15
Examination of Witnesses
Kate Caulkin and Sian Elliott.
Q33 The Chair: Good afternoon, everyone, and welcome to this session of the House of Lords Public Services Committee, where we are looking at how we design a workforce fit for the future in the public sector and public services. We are very pleased to have, in our first session, two people here in person. We cannot always manage that, but we are very pleased to see you here today. We have Kate Caulkin, who is director of people’s hubs from the National Audit Office, and Sian Elliott, who is policy officer around public services at the Trades Union Congress. Welcome to both of you.
I, as ever, ask the first question. When you come to answer it, just say who you are and so on, so that people who are watching can identify who is who, as it were, and know what background you come from.
We are very clear that the answer to the future workforce is not simply more people. The people will not be there. Other than increasing numbers, what do you see as the key things to do to change what the public workforce is doing in order to meet the increasing demands and changes for people using public services? As we all get older and as there is more challenge following Covid, all of those things, what can be done to make sure that public sector workers can meet those additional demands without all burning out and just feeling fed up? If you have any examples of what you think works, that would really be helpful too.
Kate Caulkin: I am director of people and operational management insights at the National Audit Office. I joined in October last year. Prior to that, I did 30 years in various departments in the Civil Service.
You know very well our value for money reports that go to the Public Accounts Committee. We do 60 a year, so there are huge lessons learned and good practice that we can pull from those reports. That is what my insights team does for people in operational management, so I should, I hope, be able to give you some examples of good practice. We have some bad practice, but I shall focus on the good practice today. We have other insights teams as well, which I am sure you will hear from at some point too.
We produced a guide in March last year that looked at improving operational services within government, and that gave five areas that government should focus on in terms of improving services. If you would like me to give you a good practice example, I will give you one about self-organising teams at the police authority—the people who look at complaints for the police authority. This was an example that we were able to find, having done lots of fieldwork with different people. Prior to the work, management used to organise the teams and the workload. Management made an assumption that people did not like working on complex cases. The way that they used to manage that work was that they would give people an equal number of different sorts of cases, and productivity was managed on an individual basis.
They decided that they would let the teams manage the workload for themselves, so it was a bit of a pilot and a test to see whether it would work. They found that some people loved doing the complex cases and found it far more rewarding. They moved to an approach of team productivity rather than individual productivity, and they saw increased productivity of 33%. That is a good example of not putting more resources in but asking the people who know the work best to think about how it might best be organised.
Sian Elliott: I lead the public services team at the Trades Union Congress. We represent over 5.5 million workers in Britain and represent the unions that represent workers in the public sector—both those employed directly within the public sector and those employed within the private sector but delivering public services. I know you heard last week from ADASS and the FDA about those in social care, which is a perfect example of the often privately employed public sector workforce.
I really agree with Kate about self-organisation. For us, it is absolutely key that the workforce is central to any planning around reorganising workloads, because they know best the service users and what they need in order to meet their needs. They also know the spread of the different needs in the community and how to balance those workloads. What they tell us through our union structures is that we need investment in early prevention services. I know that that was a key principle from this committee.
We have seen a decade of deep cuts and changes to the way in which we fund prevention. Funding for prevention fell by 48% between 2010-11 and 2019-20. That led to an increase in costly, late intervention spending.
What happens is that the temporary problems that families face become entrenched, immutable and very difficult to resolve. That creates very complex caseloads, exactly as Kate was talking about, that then become very difficult and lengthy to resolve. They require more and more different services to be involved, and that puts a huge strain on lots of different workloads. If we could invest again in those early prevention services, we could nip problems in the bud.
We see that across health. If we have smoking cessation services, we know that then helps dramatically reduce the number of those who are hospitalised for cancer and other conditions related to smoking. Similarly, we know that Sure Start centres, which more than halved in the last 10 years, had a huge impact on children’s outcomes.
A report by the IFS found that those investments in Sure Start centres led to a reduction in hospitalisations among children and to stronger immune systems, as well as safer home environments. Family issues could be resolved much earlier on, which then did not put a strain on social services or on schools that needed to respond to more complex cases.
