What does the NHS Long Term Workforce Plan mean for knowledge and library staff?

About the impact of the NHS Long Term Workforce Plan on knowledge and library services staff.

The publication of the NHS Long Term Workforce Plan is a seminal moment in the 75-year history of the NHS in England

The NHS Long Term Plan described the changes needed for an NHS fit for the 21st century. Now we have the first comprehensive Workforce Plan to support delivery of those changes.

Setting the strategic direction for growing the workforce, the NHS Long Term Workforce Plan focuses on three clear priorities: to Train, Retain and Reform so that the NHS has the right number of people, with the right skills and support in place to deliver the greater volume and breadth of care that is needed.

The goal is to transform the way we look after people, including patients with complex health needs and, at the same time, plan to meet the health and wellbeing needs of local populations.

The Plan sets out the ambition for significant growth in the total NHS workforce over the next 15 years at 2.6–2.9% a year. This will see an incremental expansion of the NHS permanent workforce from 1.4 million in 2021/22 to up to 2.3 million in 2036/37 (p21).

However, to quote the Knowledge for Healthcare strategy: having the right teams in the right place is not enough; to deliver high quality and efficient patient care it is essential that teams use the right knowledge and evidence at the right time.

Hence, knowledge and library services have a business-critical role to play to underpin the success of the Plan. As you and your teams start to think about the implications of the Plan, the Summary of the Plan (p12-25) is a good place to start. The NHS Employers briefing gives a useful snapshot of the numbers and key actions for employers.

How can we contribute to the Plan?

The issues addressed in the Plan are widely understood and the required changes in education, training and the workforce are set out clearly. Accordingly, none of the issues and implications that emerge for knowledge and library services come ‘out of the blue’.

Yet, to meet changing local needs, the Plan calls for sustainable place-based approaches which maximise collaboration and cooperation.  

There will be no One Size Fits All response to the plan. Knowledge and library teams will want to ‘chew it over’ - in-house, across the health economy and within networks.

There are significant questions to be unpacked and pursued locally in order to shape and deliver the right knowledge services for an expanded NHS workforce, with different training routes and expectations.

Knowledge service teams will need to read, discuss, think and gain insights from local stakeholders to shape and plan service development.

Collaboration across organisational boundaries will be needed to get local provision right, and at the right scale, to support the expansion of the clinical workforce as well as waves of new trainees, including apprentices.

Fortunately, there are hooks right through the Plan on which to hang approaches to expand and enrich existing knowledge and library services. Some of these are flagged below.

Focusing on clinical professionals

This Plan is about growing and training the clinical workforce. It looks at the priorities for the education and training of doctors, nurses, midwives, public health, allied health professionals, the psychological professions, pharmacy, dentistry and healthcare scientists (See Chapter 2).

Education leads will be key to unlocking the resources required to deliver expanded and enhanced knowledge services to a growing NHS workforce and, as local knowledge and library teams, you will know best how to get these conversations off the ground.  

Thinking about those clinical educators who may be less familiar with what is on offer, you might want to point them to our NHS knowledge and library animations. A 2-minute introduction is sometimes a good place to start!

There is a raft of policies that you can share with Education leads as helpful. These include recommendations to improve the staff ratio for the number of qualified knowledge and library specialists per member of NHS workforce, indicative guidance for placement providers on funding local NHS Knowledge and Library Services in England and recommendations about developing suitable library service space to meet the changing needs of healthcare staff, learners and educators. 

Supporting the NHS to address the productivity challenge

Delivery of the NHS Long Term Workforce Plan is based on an ambitious labour productivity assumption of up to 2% (p10). This calls for sustained investment in workforce, technology, infrastructure and innovation to enable the NHS to work differently (p22). To meet this productivity challenge, organisations need to make effective use of evidence from research, and share and implement good practice.

Effective mobilisation of knowledge to underpin the many decisions involved is where the expertise of knowledge and library specialists is business-critical. The fact is that without efficient and effective access to high-quality evidence, our health professionals would be under even more pressure.

It has never been more pressing for the NHS to maximise the skills of Librarians and knowledge specialists. We have a real impact on the cost and quality of healthcare services, working with clinicians, service managers and those commissioning healthcare services.

As you further promote the benefits of working with knowledge and library services, you may want to consider how you can use tools like the joint NHS–CILIP HLG #AMillionDecisions campaign to tell the story of where your service is making a difference to productivity from Board to ward. It will be helpful to share some of the resources that we have developed for employers and leaders especially the Gift of Time.

Naturally, ICSs are centre stage of the Plan, playing a critical role in driving productivity and value for money.   Our interactive poster sets out 9 Steps that ICSs can take to ensure decisions are underpinned by evidence. It signposts key knowledge mobilisation tools to improve knowledge management, provide clinical decision-support, make the most of staff ‘know-how’ - and more.

Additionally, there is an active Community of Practice for knowledge and library staff interested in serving health and care staff across their Integrated Care Services, through which to share what's worked - and what hasn't worked so well - on this journey.

The Gift of Time animation and another on The benefits of working with Librarians and Knowledge Specialists speak loud and clear about the impact of knowledge specialists on productivity alongside quality.

