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What’s it like being the HRD in the UK’s biggest NHS Board?

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An Interview with Alastair Blair blog

Ian Reid has spent his entire career in HR.  His first job was in the Dumbarton District of NHS Argyll and Clyde, as a Clerical Officer in the Personnel team on the minimum salary grade (but with two enhancements thanks to his degree and diploma in HR!).

Subsequent moves to Personnel Manager posts at Argyll and Clyde HQ in Paisley and the Mental Health Unit in Glasgow led to his first HRD role at the Glasgow Community and Mental Health Services Trust, where he had a short period as interim CEO, before getting the HR Director’s position at Greater Glasgow Health Board. NHS Greater Glasgow and Clyde is the largest NHS Board/Trust in the UK, employing c. 45,000 people.

When NHS Glasgow was between CEOs, he had another spell as interim Chief Exec, before returning to his HRD berth, from which he retired two years ago, only to be asked to act as interim HRD at NHS24 (the Scottish equivalent of NHS 111). All this means Ian’s an ideal person to ask about the role of the HRD in the NHS …

“When I began,” Ian told me, “I had no idea where I’d end up, but I’d always been quite ambitious. I think if you want to progress in any career then a degree of ambition is essential, but it also helps if you work with great people as you develop your experience. I’ve been fortunate to have had three major figures who influenced my career and from whom I learned a lot. 

“For those aspiring to progress, especially in a large organisation, one of the biggest challenges is when you find out just how big the gap is between HR Manager and HR Director level. As an NHS HRD, your responsibilities are far more strategic; you learn just what it is the organisation is trying to achieve, medically, financially and professionally, and how “big P” politics impact on your work. This is more so in Scotland than in England, because south of the border the NHS Trusts’ direct line of accountability is to NHS England rather than to the politicians and each Trust is more like a semi-autonomous body with its own CEO.

“The HRD has to try to steer and influence the organisation, working with the trade unions and ensuring that the HR structure is robust, capable yet flexible when required. Obviously, in a huge organisation like an NHS Trust/Board there are all sorts of HR issues daily, but you have to delegate. Although it’s tempting to get involved when something’s not going the way you might think it ought to, you need to give others the authority to solve these issues. I used to say to my HR colleagues, ‘I don’t mind if things go wrong, but tell me about them and don’t bring left-field surprises.’ Even if something doesn’t seem a serious problem, if it’s one that’s going to blow up then, as HRD, you need to know about it before it does!

“You can be dealing with huge service change, but then an issue can arise and attention is diverted to something that in relative terms isn’t huge but IS massive in the political or media world. The expectation is that as the most senior person you are held to account for what are, in the great scheme of things, not important matters. Don’t be surprised to find yourself wondering ‘why am I doing this?’ 

“Government creates a challenge on its own. When we moved to devolution in Scotland, the politics became much closer to the service and you would be dealing with wider, strategic, service change issues, while at the same time MSPs would raise local issues to the Health Minister, leading to a far greater degree of scrutiny.  Again, a key skill was managing – not interfering with - the (smaller) local issue, providing reassurance upwards to the politicians that there are not systemic problems, while not losing track of what was required for the bigger picture.

“Here, good PR and Comms people are vital and HR has to work closely with them.  In Glasgow, the link between the two was such that eventually the Head of Comms reported to me. Together, we had to manage the external and internal environment, with internal staff comms being critical.  When you are dealing with an enquiry, as we had with Vale of Leven Hospital, it’s important to keep staff involved and not let them become overly anxious.

“Social media was starting to have an impact towards the end of my career and, again working with Comms, we had to monitor it constantly.  Social media brings a new dimension to HR. You need to respond to those things that need responded to but must not engage with every criticism. In reality, about 70%-80% of social media comments about the NHS are positive and about good experiences; the rest are negative and some are obviously politically driven.  This is a key area for NHS Comms now and in the future.

“The current challenges for NHS HR are economic and political.  The single biggest challenge is sustainability of services, given the pressure on the workforce caused by significant skills/staff shortages (radiography, medical etc.) and funding. Because the political imperative is to keep everything as local as possible, sustaining services over a range of sites with a pressurised workforce is very difficult.  The normal response would be to rationalise and centralise – but politically that’s very difficult.

“Another challenge for any senior NHS director is that the decision making in government has become less clear because of health and social integration. With local authorities overseeing some NHS work, accountability and governance can be a bit confused.  This makes decision making difficult and the modern HRD needs a skillset that sees external partners as people to be worked with, not resisted.

“In recruitment, the problem is simply how to find people who aren’t there!  Traditional avenues have gone and there is a big need to bring public sector recruitment up to the best private sector practice in some places.  The NHS needs to be far more creative but set against the spending squeeze and the private sector creaming off non-medical talent it is very difficult. Resilience is a prerequisite for the modern HRD!

“As for the future role of HR in NHS, I think there will always be a need - a significant need - for HR, around Board tables.   The biggest change we’ll see will be in shared services, where the support functions of HR will have to make greater use of IT and ‘self-service stuff,’ but the strategic workforce activity will always be there. The need for sound leadership will not go away, although in the future this may not necessarily come from an HR professional. I can see more people from a general management background getting involved, but overall there will always be a need for the top-quality HR professionals in every big organisation.”