Sir Robert Naylor, CEO, UCLH NHS Foundation Trust

There are two rapidly developing trends in the health sector according to Sir Robert Naylor – availability of human resources and funding to pay for them. The over-supply of professional staff, especially doctors, professionals allied to medicine such as physiotherapists and to a lesser degree nurses, is a major problem.

Naylor asserts that this stems from political pressures to increase graduate trainees in these professions without proper evaluation of future needs. “Thousands of newly qualified doctors will need to re-appraise their career ambitions from hospital to primary care – like most other professions there can no longer be a guaranteed career path for life” he says.

In contrast to the over-supply of skilled medical staff Naylor stresses that there are still looming recruitment problems for lower skilled people like porters, cleaners and security staff, particularly in central London. With the cost of living in London and a worsening economic outlook any difficulty at this level is likely to get worse as lower skilled people move out of London into more affordable areas.

Naylor has some words of advice for the Government when it comes to local labour “the pay rates in central London for semi skilled labour have to be addressed, we have to look at how we improve the skills of this group as well as how we pay them, we can't rely on Eastern Europe and Asia for these skills forever”. He also argues that the NHS should work closely with Local Authorities to develop affordable housing solutions for lower paid staff.

The second is the unprecedented additional NHS funding in recent years. Initially this was needed to fund prior commitments such as pay awards for doctors and nurses, but more recently it has resulted in dramatic NHS under-spending compared to years of deprivation. Spending money is not as easy as it sounds, new PFI buildings and training additional staff takes years.

In this context the two trends are clearly linked. Naylor plans to continue his pioneering approach of developing clinical leadership skills to prepare them for high level managerial roles. “As one of the first to experiment with leadership training for clinical staff, I am delighted to see some really talented clinical managers beginning to come through the system. ”

To other CEOs the advice is simple “invest in clinical leadership - they may not all have ambition or ability to become ‘top-executives’, but finding those few who do can make all the difference to your executive team”. Naylor has always taken an international approach to talent spotting; “there has always been a global war for top talent, especially in R&D where academic hospitals headhunt worldwide!” Staff mobility decreases as you move down the food chain; with very little movement of junior and mid-level medical staff other than in national training programmes.

Although there is optimism for the future supply of public sector healthcare professionals and careers in healthcare are in great demand, the calibre and number of graduate management trainees is something that worries Naylor.

“When I started as a graduate trainee it the 1970’s the programme was well structured with strong mentoring support, but recently there has been insufficient investment to meet a more challenging NHS.Today’s graduates are the next generation of NHS CEOs and my fear is that through a lack of investment we will fail to develop the next generation of leaders. An increase in graduate intake and commitment from existing leaders to invest in management development must be top priorities”

http://www.uclh.nhs.uk/