Healthy Connections

This article discusses the use of an interim human resources director to provide support during the delivery of the national programme for IT, which is key to modernizing the NHS.

NHS Connecting for Health hired an Interim Human Resources Director to provide professional senior management support for the organisation delivering the national programme for IT.

The National Programme for IT (NPfIT), which is key to modernizing the NHS, is one of the largest civil IT projects in the world. Its mission is, through the use of new technology, to put in place information systems that give patients more choice and healthcare professionals more efficient access to information, thereby ensuring delivery of better patient care.

In April 2005, the NPfIT joined with the technology arm of services from the NHS Information Authority (NHSIA) to form a single new organisation, NHS Connecting for Health (NHS CFH), an agency of the Department of Health. The role of the new organisation is to harness new technology to connect patients and healthcare professionals in the delivery of safer, cost-effective healthcare in England.

NHS CFH comprises a mixed economy of permanent NHS staff, civil servants, secondments and external specialist contractors. Together they create a rich tapestry of skills and expertise drawn from a wealth of professional backgrounds. However, the structure also provides a number of organizational challenges. The diverse mixture of talent has had to be managed and a common culture and terms and conditions established, while continuing to deliver the programme to the NHS.

"There were many different HR and recruitment activities going on," says Director of Corporate Services Andrew Griffiths. "We were looking locally, nationally and globally to find highly skilled IT professionals to fill vacancies on business-critical work. We were also establishing ourselves as a new organisation, managing issues around the closure of the NHSIA, dealing with the integration of staff and their work and handling the acquisition of a large number of legacy IT systems."

In the midst of all this, the then HR Director was headhunted. "I knew we had to plug the gap with a highly-experienced HR professional to lead at the most senior level," says Griffiths. "They would have to relate to everyone from the chief executive to the doorman, and would need lots of skill, presence and authority in order to command respect. They would also have to deliver rather than just hold the fort. Last, but not least, they had to develop the HR function."

Griffiths interviewed several interim managers for this critical role before appointing Impact Executives interim manager Susan Bush as interim HR Director.

One of the first things Bush did was to start to harmonies objectives, cultures and terms and conditions by introducing common policies and procedures. "Because NHS CFH was a very mixed economy, everyone had different perspectives and was focused on different objectives, and we needed to rectify that if we were going to perform as one organisation," she says.

All they had were legacy policies of the NHSIA – but these were highly structured and many were inappropriate for a fast moving project-based organisation that placed a high premium on performance. So Bush and her team redrafted 40 key people procedures, and harmonized terms and conditions. "We had about 460 different job descriptions, which we have rationalised into a more compact structure as part of Agenda for Change (AfC), the most radical shake-up of pay within the NHS since the NHS began," she explains.

A proportion of the 1400 staff in NHS CFH are IT consultants and contractors, who are deployed within the organisation for varying lengths of time. So a further HR challenge has been to integrate these people with permanent employees in order to deliver seamless high-level professional services.

The HR team also worked hard to implement more flexible working, in keeping with the NHS’s Improving Working Lives initiative, which seeks to redress the traditional long-hours culture by providing a better work-life balance for its staff.

They also worked quickly to establish a formal working relationship with the unions. Bush's 30 years’ experience of working in highly-unionized organisations stood her in good stead. She set up a joint negotiation and consultation committee to discuss and agree all changes to terms and conditions.

She also got the green light to set up a non-unionized Staff Partnership Forum, to help ascertain staff views on issues of concern to management and to address problems arising between staff and management.

But Bush thinks her most significant contribution to NHS CFH was restructuring and refocusing the HR department. "It was very internally focused and reactive, and had little direct involvement with either the management or the workforce," she says. "I helped to create a more responsive and proactive team who now act as HR business partners and work closely with managers to help them get the most out of their teams. This is critical to sustaining the performance of NHS CFH at a high level – particularly when the recruitment rate is running at around 25 people every month."

One of the key things the new restructured team is now able to do is proper inductions. "NHS CFH is a complex organisation and a well structured induction process is vital to helping new people become effective much more quickly," she says.

Restructuring and refocusing the HR team involved bringing in six or seven new people with different perspectives from both the public and private sectors. The administration was devolved to more junior people, allowing the more senior people to become more strategic by working alongside the managers. This change unleashed talent that had previously been under-utilized, says Bush.

There is now a well-established team of HR professionals, including organisational development and training

experts, and when Bush left at the end of January the team had just started to determine the kind of culture needed by the new delivery-focused NHS CFH.

Bush’s legacy to her permanent successor, Paul Dowie, who joined the organisation at the beginning of the year from ITN News, is a well structured, proactive and professional HR department that is focused on business activities and delivery. She also implemented a number of activities that NHS CFH can build on in the future.

Griffiths knew that Bush would contribute high-quality professional talent to back-fill a permanent role at a critical point in the organization development. But he discovered that the value she brought during her six-month assignment exceeded his expectations.

"The mix of skills, competencies and experience Sue brought made the six months it took us to find a permanent HR Director a great deal less stressful than they would undoubtedly otherwise have been," Griffiths concludes.

Previously published in the Business Review, Impact Executives and http://www.onrec.com/newsstories/22277.asp