Victoria Maher, workforce director at the Shrewsbury and Telford Hospital NHS Trust (SaTH), answers some of the frequently asked questions around Future Fit and staffing.
The Future Fit model of hospital care proposes significant changes. What does this mean in terms of staff? Is it true there will be 330 fewer nurses and 842 fewer hospital staff as has been claimed?
Future Fit is all about improving local hospital services and our workforce is absolutely critical to delivering these important changes. Changing our hospitals by creating a separate Emergency Care site and Planned Care site will create new job opportunities, new roles and a much better working environment.
Traditional medical and nursing roles are changing and we need to make sure our workforce is sustainable, so we are creating new roles and working hard to support our teams to grow and develop.
While our plans show a decrease in Registered Nurses, they also show an increase in Nurse Associates. This is a new role that will see staff – sourced predominantly from our Health Care Assistant workforce – trained to fill what are currently some of our Registered Nurse roles. Our first Nurse Associates will start at our hospitals this year following a two-year training programme and we plan to grow our Nurse Associate workforce to over 120 staff over the next 5 years.
At the moment, we have more than 120 nursing vacancies, and we’ve lost 17 nursing and midwifery registered staff in the past 12 months. This means we have to rely heavily on temporary staff, including agency workers. It shows how crucial the new Nurse Associate role is to helping us make our nursing teams sustainable. And, crucially, it also means our staff will benefit from opportunities to grow and develop their careers with us.
But doesn't the Outline Business Case mention that there will be a small reduction in staff numbers?
Under both options, there is a small reduction in staff numbers, as outlined in the Outline Business Case. Over the next five years, we will see huge developments in new technology. This includes moving to electronic patient records, which will have an effect on our workforce needs. There will also be fewer staff needed in some areas due to the reduced duplication of services across two sites.
As we currently have a turnover of around 350 staff each year, we are not expecting these changes to mean anyone will have to be made redundant. We aim to deliver the necessary changes in a planned way that will allow us to retain our existing staff and attract new staff – and be able to deliver the best possible care to local people.
How many fewer registered nurses will there be under the Future Fit proposals?
There is no intention to reduce the number of registered nurses employed by SaTH. It’s important to remember that we currently have over 100 nursing vacancies. We always aim to recruit to full establishment, but recruitment challenges mean this has never been possible. This means we rely heavily on temporary nursing staff, including agency staff. What we want to do is reduce our reliance on temporary staff by building a sustainable substantive workforce. The introduction of Nurse Associates is one of the ways we will do this, and we expect that our new Nurse Associates will cover much of the work that we currently rely on temporary nursing staff for. We are also working on a robust staff retention strategy, which includes career planning, flexible working and access to training and development.
There are rumours that hospital staff are not being given opportunities to express their views about Future Fit. Is this true?
Our people are our priority and it’s important that we hear all of their views. We have launched an intensive staff engagement programme to ensure that every member of staff can have their say. The programme includes weekly roadshows, newsletters and communication through payslips.
Many of our staff have worked together to develop the new model of care that will deliver improved services to the people that they serve. We have and continue to promote the Future Fit consultation to all our staff and would urge everyone to have their say as everybody’s views are crucial to us.
Why are you struggling to recruit doctors and nurses and how will Future Fit solve the problem?
Across the UK, there is a severe shortage of healthcare staff. It is becoming more difficult to make sure that we have enough doctors, nurses and other healthcare staff to provide a 24-hours a day, seven days a week service at both our hospitals. Although a similar picture can be seen across the country, this problem has a greater impact in Shropshire and Telford & Wrekin as we have two hospital sites that are less than 20 miles from each other that currently provide many of the same services.
We are finding it harder to recruit and retain staff, particularly within our Accident and Emergency (A&E) departments and critical care services. The Royal College Guidance states we need 20 consultant doctors to run our two A&E departments, 24-hours a day, seven days a week. Currently we only have three permanently employed consultants in post. We have recently made three offers to consultants following the news of the capital investment.
Staff shortages have meant that our doctors have had to be on-call more often or work extra hours across two hospital sites in order to keep patients safe. We have also had to recruit temporary staff that are not as familiar with our hospitals and have therefore needed additional support.
We’ve tried hard to address the recruitment challenge in a number of ways, including recruitment drives nationally and overseas and sharing posts and rotas with neighbouring trusts, but these have all failed to provide a sustainable solution. Day-to-day operational plans are in place to ensure the care and safety of patients within the Trust’s clinical services, but a long-term solution is urgently needed.
Future Fit is proposing a separate Planned Care site and Emergency Care site. We know that by changing our hospitals in this way we will become a more attractive place for people to work. This would enable us to recruit more doctors and nurses to work at both our hospitals in the future. Already, since the announcement that we are going out to consultation, we have had greater interest from staff wanting to work with us.