· Features

Key workforce issues in the NHS: An HRD perspective

Stephen Moir, head of profession for HR in the NHS, responds to some of the NHS' key workforce issues.

Strategy and operations

“In HR, there are two impacts. The first is the impact on HR – we have to cut our cloth accordingly and be more efficient. Second is the impact on workforce – where do HR functions help their organisations recruit, retain and develop people to provide the best care? It’s about looking for ways to improve patient outcome within an employed workforce. It’s a very competitive market – this isn’t just the NHS, it’s private and third sector providers.

The challenge around spending means the workforce becomes more important, not less. It’s a great opportunity for HR to demonstrate its value to organisations and boards, and show that getting workforce issues right is the way to achieve better care.

It’s that constant HR challenge – making sure the business runs well, ensuring you’ve got processes in place, but carving out some time to look upwards and outwards. You’ve got to be ingrained in the organisation and understand the business context, but you’ve also got to look outwards and understand the environmental context, what patients want, what politicians want and what the longer-term strategy is.” 

National vs local

“There are huge benefits around having national pay arrangements, including economies of scale for HR. The advantage of having a national framework is that we don’t get into the bidding wars I’ve seen in other parts of the public sector.

As for localised pay bargaining and negotiations on terms and conditions – some of that opportunity already exists, but equally, does the HR profession have the capacity and capability to do that locally? There’s a huge challenge for the HR profession to step up if that’s what the NHS of the future intends to do.”


“There are lots of ways to redevelop the workforce. How do we upskill employees to do work that previously would have been done by clinicians? How do you make the best value out of everyone you employ?

Support staff can make really important contributions so we need to maximise them as well as making sure the education pipeline is right for the future.

The workplace is changing fundamentally and education needs to keep pace. We do have a strong strategic view for the future – interaction at local and national level is key. It’s not perfect, but an awful lot of work goes into this that perhaps isn’t visible to people outside the system. HR has a critical role to play, but it’s not just an HR role, this is a shared ownership issue.” 

Whistleblowing, leadership and culture

“If you look at whistleblowing in the purest terms, it’s about providing safe routes for people to raise concerns. The policies and processes are important, but it’s about the culture and behaviours.

The role of HR should be working with other parts of the organisation to help create the right culture and make sure people want to come forward and raise genuine concerns. Recognise that people speaking out is not a bad thing – it can bring massive benefits to businesses. It comes back to staff experience and voice.

HR has to be enabling leadership and ensuring line managers are skilled and equipped. [We need] enabling leadership styles and the right culture of recognition and support. HR has a key role in creating systems and processes and making sure the skills are there, but it’s really about values. [We need to] make sure front-end recruitment decisions focus on values and behaviours as much as technical capability.”

Read more about the workforce issues facing the NHS