Health Business

Last year the acting director-general of workforce at the Department of Health said: “Running the NHS is not like Tesco, where you have a head office and lots of stores and can tell them to sell beans at 40p a can.” But new NHS workforce DG Clare Chapman has made the move from Tesco, a vast organisation dealing in customer care, where she worked as group HR Director, to the NHS whose business is patient care. This shows that while the two organisations might be very different in terms of the nature of the business, people play a key role in helping to achieve objectives.

Improved patient care
Chapman joins the NHS at a time huge changes are taking place in the nature and organisation of its services. And there is increasing recognition within the NHS that health care delivery relies on the capacity and capabilities of the workforce.
    
This is reflected in the research that is being undertaken by the University of Manchester, which will explore how human resource management contributes to improved patient care and performance in the NHS. The research is sponsored by the Department of Health, the Chartered Institute of Personnel and Development and Healthcare People Management Association.
    
Chapman’s former employer, Tesco, took part in an earlier CIPD study with the University of Bath that explored the relationship between the way people are managed and the performance of organisations more generally. This work on ‘unlocking the black box’ has made an important contribution to improving the evidence linking people management to business performance. It also highlighted the vital role that front line managers play in ‘bringing HR policies to life’.

Live longer
In the arena of healthcare, studies by Michael West at Aston Business School and colleagues have also shown relationships between mortality rates and human resource management practices. Better managed units with better trained and more motivated staff display lower mortality rates. While previous studies demonstrate the ‘what’ of these linkages, they don’t really get underneath the ‘how’: how can we continue to improve people management in the NHS to further raise standards of patient care widely across the Service?
    
The first phase of this new research, Improving health through human resource management was published in January 2006. Based on extensive literature views and consultation meetings with NHS managers, staff and stakeholders, it highlights the particular challenges for people management in the unique context of the NHS.
    
The NHS is the largest employer in Europe and over half of the people it employs are professionally qualified. What is more, increasing numbers of people who are not directly employed by the NHS play a crucial role in the provision of our health care and the growing trend of contracting-out introduces additional complexity into the management of people and the teamwork and co-ordination required for effective patient care.

Changing sector
The NHS’s workforce strategy has driven a range of recent changes including Agenda for Change, a major reform of pay arrangements and an initiative aimed at Improving Working Lives. The research to date demonstrates the impact of these initiatives, but also points out there is a need to balance central initiatives with local freedoms, to tailor HR practices to suit the needs of each location.
    
“There is a realisation that clinical managers need support from specialists…. The result is that we are beginning to impress clinicians that HR understands the business... Most HR practitioners in the NHS believe they make a contribution to patient care. They are interested in how what they do impacts on the frontline. They had to crow-bar themselves in, but to learn to talk the talk, speak the right language,” according to one HR Manager within the NHS.
    
As these observations from an HR manager suggest, patient care is an important motivator for HR staff. It is also an area where good people management really can make a difference. The research aims to draw out examples of good practice from these Trusts and disseminate them widely around the Service.

For more information
For more information about the research project and to see the first findings visit www.mbs.ac.uk/research/improving-health/index.htm .
A hard copy of Improving health through health through human resource management: mapping the territory is available from www.cipd.co.uk/bookstore .
Clare Chapman is speaking at HPMA’s UK Conference on 7-8th June, for more details see www.hpma.org.uk .
The research findings will be launched at CIPD’s annual Conference and Exhibition at Harrogate, see www.cipd.co.uk .