Maqsood Ahmad on the challenges currently facing HR in the NHS

Maqsood Ahmad is the Strategic Manager and Director for NHS England. 

He spoke to HRD Connect about how HR can make a difference to the NHS, the role that HR has to play in creating future leaders, and how it can help to regenerate both communities and people.

Maqsood was speaking ahead of his keynote session at the HRD Summit 2017.

What is the biggest challenge and opportunity facing the HR profession right now? 

The biggest challenge for us is to provide an effective and efficient service to diverse and vulnerable groups within the financial constraints of the NHS, and within the devolution agenda within Manchester.

We also have the challenge of securing a very skilled, flexible workforce that will meet the challenges of the future – not just financially, but thinking completely differently about the way we provide healthcare within our communities.

The third one, which is interlinked to the workforce, is how do we involve communities to provide some of that care within local areas and link that with the prevention of bad health? I think we’re still on a traditional view, as we see people with these as diseases and we take them into hospital and they tie up beds, instead of thinking about it from a different angle.

In order to think differently we need to have the right workforce with the right skills and the right flexibilities for them to really meet the needs of the community.

To meet the needs of the community, the challenge is going to be that every staff member of the NHS and every partner organisation will have to understand the communities.

What is likely to have the biggest effect on the work of your HR team: business strategy or government policy?

They both impact us equally. Government policy that comes down has an impact, and so does the strategy we build locally.

In the past we’ve been directed by government policy on the NHS, and then tried to fit that into the local business strategy.

For us in greater Manchester, we’ve got devolved resources – we can make our policy from government policy, and implement that locally. It is absolutely an opportunity for us.

Having said that, the workforce has to align itself with the devolution regime and agenda; we can’t continue behaving the way we have done in the past.

So the challenge is going to be thinking like a business: we don’t make a financial profit as a public service, but our profit is the health of our citizens. If the citizens are healthy, then we’ve made a profit.

Where can HR make the biggest difference in your organisation?

There are a number of ways HR can make a big difference.

For example, it can look at the skill set of the staff we already have and how it matches up with the vision of devolution and the Greater Manchester strategy. Are there any gaps? And how can we get people to think with a different cultural mindset to the one we have now?

HR has to move away from just human resources towards more leadership development, and finding the compassionate leadership we need. It’s about how you make leaders of people – whether they are a nurse, an administrator, a manager or a strategist.

We all have leadership potential, so how do we realise it? HR has a huge role to play in reminding us: “You are leaders of the public.”

Second, we need bold HR leaders. That promotes credibility within HR and it takes a bold HR manager to challenge the senior team inside the system, so we need bolder people, or people who set the agenda for development of staff within the organisation.

I would like to see them become the primary partners in the senior management team – setting the agenda with regards to the workforce, future leadership and future development.

I see very little of that work being carried out by HR departments. They’ve got to go beyond recruitment and retention. They’ve got to be the producers of future leaders, and they have to contribute towards increasing the trust and confidence of taxpayers. They also need to be the moral compass inside the organisation.

These are the challenges that HR is facing amidst ever-decreasing financial support.

How do you balance the issue of having two (sometimes conflicting) centres of control – in this instance the NHS England executive and Government?

I’m a great believer in democracy and justice: democracy has to have justice to be effective, and I see organisations working like that.

We can have democracy, but if there’s no fairness and justice, then organisations are never comfortable with themselves, because the staff are not comfortable with themselves.

In order for an organisation to feel comfortable and have the energy, it has to have its people feel comfortable and have the energy.

Whichever government comes to power will set that agenda and we will accept that agenda, but it has to go with fairness and justice to make it happen.

How do you convey the importance of HR and the people who work in the NHS to these two different control centres?

My experience of working within HR in various organisations is that there’s a common thread that HR professionals are not promoted enough generally.

The profile of HR is really poor, and yet to have a good strategic approach, you need good people. It is people that make good strategy, and that makes good operations happen, but there isn’t that much emphasis on people.

When people talk about regenerating areas, my view would be that HR has an important role to play in regenerating people. If we can regenerate people, empower people, we can certainly regenerate an area.

We think of physical things which communities will use, but then we don’t get people involved in those areas, or hire the staff to make those things happen.

So there’s got to be a radical shift to emphasise human resources regenerating and empowering the people of those organisations, and that means HR having a very high profile.

Innovation will come through people if you make it easier for them to set up their own businesses. If young people have the means to become entrepreneurs, they will produce everything else through their brains and investment in their projects.

The NHS is effectively a network of different organisations with their own HR and other executive teams and goals. How are you able to bring this together into one vision for the whole body?

Strategically, HR plays an important part in the vision to regenerate communities and produce leaders of those communities. They can have an overview of very high-level policy at the top, but what that policy needs to do is make it a reality for local people.

Has HR ever done any mapping of skills among the community? Just imagine if we had those people on our books. They could be designing and regenerating things for the NHS.

We don’t know the skill set in our own communities, which in my view is a shame. That should be the role of HR.

HR should not only be internal; it should be external, and it should also have a handle on where the skill sets are within the community. If HR is going to have a vision of community development and support, then HR cannot limit itself to solely looking at an organisation from an internal perspective.

For example, we should be finding the medical students in our universities and colleges and matching them to the hospitals and GPs. This is all human resources.

We should also be identifying early on people who are very good at maths or science. We have enough people in Greater Manchester who would love to become nurses, but someone has to take the agenda to them; they’re not going to find us. That should be the role of HR the way I see it.

And we have to plan ahead to see where are those gaps will be in and five and six years’ time, so that we can train people locally to fill them.

You’ve spent a lot of your career working in diversity and inclusion roles. How can you successfully encourage leadership teams to embrace the importance of diversity and inclusivity in organisations?

If we can get the right people from diverse backgrounds to be chief executives, chief constables, directors and deputy directors, then inclusion and equality will naturally come with that. But having the right diversity at the top is the key.

Just because you’re black or a woman at the top doesn’t mean you are naturally going to improve inclusion or equality. Sometimes you might get absorbed into the culture of your colleagues.

So slowly, we need to take on people who are not the same as us, who think differently to us. HR has to play that ‘moral compass’ role. Some HR departments have played that effectively, and some have completely failed that inclusion agenda. I measure the effectiveness of an organisation by how it treats its minorities, not its majorities, and that’s what HR needs to think about.

It’s also very important because the NHS is a diverse community and is very diverse of ill health. For example, diabetes is high in the Asian community; prostate cancer in the African-Caribbean community is high; depression amongst women and Asian women in particular is high; smoking in the Bangladeshi community is high.

Business-wise, it’s costing us a lot of money, and we need people inside the system to understand those communities and provide leadership so we can reduce that cost. If nothing else, it makes financial sense.

We have all these facts and figures, but in order for us to help those people we need to have the right people in the organisation. Do we have a skilled workforce that reflects the communities but also reflects the ill health within those communities?

It’s a huge role for HR leaders to play and change the culture with regards to inclusion. If HR played that part, we wouldn’t need full-time equalities directors.

Hear from Maqsood Ahmad about HR’s position in the boardroom as a key influencer at HRD Summit in 2017.

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