Enabling healthcare teams to work differently

The dramatic increase in the size of the workforce, and the numbers of training places needed to achieve this, have captured the headlines. Certainly, the increase in training places is part of the solution and will have many implications for knowledge and library services on the ground.

However, the Plan also focuses on enabling the workforce to work differently - maximising the benefits of new technology as well as new therapies and treatments. Here are some thoughts:

• what more can knowledge specialists do to support the NHS to drive these innovations?
• is there more to be done in the way of helping clinical teams keep up to date, learn about new tech, evaluate innovations and share know how?
• how well do knowledge services promote the impact of this element of the work?
• perhaps it is about further tailoring services, and then placing an ‘innovation wrapper’ around the promotion of services already available?

Focusing on the health and wellbeing of the NHS workforce

Retaining the healthcare staff working in the NHS is central to the success of the Plan.

“Well-established evidence demonstrates a correlation between staff health and wellbeing and patient outcomes. We also know an integrated approach to staff wellbeing can increase employee engagement, which plays an important role in patient experience, satisfaction and mortality rates” (p63).  

Embedding the right culture is an area in which knowledge and library services can play a useful role. Do we underplay the contribution of Knowledge and Library Services in looking after the health and wellbeing of NHS staff? Perhaps some Occupational Health and HR and OD teams may not be aware of the Uplifting resources for the NHS from the NHS or Your Health Collection.

Are healthcare staff aware they can use library spaces not just for learning but also for their own wellbeing?

Contributing to Learning Health Systems

The NHS Long Term Workforce Plan is underpinned by the People Promise, of which ‘We are always learning’ is a key element.

The Plan is explicit that “Locally, systems should be adopting the principles of learning health systems, and ensure they are systematically gathering and applying evidence and data to support continuous learning, and aid clinical decision-making and improvement” (p104-5).

Our report on Supporting Learning Health Systems mapped the work of NHS Knowledge and Library Services onto the Learning Health System Framework. Author Dr Tom Foley noted that “A Learning Health System captures data from practice, generates knowledge from the data and puts the knowledge back into practice to improve care. …

This requires capabilities in digital (data and technology), knowledge management and quality improvement. Knowledge and Library Services are the heart of knowledge management within the NHS.” His report provides useful prompts for local discussion as part of the reform agenda.

Managers will be considering how best to work at system level in order that knowledge and library services are appropriately resourced to meet the needs of a changing and growing workforce. Knowledge services need to be right there, integral to effective learning environments, central to innovation and quality improvement.

Emerging issues

There are certainly plenty of other questions to ponder. These three stand out:

Apprenticeships

How well are knowledge and library services plugged into existing  apprenticeship schemes used by the organisations they serve? Working with educators and with neighbouring services, how will knowledge and library teams ensure that apprentices have the right knowledge resources and services, including information skills training?

Tackling health inequalities

People experiencing health inequalities develop long-term conditions earlier, accumulate them faster and live with them longer (p26).

All ICSs will be supported to build partnerships to develop a sustainable supply of locally recruited staff, support the health of communities and reduce inequalities (p52). This is explicitly an ‘upstream’ approach, investing more in prevention and early intervention (p37).

Are trusts aware of the involvement of NHS library staff in initiatives to improve health and digital literacy, working through public libraries and community partners? Do they know about the benefits being achieved through this partnership approach? Are they using the geodata to target wider initiatives?

Primary and community care and prevention

One of the demand drivers underpinning the modelling of the NHS Long Term Workforce Plan is that the ambition to move care upstream, and deliver more NHS care out of hospitals, will increase demand in the community (p37). The goal is to equip the workforce with the right skills and knowledge to shift care towards prevention and early intervention (p103).

What does this mean for the customer base, the service offer and, potentially, the service configuration currently in place? How will NHS Knowledge and Library services pivot to support all parts of the workforce? What can we learn from experience of primary care knowledge specialists?

By librarians, for librarians, colleagues from around the country have already built a range of resources to support the introduction of new roles. These include an Apprentice Library Assistant, a Patient Information Specialist Librarian and a Primary Care Librarian.

Taking imaginative approaches

Ultimately the scale of change promised by the NHS Long Term Workforce Plan requires imaginative approaches, taken in parallel, to:

• support the system to meet the productivity challenge
• develop knowledge service provision for new generations and increasing numbers of healthcare professionals as they progress through flexible careers
• make the case for investment in knowledge services with the right resources, the right team and the right roles

The Plan is intended as a living document setting out a 15-year ambition with biennial reviews – so there will be opportunities to feed into this over time. In the meantime, as ever, we need to work together to keep a high profile for the impact of NHS knowledge and library services.

It’s an exciting time, with new imperatives to deliver Knowledge for Healthcare, to inform #AMillionDecisions and support the whole workforce, learners and staff alike.  There is much to think about, much to discuss, and so very much that we can do together to work collectively to put the NHS workforce on a sustainable footing for the years ahead (p111).

 

Sue Lacey Bryant

Chief Knowledge Officer

NHS England