I know that you understand this, from having read your vulnerable children report. Our public services and our communities that rely on them exist within an ecosystem. When one part of that ecosystem is not working, it creates strain and pressure everywhere else in that system. If we can begin again to invest in those preventive services, we can start to reduce those workloads, see that positive impact that we were seeing with, say, Sure Start centres and get back to really making improvements to the lives of children, their families and our communities.
The Chair: I always try to make sure that, if any member wants to come in on anything that you said, we can bring them in, but let me follow up a little bit. You were saying, Kate, that pushing decision-making down to a flatter structure and involving the workforce in deciding priorities and how they handle them worked a lot better. Was it the Met Police that did that?
Kate Caulkin: It was the independent police conduct authority.
The Chair: There are two of our colleagues who will know far more about the differences there than I do. I wonder whether you have any specific examples, Sian. When I was doing this in government, I came across some workforces that had changed the way they did things. The problem is that this is a long time ago and I am not sure that it has continued, but I remember that there was a group of midwives who were allowed to set up a co-operative, and to take their pension rights and so on with them, which was always the biggest thing. Because they then had a stake in the way in which they delivered the whole service across a county, the productivity went up fantastically, as did the job satisfaction.
It is that sort of thing where we are looking for examples of where people are changing the way they work. I always used to think that classroom assistants were a great help to teachers, even though, right at the beginning, teachers did not want them. We have heard the same about nursing assistants and that they have made a real difference. I wondered what you have looked at but also what the unions say about those sorts of things now.
Sian Elliott: Something that they fed back to me before I came today was that there are really good local pockets of that kind of self-organisation going on, where workers have much more of a stake in their workload and in the services that they are delivering.
One of the difficulties has been about scaling that up and sharing that best practice. That has worked really well in the NHS. As well as having its agenda for change, which is where employers and unions, on behalf of the workforce, come together to talk about industrial relations, it now has the social partnership forum, which is specifically tasked with identifying exactly that kind of best practice and then making sure that it is shared not only regionally but nationally.
We would like to see the rollout of that social partnership forum across other areas of the public sector, so that we have a litany of case studies across the public sector that we can turn to and say, “This is working really well in this area. This could be transferred across”. At the moment, we are having some difficulty in getting that information from the ground up through the structures that we have in order to understand and share that best practice across the public sector.
We know that, during the pandemic, many of those on the front line, using the local knowledge that they had, clicked into action. They worked with community groups, because they had those connections and relationships, but that information is not being collected on a national or regional level outside of the NHS, where there is that social partnership forum. We urgently need a structure to do that, so that I can come back in a year’s time and talk about a social partnership forum for local government or for social care, and say, “This is the best practice they’ve identified. These are the lessons they’ve learned”.
That would be a really good recommendation and a way to take forward and strengthen some of the lessons that we have learned not only in the lead-up to Covid, but particularly about the way that people on the ground were able to work together very quickly, change their workloads, adapt and meet those needs, but we need a way to collect that information and those case studies. The social partnership forum model that we have in the NHS is a really good way of doing that.
Kate Caulkin: I was going to add another example of one of the reports that we have published recently, which I think you will be aware of—the vaccines report. We saw some really great examples there, not of the self-organising teams but rather of system thinking and having central control while allowing local communities to implement in the way they needed to. It was about using existing processes but adapting and learning as you go, using not one approach but different approaches. There is definitely something around learning lessons from things that have gone really well during Covid-19 and how we can balance central control with allowing local people to make sure that it is right for their community.
Q34 Lord Bichard: For what it is worth, I have been trying to think of a framework that would enable us to focus our thinking in this Select Committee, and Kate and Sian have helped me quite a lot. I would be interested in whether they think it is right or wrong, or whether they want to add to it. We can first of all think about how we recruit better into public services. We heard some of that last week, but, as the Chair said, just recruiting more people is not going to solve all our problems.
