NHS: supporting those furthest from the labour market  

This article first appeared in the HSJ.

NHS trusts and health boards should take the lead in deploying progressive employment interventions at local level, which can be used to leverage employment opportunities towards people who are farthest from the jobs market, write Tom Lloyd Goodwin and David Burch.

Despite the claim that unemployment has now peaked, and reports of record vacancies in some sectors, 1.6 million people face uncertainty in the workplace as the furlough scheme comes to an end in the UK. In this context, increased youth unemployment is predicted to be a painful hangover from Covid-19 in the UK as we undergo wider economic recovery.

At this critical juncture, interventions like Kickstart should be helping those young people who are at the greatest risk of long-term unemployment transition into new jobs. But Kickstart, as a market-led intervention, allows prospective employers to cherry pick certain cohorts, like young graduates who appear to offer more value for money. As a result, those in need of more support risk being overlooked.

Health institutions as anchors

To address the short comings of interventions like Kickstart, though, there is much to be learned from the emerging progressive employment interventions of local anchor institutions – particularly within the NHS.

A number of NHS trusts and health boards now map their workforce against all postcodes in their locality, with a view to being more inclusive employers. This practice often reveals current employees to be older and less diverse than the local population as a whole, with a high proportion not resident in the locality they serve. Another commonly observed trend is a relatively low level of employees from areas of high unemployment and deprivation.

Armed with this information, trusts and health boards are able to take purposeful action: to lever employment opportunities towards individuals who are currently furthest from the jobs market.

Examples of practice

During the pandemic, Hywel Dda University Health Board in south west Wales needed to recruit 2,000 posts – from cleaners and porters to healthcare support workers. This presented an opportunity to recruit specifically from the local population and to target sectors such as hospitality, which has been disproportionately affected by the pandemic. To help this transition, they have changed typical person specification criteria – such as “experience of being a carer” or “working in the NHS” – to focus instead on values and behaviours. This has in turn led to a wider programme of work around reviewing person specifications for jobs, to make them less intimidating for local applicants.

In the West Midlands, the Birmingham & Solihull Integrated Care System is leading a programme across all of its employing providers. The programme will deliver a minimum of 100 entry level job opportunities each year for three years for unemployed and young people, targeting economically disadvantaged areas across the sub-region. It includes the provision of tailor made “get into work” development and support programmes, with careers, interview, application support and a programme of post-employment mentorship. The programme will commence during November 2021 and hopes to see its first successful applicants employed early next year.

In Greater Manchester, the Northern Care Alliance NHS Foundation Trust has bypassed the advert and interview process for many of their entry level positions and they are now reserving these positions for the recipients of targeted pre-employment training programmes.

Having mapped their employment profile, they have identified deprived postcodes where they are not employing people and have designed specific pre-employment training packages to help these local residents to enter their workplace. These programmes have been developed in conjunction with the local community and they are calibrated to help groups, such as BAME people, get ready for work.

Through the adoption of these programmes, these health institutions are starting to change the narrative around their workforce by using their power as employers to tackle the social determinants of health and create a more just society. It’s not about just wanting “the best person for the job”, but using the job to do the best by the people who make up your local economy.

Spreading the word

As we continue to face uncertainty around employment in the aftermath of the pandemic, these inspiring examples should be seized upon by all NHS trusts and health boards across the UK. To this end, as part of CLES’s work to promote community wealth building, we run a community of practice to support health institutions from across the UK to use their institutional impact to affect change within the wider economic, social and environmental determinants of health. By bringing people together, this network is providing a space for the NHS to share learning and experiences, helping to scale and amplify progressive practice. If you’d like to find out more, please do get in touch.