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Thanks to business links with Zenon Consulting and Skillstream - Attractor was invited to take part in a round table discussion about the challenges of managing the healthcare workforce. The event, hosted by Kings College, focused on the challenges of managing healthcare’s contingent workforce in a strategic manner.

Professor David Guest, reviewing recent European research on the deployment and use of contingent workers, highlighted a number of key areas for discussion by the small group of  healthcare management practitioners. Issues of cost, control and risk, work quality, patient safety and service were considered.

Research across Europe is showing the performance of temporary workers is, at least, as good as permanent workers while they are also reporting  higher levels of well-being than permanent workers.

This seems to contradict the suggestion that temporary work is typically of  low quality and involves exploitative working relationships. Instead, is seems, there are large numbers of workers for whom the job role or profession of choice, perhaps even the level of autonomy and flexibility offered by temporary work is more important than having a permanent contract.

Commenting on this point,  David Guest said -

“Temporary work is certainly less secure but this may not cause a problem unless a temporary worker faces the risk of becoming ‘unemployable’.”

In relation to temporary workers, healthcare management often express concern over the impact of temporary workers on the quality of patient care, linked to workers’ unfamiliarity with the environment and local service requirements, possible lack of experience or, more importantly “free-riding” – where workers are less inclined to take appropriate responsibility for care outcomes though a lack of commitment to the organisation.

While it is clear that support, induction and supervision are vital ingredients for protecting quality and safety, discussion participants considered most healthcare practitioners demonstrated significant professional commitment to patient care (contrasted with any healthcare organisation) to acceptably reduce the latter risk.

Given the extent to which UK employers talk about flexibility, it was interesting to learn the UK has a lower proportion of  the workforce in temporary contracts (around 6-8% or the workforce) than other European countries (typically over 10% with Spain as high as 30%) and about half these are in fixed-term contracts rather than “agency” work.

Healthcare has some large groups of staff working across the country who are typically not permanent employees of a particular healthcare provider – including junior doctors, the large in-house staff banks and medical consultants – each of which have special factors that have made them a permanent feature of the NHS.

So what are the key issues impacting on contingent workforce management in healthcare? Read the rest of this entry →

In 2009, the Chartered Institute of Personnel and Development (CIPD) reported 29% of organisations now outsourced HR services.

Just 7% however, reported outsourcing was an all-round success, with only 47% saying it had been a success in some areas.

Many outsourcing and shared adopters have a “bundled deal” with a assortment of services including HR, Finance, Estates and IT services from the same provider.

Maybe such solutions haven’t had sufficient capacity and competence built-in to deliver high quality HR services.

Service is likely to be perceived as poor unless client needs are well understood, service levels properly documented and supported by effective operational and technical solutions. Finally, services should be subject to the same detailed monitoring as the provider and client organisations are using for other functions. Read the rest of this entry →

The HR Director of a Special Health Authoritycontacted Attractor to help resolve problems between the organisation and its outsourced payroll service. Payment errors were experienced by many employees and confidence in the service (and management) were being undermined.

The HR Director, recently joining the organisation, needed an independent view on the cause of the problems and the range of viable solutions.

Attractor agreed to respond quickly and assist the organisation to understand and address the issues, helping to build the confidence of employees and their representatives the problems were recognised and being efffectively addressed. Read the rest of this entry →

Attractor has developed a reputation for building long-term effective working relationships with Directors and Senior Team members, based on strong subject matter expertise and industry experience.

Attractor’s effective consulting work will always support local strategy and direction with well-targeted, light-touch, expertise. Customers always retain control over what support they need and use.

Aiming to minimise dependence, Attractor’s interventions are complete as soon as the client team has matters back under local control and grow effective solutions confidently.

Attractor’s work generally comes through personal recommendations and referral so business relationships are important to us. Conversation often continues for months or years, between assignments this ongoing interaction is welcome.

Consulting work has generally focused on change and efficiency in back office functions – with structural and functional change linked to deploying new business models and workforce management solutions. Attractor has supported clients to –

• Clarify their vision for back-office functions and both front-line and support service workforce management arrangements – shaping and guiding service improvement, productivity, efficiency and organisational effectiveness,
• Convert a “vision” for Service Transformation into a tangible plan with transition activities, benefits delivery and tracking to ensure delivery towards strategic objectives,
• Re-design and reshape departments, teams and roles, optimising added value, making best use of workforce management systems, reducing back-office costs,
• Engage and communicate strategy and actions to key stakeholders, securing support and political influence supporting change and benefits actions, supporting work to embed new ways of working and deliver benefits,
• Create and monitor plans which address corporate and organisation-wide change – resourcing, skills and capability, plus redeployment and exit strategies – technical, risk and assurance issues for organisation-wide change programmes and smaller technical projects,
• Change management and facilitation for complex projects, with workshops and other activities to support business change and improvement.

Consulting work commonly builds on a formal proposal responding to client needs, and often involves basic fact-finding, strategy, options identification and appraisal, recommendations and, where needed, implementation support.

A Mental Health Trust recently adopting the ESR solution was concerned that, due to problems during the implementation project, they had not adopted effective working methods. Concerns existed over core business processes and how these would work with the external payroll provider. The Head of Human Resources asked Attractor to review role allocations and processes. Read the rest of this entry →

A London teaching hospital had received a critical audit report which identified problems with payment outcomes. The level of overpayments was considered unacceptable and major changes to data management and payment control within the organisation had been recommended. Attractor was asked by the Deputy Director of Human Resources to -

• provide an independent review of business structures
• consider working arrangements and processes
• identifyoptions for delivering the required changes
• highlight key issues for change implementation

Read the rest of this entry →

A trust was experiencing problems with internal HR and Payroll operations, manifested by poor data quality, performance problems and payment errors. The Deputy Director of Human Resources invited Attractor to examine the department and make recommendations for change and improvement.

Attractor uncovered problems with team priorities – driving inappropriate work practices, timing of routines and tasks – plus unexplained variations in working method and business process. The department had, for some time, endured a history of fragile management practice with negligible investment in training and development of team members, resulting in low skill levels – all exacerbating the problems identified.

Attractor worked with new service managers to develop and communicate an service development plan incorporating actions on teams, tasks and individuals designed to address all identified weaknesses.

In early 2007, The Department of Health ESR Team asked Attractor to deliver a rapid review of ESR deployment in an acute hospitals foundtion trust. Reviewing the organisation and working practice of key teams, interviews revealed a basically sound deployment which exhibited some shortcomings in data management and quality assurance.

At the end of the rapid review Attractor recommended specifc actions to -

• improve data quality
• improve the timing and communication on posting to the general ledger
• implement further automation to improve efficiency

Furthermore the existing “hybrid” operating model for HR and Payroll services was recognised as the initial step take towards further planned integration. Attractor recommended further structured review action to refine thinking and set direction for integrated working.