Secondly, we could retain better than we do at the moment, and you have come up with a couple of examples of that in terms of more flexible working and more satisfying jobs. Thirdly, we could increase productivity, and Kate has given us a good example of how teams working together can do that, but digital technology could also help us to do that.
The fourth—and, in my model, the final—grouping is about reducing demand or, in other words, better prevention. Again, digital can help quite a lot with that.
Maybe this is particularly for Kate, because I know my friends at the NAO like models and frameworks. Is that the kind of framework that makes sense to you?
Kate Caulkin: That touches on a number of areas that we would talk about. I did not talk about the last one, on preventive measures, which we probably talk about in terms of failure demand. Our report in relation to improving operational services has some advice on how you can do that. Once again, it involves customers as well as the people who are doing the work in how you can do that. Your four areas probably cover most of what I would say.
The only other thing is the workforce strategy piece and being really clear about what skills are needed for the future. I know that there are some real challenges with that in terms of what the changes are going to be, what technology will bring and what skills we are going to need, but that is probably the only other thing that I would add.
Lord Bichard: You are absolutely right to raise the issue of users, customers or clients, whatever you want to call them. They impact on increasing productivity as well as on reducing demand, because it is often the person who is receiving the service who can tell you how you could deliver it better and more cheaply, and we often do not listen to them. That is a very good point.
Sian Elliott: I would like to add to that co-production point. Service users in the public sector are best placed to know the outcomes they need from the service they are interacting with. When co-production is talked about, the other crucial group that is missed is the workers on the front line who are delivering those services, because they see those communities day in, day out. They know the different needs that they have. When we talk about co-production, we need to make sure that it is both the workers and the service users. The more trust we can build between those two groups, the better the outcomes overall.
Digitalisation can bring huge benefits and gains in terms of productivity, but I did some research looking at the experience of workers and users in the Jobcentre Plus system. What we need to be really careful of with automation and digitalisation is “Computer says no”, because that can sometimes reduce the ability for workers to have autonomy and to engage with the family they are sitting in front of and think, “This person has a somewhat legitimate reason as to why they have lost a job or something has gone wrong”. More often than not, Jobcentre advisers would tell me, “I had no choice. I could not interact with the system and, as a result, I had to sanction the family and give them a food bank voucher”.
Digitalisation is really promising for what it can bring, but we have to bring users and workers into that journey from the very start, to make sure that we do not end up building in any such systems that take away autonomy from our service users, denying them a voice, and from those people delivering it at the front line.
Lord Bichard: In the early work that we did on how public services reacted to the pandemic, we found quite a lot of evidence that users were saying to us, “But this wasn’t our first priority”. In other words, “You’re wasting money by investing in this. Why don’t you listen to us?” That is another way in which co-production is so important in terms of increasing productivity and reducing demand.
Q35 Lord Hogan-Howe: One of the big issues for anybody is controlling the hours they work. Particularly if you have public services working 24 hours, it is often in shifts, which is never attractive. We have learned things over the years about circadian rhythms and whether you work fixed shifts. Have you found many examples of where people got real control over their working hours? What tends to happen is that their managers want them to work in teams, when, in fact, they might want to work six nights. Provided you get the work done, you could argue, “Does it matter?” Have you seen many examples where public services have allowed employees to control their shift patterns?
Sian Elliott: Our NHS trade unions have won for workers in the health sector the right to work flexibly from day one. That has led to huge changes. There is one NHS trust that has allowed a group of A&E workers to self-roster, which has meant that they can plan caring commitments or somebody’s birthday. They all sit together and look ahead at the next six months, and they say, “I can cover you on that day. You can cover me”. Giving that autonomy to workers leads to higher productivity and motivation, because you are there and in control of your hours.
What we are seeing come through from our unions, particularly in the health sector, where that has been introduced and people are working shift patterns—and they are used to working shift patterns and take on those jobs knowing that that is part of the job—is employers being flexible and saying, “Let us meet you in the middle. These are the business needs that we need to be able to cover. These are the shifts that we need covered. Let us work together to find a way to do that that works around your work and care commitments”.
