiotherapists were unable to secure graduate posts in 2007. This was of major concern to the Strategic Health Authority. When this project was initiated, we knew that its success was dependent on all partners coming on board, facing and tackling the issues together. We had a common agenda, which helped the team to really focus.”
The issue became more challenging due to a number of reasons.
These included:
- failures of workforce planning following planned increase in commissioned training places resulted in a lack of suitable posts for newly qualifed staff.
- some local employers were facing financial difficulties with a number of physiotherapist posts being frozen due to the lack of funding.
- some employers were only taking on more experienced staff rather than newly-qualified graduates. A few newly-qualified graduates were however able to secure ‘bank’ work with NHS employers to gain experience, whilst waiting for new posts to be advertised.
- there was a difference in the way higher education institutes prepared their students for work, which lead to an imbalance of ‘work-ready’ and unprepared graduates. The proactive universities worked with employers to offer job application writing skills and interview preparation, for example
most graduates were prepared to relocate although some were unable to be as flexible due to family and other commitments.
On the positive side, some healthcare employers worked closely with local higher educational institutes and planned their recruitment activity to ensure opportunities were available for the students on completion of their courses.
To tackle the issue head-on, in May 2007 the East of England Strategic Health Authority formed an Employment Stakeholder Group to resolve what was a highly publicised challenge facing newly qualified physiotherapists, the health sector and higher education institutes.
The project was chaired by Professor Mike Cook, the director of workforce for NHS East of England. It consisted of representatives from NHS East of England, NHS Employers, Chartered Society of Physiotherapy, healthcare employers, higher education institutes and newly-qualified health professionals.
The Social Partnership Forum subsequently produced an action plan for maximising employment opportunities for newly-qualified healthcare professionals in a changing NHS (DoH, 2007).
Professor Mike Cook stressed: “To ensure success of this project, it was important for universities and employers to collaborate. Higher education institutes were therefore engaged from the beginning of the project.
“There was little point in higher education institutes continuing to commission more undergraduates than jobs available. We needed to restore this imbalance. We also had evidence that some local trusts had frozen a number of physiotherapy posts due to financial pressures. This also needed addressing.”
Using problem-solving methodologies and analytical tools, Professor Mike Cook and the project lead, Sean McLoughlin dissected the key facts and figures, allowing decisions to be made on the actual evidence found, rather than perceptions. Understanding the key issues was vital to a successful outcome.
Sean McLoughlin said: “For a newly-qualified health professional seeking employment, the graduate pool was essential for identifying work opportunities and a means of communication between graduates and employers. We needed to further develop the pool for new qualifiers seeking their first post. The pool therefore became our main focus of attention.”
Through this measured approach, the newly-qualified profile pool was identified as one of the key tools in tackling the graduate unemployment issue. It needed to be maximised in a number of ways:
- as a method for communicating with candidates
- as a tool for employers to identify job seekers
- to target physiotherapists for those employers securing new physiotherapy posts
- as a tool for constant monitoring to changes in employment.
Professor Mike Cook said: “In 2006/7 we were in a position where employers were receiving 300 applications within two hours of a new physiotherapist post being advertised. We needed to manage the demand and supply in the pool in a different, more structured way. The talent pool was central to this project.”
The stakeholder group was keen to educate employers on the real need to embed the role of the physiotherapist into their healthcare practices, even though some employers had insufficient physiotherapy posts for new graduates.
Rather than just focusing on the traditional skills of a physiotherapist, the group also wanted to promote new and innovative ways of employing a physiotherapist’s vast skill base. Incentivising employers was an important strand of the project.
Sean McLoughlin said: “We needed to get local Trusts to consider local graduates. Although some employers had insufficient physiotherapy posts for new graduates, there were other roles that they could undertake. It was a case of thinking outside the box.
“A pilot scheme was put in place to ensure newly-qualified physiotherapists used their skills and knowledge soon after their university courses, enabling them to develop their experience and to maintain their registration status.”
A one-off financial incentive was provided for 50 one-year physiotherapist contracts in the East of England. Those Trusts employing the 50 physiotherapists from the pool into new roles were offered a contribution towards the cost of the post for the first year. The posts were for a Band 4 or 5 role with the ultimate aim of retaining the physiotherapists within the workforce. The posts were primarily hospital and community-based.
Professor Mike Cook said: “Employers were invited to apply for the funding through a formal bidding process. We asked Trusts to evidence how professional development, mentoring and supervision would be provided. We looked at how they would bring about a sustainable improvement to employment prospects.
“We also wanted to help employers think more creatively by considering the role of a physiotherapist differently. We were challenging traditional approaches in primary and community care.
“The bids therefore required careful thought and consideration and needed to demonstrate a real desire to embed the range of skills of a physiotherapist within their organisation. Ultimately, we wanted them to improve patient care through physiotherapy.”
Partner to the project, the Chartered Society of Physiotherapy, helped trust managers to improve their bidding skills and offered guidance on commissioning to physiotherapy service managers via their publication 'Making the Business Case.'
Download a copy of Making the Business Case.
A Compact agreement developed in the NHS East of England was at the heart of the solution, enabling the Strategic Health Authority to retain staff for the future workforce, to be seen as having good employers and to deliver its ‘Improving Lives, Saving Lives’ pledges. To achieve this, much effort was required.
Professor Mike Cook added: “The success of the project can be attributed entirely to taking a holistic approach to the challenge facing the physiotherapy profession. Gaining and maintaining the buy-in of so many key partners has been absolutely essential.
“Understanding different perspectives, taking on board opinions and ideas of everyone impacted, from unemployed physiotherapists, to the union and employers, means that we are better-equipped to sustain employment in the future.”
Through considerable efforts of the partnership, the employment prospects have been improved significantly from 23.7% of newly-qualified physiotherapists not being able to secure their first post in July 2007 to only 3.09% in May 2008.
Professor Mike Cook said: “The result of this project is evidence in itself that no party can stand alone and solve an issue of this nature, but needs to take a more holistic approach through partnership-working.
“The project has been recognised nationally as a best practice initiative and discussed at a number of conferences. Sheer hard work and a desire to resolve the unemployment issue by so many partners, has ensured this outcome.”
The number of places commissioned from Universities in the East of England has been reduced to resolve the imbalance of future supply and demand. 54 graduates have been employed through the incentive scheme so far, and the number is likely to reach around 75 in the future.
Sean McLoughlin comments: “By sharing and learning from this experience, we are now in a much better position to manage recruitment challenges in the future. The number of places commissioned by Universities in the East of England has been reduced to resolve the imbalance of future supply and demand.
“Employers are now in a better position to realise the potential of physiotherapists within their organisations, giving the physiotherapists a new-found confidence to develop their careers within the NHS.”
Professor Mike Cook concludes: “The key for continued success is to keep the lines of communication open between the universities, employers, the Chartered Society of Physiotherapy and other key partners. The future employment situation for newly-qualified physiotherapists needs careful control and monitoring. Sean will keep a constant watch on the movements of the pool.
“We are continuing to hold regular group meetings so that our solution grows and evolves over time. We need to ensure that the reconfigured services in the health sector continue to meet the needs of patients and that we bring new ideas to the role of the physiotherapist.”