People in Place: Meeting capacity and cultural challenges in the NHS

People in Place is a call to action on the fundamental skills and people issues which will determine the future of health and care in the UK.

The pandemic has thrown a sharp light on an increasingly complex and challenging people agenda at local and national level. This agenda is often characterised as a series of problems to be addressed, including capacity gaps in critical skills, staff health and well-being, embedded issues of cultural inequality and lack of diversity, and longstanding problems with fair pay and reward. More positively, there is growing evidence of more collaborative solutions to new ways of working, a live appetite for change nurtured by the pandemic, examples of more flexible career pathways and new ways of deploying skills across traditional boundaries.

There is consensus that this agenda requires collective thinking and action by the NHS and its partners both immediately and longer-term. But how can this be done most effectively at the pace and scale now needed?

People in Place takes a positive and practical view of the future. It offers solutions based on interviews, workshops and evidencegathering from leaders and thinkers in the field. It argues that effective collective leadership at system and place, supported by creative modern governance, now holds the key to the people agenda. This report also offers a range of practical tools and resources to help make this happen, based on experience of what works. It sets out a clear set of realistic opportunities and possibilities for progress.

We explore how the guiding principles of good governance and subsidiarity can provide the right framework and enable a strong foundation for sustainable change. Whatever the pressures to tackle immediate people issues, we argue the real focus for ethical leaders who take their stewardship responsibilities seriously must be on a longterm framework, founded on clear principles and involving a wide range of partners. We focus especially on the unique role and potential for people committees, operating in systems above employers and below national level.

With the detail becoming clearer, we believe that the NHS reforms in England offer a genuine opportunity to refocus energy on driving forward the people agenda at local levels. The scope is there to tackle people issues in a way that serves local communities and employers well and helps meet the health and care needs of local populations better. In the rest of the UK, where integration and collaboration are more established, we recommend a similar approach, ensuring local leadership is truly enabled, through good governance, adoption of sound practical tools and effective resources, to create solutions to long-standing people challenges.