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Enhancing NHS Performance: Strategies for Transformation & Success

Delve into the 2003 King's Fund CEO meeting background on NHS performance and Agenda for Change aspirations. Explore pay system reforms to boost efficiency, workforce quality, diversity, and recruitment. Discover cost-saving programs, management strategies, and handling principles for sustainable improvements.

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Enhancing NHS Performance: Strategies for Transformation & Success

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Presentation Transcript

  1. SW Acute CEOs MeetingBackground Presentation

  2. King’s Fund: How is the NHS performing?

  3. Agenda for Change aspirations (March 2003) • Pay system which leads to more patients being treated, more quickly and higher quality • Assist new ways of working – promoting efficiency and effectiveness, meeting needs of patients • Achieving a quality workforce with the right numbers, right skills and diversity, organised in the right way • Improve recruitment, retention and morale • Improve all aspects of equal opportunities and diversity • Meet equal pay for equal value • Implement new pay system within the management, financial and service constraints

  4. Example NHS Foundation Trust • Acute district general hospital • Turnover: £150m • Workforce: 2500 staff (£100m salary bill) • Vacancy rate = 5%; turnover = 8% (excluding doctors) • Sickness absence rate = 3% • Temporary staffing spend = £10m • Savings target (cost reduction): £15m 2011-13 • Savings profile: workforce £9m (60%); non-pay/infrastructure £6m • Average unit employment costs: £40,000 • 5% management costs • 200 consultants

  5. Ready reckoner: impact of 2% pay cut on pay packets

  6. Ready reckoner: the actual impact

  7. Ready reckoner: jobs and savings

  8. Pay compressor options • Pay inflation (uplift) • Increments • Temporary staffing rates • Two-tier workforce • Annual leave • Sickness absence • Unsocial hours allowances • Flex-release • Premium sick pay • Recruitment and retention premia (RRP) • On-call • Supporting PAs • Remuneration for extra clinical work

  9. Labour cost compressors

  10. Sample contrasting savings programmes (over 2 years)

  11. Sample contrasting savings programmes (2011-2013) Assumptions

  12. Possible handling principles • Comprehensive, resourced, undiluted engagement and involvement of staff and their representatives • Widest possible, and reasonable, definition of suitable alternative employment • Investment in training and professional development • Reversal of pay and conditions compression if circumstances allow • Introduction of a new Knowledge, Skills and Performance Framework to promote advancement and withhold increments from under-performance • Bonus scheme for all staff (% unconsolidated pay rise) when trust delivers financial and service objectives, and generates available surplus

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