With the NHS in the midst of the largest ever IT investment programme, staff with the right skills and experience are at a premium, but can NHS organisations attract and retain these key staff?  And is the gentleman’s no poaching agreement between local service providers and the NHS actually working?  

At last week’s E-Health Insider conference, ‘The Healthcare IT Revolution: what’s happening to people?” the experiences of speakers and delegates made clear that strains of recruiting and retaining the necessary staff are already becoming apparent in some parts of the country.

One NHS delegate, an IT project manager,  said: “Out of a team of 15 people I have lost ten.” 

Survey figures provided by Di Millen, Head of Informatics at the NHS Information Authority (NHSIA), indicate such levels of staff turnover are not uncommon. “Turnover in certain groups of staff was very high.  In some groups its 43% a year,” she said.

Significantly she added that when health IT staff were asked why they were leaving salary only ranked as the third most important factor.  “Top of the list was low status, poor development and lack of career pathway.”

Tony Eardley, chairman of ASSIST, the association for healthcare IT professionals, said that even though transfer of undertakings and protection of employment (TUPE) arrangements for moving staff en masse to the private sector were not in play, there was still a lot of anxiety.

“Managing fear is part of the job at the moment.  The overwhelming feeling is that of uncertainty and it’s a bit of a void at the moment and that’s something we need to turn around.”

He stressed that the essential domain-specific knowledge of healthcare business and clinical processes overwhelmingly resided within the NHS.  Speaking of his own organisation, South Staffordshire Health Informatics, he said: “The 120 staff working for us have vastly more knowledge than the LSP has.”

Conference chair Roy Lilley asked LSP representatives bluntly about how many of them had poached staff from the NHS.  He got a variety of answers: one LSP representative said :“We are making people aware of options and choice.” Another replied: “We are trying to tap into as much clinical knowledge as possible.”

One LSP delegate, though, received a round of applause for his more forthright answer: “Four”. He added that some of the LSPs did have “no poaching” deals with alliance partners.

Lilley reminded the conference that it wasn’t possible to just arbitrarily retrain people’s career progression, and pointed out that the national programme was occurring in an economy approaching full employment.

Professionalisation of health IT

 It was apparent that the NHS was trying to address some of the career concerns of staff and protect the public with efforts to professionalise health IT, or health informatics.  Eardley said: “If you were in an ICU unit wouldn’t you want to know that the equipment was put together by a professional, rather than an enthusiastic amateur.”

Part of the problem, the ASSIST chairman explained is that there are currently few objective benchmarks to indicate whether a healthcare IT professional is competent.

He said that the formation of UK CHIP (Council for Health Informatics Professions) in March was a huge step towards professionalisation.  Registration with UK CHIP is currently voluntary.  “In four years time that voluntary registration becomes mandatory and then we are in to a whole new world of registration and possibly de-registration.”  

Millen, told the conference that the NHSIA’s original estimate of 20,000 staff involved in health informatics had been revised up.  “We now believe the figure is more like 60,000 to 80,000 people.  Initial figures did not include people like coders or medical records staff.” 

She explained that through its human resources strategy, ‘Making Information Count’, the NHSIA aimed to make health informatics issues mainstream, and was now working with local workforce development confederations to achieve this. 

In addition to being a founding member of UK CHIP, the NHSIA has developed a set of national standards for health informatics, made up of approximately 130 units. 

The NHSIA has also been working closely with universities and the NHSU on developing health informatics courses:  “There are now eight or nine universities around the country where students can gain professional qualifications from the NHSIA and UK CHIP,” said Millen adding that it was hoped work on a CIO development scheme, would start this year.