The Employee Relations Adviser at the CIPD discusses their new report on people management and development on NHS which looks at ways human resources management could enhance performance improvement based on empirical evidence.
How can people management and development help NHS organisations achieve their goals? This is the issue addressed by a report on research undertaken by Manchester Business School in 2006, which was jointly funded by the Department of Health, Healthcare People Management Association and the Chartered Institute of Personnel and Development (CIPD). The research was conducted in six case study organisations from the NHS acute, mental health and primary care sectors.
The report focuses on the importance of the psychological contract in influencing the relationship between organisations and their employees. It suggests organisations should recognise that individuals’ emotional responses are a part of the process leading to individual performance, and that enabling and encouraging a supportive workplace for all staff needs to be a management priority.
Creating a positive psychological contract between employer and employee
The report finds that the psychological contract in the NHS is one where people expect to give the employer their loyalty in return for a career. Over 70% of individuals had their expectations met at work and three out of four believed that this had a positive impact on the delivery of patient care.
It is also important for staff to be able to influence changes and get involved in them. This includes improving systems and developing flexible working arrangements, and the opportunity for individuals to use their autonomy to introduce local improvements. Staff responded very positively to situations where they were able to improve services for patients, and where their professional commitment and ability to achieve results was recognised.
Employer expectations
The report also looks at what individuals think their employer expects of them. The majority of responses centred on getting the job done, reflecting the belief that doing one’s job contributes to patient care. Staff are generally willing to go beyond expectations, especially where there would otherwise be a detrimental impact on patient care. The report says that organisations need to communicate a culture where it is acceptable to raise issues of workload.
Getting people management right
The report finds that people management policies are brought to life by the work of line managers who recognise their importance. It also finds however that NHS line managers often have little engagement with developing HR policies and that managing and developing people is given low priority in comparison to other activities.
Managing performance
The report discusses different interpretations of what is meant by the idea of “performance” in the NHS. Individuals see their own performance as being concerned with how they do their work, which then leads to outcomes for patients. Organisational performance on the other hand is perceived to be assessed using “targets”, which are seen by some to be in conflict with patient care.
How should HR departments support organisational performance?
The report suggests that HR managers need to look to their relationships with a range of stakeholders, including other managers and colleagues, to enable improvements in performance. It recommends that the HR function should:
- ensure that policies, as well as the rationale for their use and guidance on implementation, are translated and adapted to be clear and understandable
- recognise that one size will not fit all, and different emphases will be required, depending on the organisational strategy
- understand that line managers have a key role in implementing people management policies, and need to have appropriate knowledge and skills.
Comment
CIPD research has repeatedly underlined the positive impact of people management practices on organisational performance, but the message needs to be customised so as to reflect the circumstances of individual sectors and organisations. This report provides valuable insights into the things that help deliver high performance and the things that hinder. HR managers have a key role to play in engaging and supporting senior management. CIPD hopes that the findings of this report will be widely discussed within the NHS.
This article presents independent research commissioned by the Department of Health. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, or the Department of Health.
A copy of the research report ‘Improving health through human resource management’ is available at
