HEALTHCARE ESTATES 2022 KEYNOTES


Sir David Behan, today Chair of Health Education England, was CEO of the Care Quality Commission from 2012-2018.


we develop those things, and what does this all mean?”


Future workforce characteristics Turning next to ‘What are the future workforce characteristics?’, he said: “The shape of work, and of education, will change, and indeed as we at HEE have developed some of our work over the past year, people have told us they want to see something different to what we currently offer. So,” he added, “we will need more clinicians with generalist skills able to provide personalised preventative, joined-up care, supporting flexible careers, alongside specialists. We do want specialists to undertake specialist interventions like the complex shoulder reconstruction I recently underwent, but will also need many more generalists to treat the complex comorbid conditions many older people will present with.” Sir David Behan said there would be a


need for ‘a greater focus on skills rather than roles’. He elaborated: “What got people into the multidisciplinary teams responding to COVID was their skills, rather than the roles they occupied. The ability to undertake airway management got somebody in a COVID team, rather than whether they were a consultant. We will need to deploy skills when and wherever they’re needed, and those skills will need to be developed and adapted. In 1950,” he told delegates, “the shelf life of medical knowledge was 50 years, but in the early 2020s, it’s 73 days, and falling.” Consequently, an approach to education based on knowledge retention was ‘limited’; it was more important that people knew where to obtain the knowledge they needed, and whether they could use it in real time.


A ‘pluripotential’ workforce Sir David said: “So the problem/solution will be the challenge of the future, rather than physicians knowing every bone in the human body.” This shift would, he believed, require a ‘pluripotential’ workforce able to work in different settings, with roles including nurses, nurse associates,


24 Health Estate Journal January 2023


Nick Hulme, CEO of East Suffolk and North Essex NHS FT: “You cannot remind your staff often enough that every single thing they do, every single day, is saving a life.”


advanced clinical practitioners, physician associates, middle grade doctors, and allied health professionals, who could work in the community, in acute, primary care, and mental health settings, and in social care. To create the ‘conditions for success’ the sector would – the speaker contended – need ‘more and different’, requiring changes in how we recruit, educate, train, employ, and treat, our workforce. He said: “We’ve still got too many people leaving, because they’re not treated well, and to deliver these changes we’ll need a workforce that represents the community they serve.” This would mean widening participation and promoting social mobility approaches, and creating more routes into careers; the speaker said he really appreciated IHEEM’s work to date on apprenticeships.


Blended learning He told delegates: “I would add to these various elements blended learning. We start our first Medical Apprenticeship Degree in 2024, and are going to develop a much greater approach to Continuing Professional Development and lifelong learning on multiple platforms. We need to enable people to learn and work together, because they will need to do so in adaptive teams. We also need to develop cultures that value people and lifelong learning. So, I hope I have clearly set out that we need to provide a workforce for the future. I’d advocate thinking about the long term alongside the short term, and taking the opportunity of the development of ICBs and Health Education England transferring into NHS England to develop an approach which takes a longer-term, more strategic, approach.” With this, Sir David Behan concluded his address, and Paul Fenton asked Nick Hulme to join give his presentation.


EFM staff’s ‘invisible work’ Nick Hulme told delegates: “What I want to talk about is fundamentally all about leadership. I believe good healthcare has three major components – science, compassion, and environment. The science


we get is from the incredible speed at which scientific developments are moving. A very good friend has pancreatic cancer, and she’s not well, but she says ‘if I just hang on for one more day, the cure might be around the corner’ – and increasingly, it is. So, the science is progressing.”


Importance of the environment He continued: “Care and compassion is what you and your colleagues do every day, and a bedrock running through the NHS. Thirdly – and the least talked about by professionals – is the environment; the same warm, comfortable environment you ensure with your colleagues every day. It is ignored by so many, but if you look at my inbox – at what patients talk to me about – it’s about the care environment, and car parking, but it’s also about the invisible work that you and your colleagues do every day around safety.” Nick Hulme said it was ‘a crying shame and a disgrace’ that ‘Estates and Facilities’ was ‘talked about so little by our leaders, right across the political and the executive spectrum’. He said: “I find it interesting that our new Secretary of State talks about ‘a, b, c, d’, but where’s the ‘E and the F’? Because the E and the F – the work you do – is often the difference between fantastic, and merely adequate, healthcare.”


An ageing workforce Turning to ‘the challenge for workforce’ from his perspective, Nick Hulme said he knew that (according to the NHS Estates and Facilities Workforce Action Plan, published last June), 34% of the current UK healthcare estates and facilities workforce is aged over 55 (compared with around 19% of the overall NHS workforce). He said: “So, we know we have a major problem with recruitment and retention. We also know people don’t leave organisations, and don’t work for organisations either; people leave and work for their leader, their boss. The challenge we have as a profession is to provide that exquisite exceptional leadership – treating every employee as a valued member of our staff, with all the


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