Article

Workforce redesign

Find out what workforce redesign is and how it links to the Long Term Workforce Plan to support developing and retaining your existing workforce.

17 July 2024

Workforce redesign is about seeking new ways of working for your existing staff to develop their current skills and gain support in building resilience and confidence; meeting the needs of new organisational systems and processes to improve patient care.

It is important that when changes occur staff feel supported and are engaged in the process of your organisational transformation, which is where workforce redesign can be used to help your existing workforce adapt.

Workforce redesign and the Long Term Workforce Plan

The Long Term Workforce Plan (LTWP) promotes a new approach to workforce redesign and planning, based on engagement with the system. A successful redesign approach may involve working with your integrated care board, service providers and NHS England. You may also consider collaborating with higher education institutions and further education colleges

System-wide strategies may have been developed or in-development that will support health and care organisations with workforce redesign:

This Plan commits to supporting ICSs to develop local apprenticeship strategies that maximise benefits from changes to funding approaches and to focus on workforce shortfalls and the deployment of roles that enhance patient outcomes.

Examples of workforce redesign

  • Designing new roles for current staff based on their skill sets.
  • Introducing brand new roles to tackle workforce challenges such as staff shortages.
  • Developing new programmes and models to allow staff to work in other areas of expertise.
  • Increasing opportunities for current staff to broaden skills such as through apprenticeships.

Benefits of workforce redesign

Implementing workforce redesign effectively and making sure staff are part of the process can create significant benefits for staff, teams, patients and the organisation as a whole. These benefits include:

  • enhanced patient care and experience
  • improvements in staff retention
  • increase in recruitment
  • increased staff motivation and recognition, as staff feel part of the transformation
  • increased trust and efficient working within teams
  • empowered, more confident and skilled staff
  • increased staff satisfaction and morale, through development opportunities
  • increase in effective system working for organisations

Supporting staff through change

To help support staff through the change process, the following should be considered:

  • What is the rationale behind the proposed workforce redesign, colleagues who understand the ‘why’ will be more likely to support the changes.
  • Consult staff on the changes, there may be ideas and potential pitfalls that have not been considered. Co-creation of workforce redesign projects can ensure high levels of acceptance and support quicker implementation. 
  • Provide chances for review and feedback even after the new roles or developmental opportunities have been introduced, it is possible that there are unintended consequences. Actively seeking feedback may also ensure that staff feel engaged and involved. 
  • Ensure managers are kept informed of how a project is developing, as staff members are likely to go to their line manager as the first point of contact should they have concerns. 

Understand how individuals adapt to change 

Not all colleagues will adapt to changes in their workplace at the same rate, there will be those who have different approaches to change and your communications plan and support offer may need to flex depending on their attitudes. Individuals can be broadly grouped into the following types:

  • Innovators – those at the forefront of change, they enjoy change and the possibilities it brings. They will be happy to support with problem solving and aiding in promoting change within an organisation. 
  • Early adopters – these individuals will embrace change and be happy to adapt to any new changes. 
  • Ealy majority – prefer that change implemented at a steady pace, and that changes should be agreed by everyone prior to implementation. Once everyone agrees, they are happy with proposed changes.
  • Later majority – would prefer to know that a change will be successful prior to implementation, will be more likely to find issue with proposed changes. 
  • Laggards – individuals who prefer to maintain the status quo and will find change difficult. 

Career progression

It is important that any workforce redesign project focuses on career progression from conception, as staff will be curious to understand how the changes can impact their careers, and what opportunities and pathways will open to them. If a new role is introduced the business may need to recruit externally to fill vacancies, but there should also be considered on how current staff can develop into these positions. 

Widening Participation

Workforce redesign initiatives should consider how widening participation will be encouraged when implementing any changes. As health and care organisations will generally be anchor organisations in their local area, focus should be given to how the local population are impacted by the changes. This could include using the opportunity to create a talent pipeline bringing individuals into the organisation from the local area, or to consult with the local population as to what benefits they would want from any change. NHS Employers have a widening participation hub that has some guidance on considerations that could be made. 

Workforce Redesign Methodologies

  • Launched by Health Education England (HEE) to support implementation of the NHS People Plan (2020/21) the HEE star is an easy to use tool to help a team or service redesign it’s workforce through a facilitated process. It takes users through five stages; supply, upskilling, new roles, new ways of working and leadership. HEE has now merged with NHSE and the dedicated support now sits with ICB workforce teams however there are still user guides via the link above and helpful case study from Greater Manchester workforce futures

  • Developed by Calderdale Hospital to provide a framework for workforce redesign, it was quickly adopted by many organisations across Yorkshire and the Humber supported by NHS England. It is a seven-stage process (awareness raising, service analysis, task analysis, competency identification, supporting systems, training, sustaining) and is particularly helpful for identifying skills development and new roles.

  • Skills for Health provide a resource for workforce redesign through a six-stage plan (define the plan, map the service change, define the required workforce, understand workforce availability, develop an action plan and  implement, monitor, revise). It’s inclusion of local demographics can be a useful focus.

  • The Workforce Repository and Planning Tools ( WRaPT) is aimed at those within a system or organisation who is responsible for workforce planning in the health or social care setting. At its core, the approach establishes a relationship between workforce capacity and required activity, and provides the information needed to meet the significant challenges of current trends, including:

    • an aging population placing greater demands on overworked providers
    • a reducing workforce

    At it’s heart is system redesign so may be of particular interest to ICBs.

  • CLEAR, which stands for Clinically-Led workforcE and Activity Redesign, is a whole systems approach focusing on solving complex health and care problems by simultaneously providing workforce and service redesign, and training clinicians to deliver it.

    CLEAR aims to offer service transformation benefits for NHS organisations and integrated care systems; and work-based learning for clinicians. Participants are assigned to live projects, with education and supervision by the national CLEAR Faculty, and support from data scientists who work closely with each participating organisation to extract and visualise the relevant data.

Resources

We have compiled some resources below to support you in planning and executing new ideas for your workforce redesign.

  • The Roles Explorer (login required), hosted on the Future NHS platform is a collection of resources to support the planning and delivering of workforce redesign to introduce new roles, or innovative adaptations to existing roles already being deployed within a service or system. It provides information on the capabilities, training requirements and career frameworks for different roles, enabling workforce planners to choose the best fit for their service model. It also contains best practice planning methods and case studies which illustrate how roles are being deployed across different system priorities.
     
  • Health Education England’s multidisciplinary team (MDT) toolkit provides a comprehensive guide on building and developing effective multidisciplinary teams across a broad range of professional groups and system structures. It is designed to be relevant in any setting, to any objective and to progress a ‘one workforce’ approach.
     
  • Skills for Care’s principles of workforce redesign can help organisations who are undergoing any form of organisational restructure or transformation to set out the key things that need to be taken into account when changing the way your staff work, to ensure they play a role in change.  
     
  • The Supporting integration through new roles and working across boundaries report, commissioned by NHS Employers and the Local Government Association, looks at evidence on new roles and ways of bridging organisational workforce boundaries to deliver integrated health and social care.

Workforce redesign

The NHS is exploring new ways of developing the skills of existing staff in order to meet the ever-changing needs of the service and to improve patient care.

Watch our workforce redesign webinar below, where Derbyshire Community Health Services NHS Foundation Trust, London Ambulance Service NHS Trust, and North Tees and Hartlepool NHS Foundation Trust share good practice, discuss the topic of workforce redesign, and explain how they are doing things differently.

Good practice examples

  • London Ambulance Service (LAS) has developed its own first response initiative using the Mental Health Joint Response Car (MHJRC), which ensures patients with mental health conditions receive specialist care at the right time.

    The initiative has helped the trust to manage the number of unnecessary mental health related admissions to emergency departments, where teams have previously been unsure of the right care callers have needed.

    Read the full case study.

  • North Tees and Hartlepool NHS Foundation Trust identified a gap in their workforce and developed a band 2 Team Support Worker role that created a new pathway into NHS careers and helped reduce the pressures on staff during the pandemic.

    Read the full case study.

  • Antony Eneas, professional education lead, and Jill Pallister, professional education manager at Portsmouth Hospitals University NHS Trust decided to introduce a new band 3 role - the learning pastoral support worker - to be a point of contact for new healthcare support workers.

    Read the full case study here.

  • A case study, shared by Skills for Health, explores how Southampton NHS Foundation Trust approached difficulties in the recruitment and retention of healthcare support workers (HCSW). They aimed to improve recruitment and retention through two approaches, the first being the centralisation of recruitment reducing complexity and streamlining the application process, and ensuring that those recruited were placed in the areas most suitable for them. The second element was the creation of two new roles, Senior HCSW mentors and project manager focused on improving the support worker experience. These approaches have led an increase in retention rates and support workers feeling more confident and prepared for their roles.