That feeds into the wider point about retention. Huge numbers of people working in education and in the NHS are leaving to go and take on bank work, because that allows them to say, “I can’t work Tuesday, because I need to pick my child up from school that day”. That insecurity then leads to all sorts of other difficulties. You cannot predict your income from one month to the next, but that lack of flexibility that they had then forces them into those situations. Where we are winning in places such as the NHS, I believe that, within a year or two, we will be seeing some really significant changes and more of that self-rostering. Again, that plugs into that social partnership.
Lord Hogan-Howe: You have answered the question very clearly and given examples. Is the good case that you described usual or unusual?
Sian Elliott: At the moment, it is unusual. That right to work flexibly is a recent win, as it has been in the Civil Service. We are seeing change, but it is trickling through. Again, it points to the problem about how you scale up best practice. How do people know that this is working really well? That is where unions and union members who come together in many different forums can be talking to each other, and where union officials play a really key role. People such as me go out to different webinars and talk about flexible working gains, but there is no formal structure within the public sector to share that information. That is what we really have to focus on, so that it becomes the norm rather than the exception.
Q36 Baroness Pinnock: This is a different area of exploration that is thinking about how public services attract and keep employees who come from a huge variety of backgrounds and different communities, or with disabilities. Some good examples would be helpful again. You are full of them today, which is great.
Kate Caulkin: A couple of years ago, prior to Covid, we did some work with the Army on recruitment. They wanted to attract as many candidates as possible. There is a good practice example from which I can share more of the detail, but they helped candidates all the way through the process. They found that the process was taking six months, so they put a lot of effort up front into helping and supporting candidates through it. They put in place a digital front end but allowed candidates autonomously to ask current soldiers any questions that they wanted to, which helped them understand the sorts of roles they would be going into.
Because it was completely autonomous, there were no worries in terms of the questions that they were going to ask. They put other things in place too, but that was about using the people who were potentially going to be candidates and using their current staff by changing the processes and making them more user friendly.
Baroness Pinnock: Did that work?
Kate Caulkin: Yes. I cannot remember the percentages, but they saw an increase in recruitment in people who stayed within the recruitment process and did not drop out. One of the other changes that they put in place related to preconceptions about what health conditions were needed to be a soldier. So they also put help in place for getting through the assessment centres. People were recruited more quickly by doing that. It was about thinking about the candidate. Where people did not need the additional help, they might have been recruited sooner, but it was about allowing candidates to take a bit more time where they needed to and helping them through the overall assessment centre and process.
Baroness Pinnock: That is very interesting and would apply, presumably, to policing.
Lord Hogan-Howe: They have done some of that, for the reason that Kate has explained: because people are frightened.
Sian Elliott: It is about peeling back that window. A point that builds on that slightly is that the public sector has historically always employed more women, more black workers and more disabled workers than the private sector. That is, in large part, due to the terms and conditions that public sector workers are offered. It is typically more secure work than you increasingly get in the private sector, but some of the additional terms and conditions are also really important to some of those workers.
We know that, for women, participation in the workplace often depends on their ability to manage work and caring commitments. Our unions have been encouraging employers across the public sector to advertise, up front, the types of family-friendly policies that they have on offer. Are you a flexible work employer? Are you, in the tagline of all your job adverts, advertising that you are happy to talk about flexible working?
We know that employers report a huge increase in women and disabled workers applying once that kind of messaging is made public. Do you have your maternity, paternity and carer’s leave policies advertised on your vacancy portals, so that parents do not have to identify themselves and possibly risk discrimination or fear that they might face discrimination if they say they have caring commitments and might need some additional policies that they can turn to? If you have that open on your website and on your vacancy portal, women and those with disabilities are much more likely to apply.
We have historically had those benefits in the public sector because of union density. Unions have long understood that these are the issues that the workforce is facing and have been able to work with employers to negotiate, to enhance some of those policies, and to make the public sector a much more attractive place for that workforce.
Similarly, there is research by the IMF, the OECD and the TUC to shows that pay differentials in unionised workplaces are less than those in non-unionised workplaces. You are much less likely to have gender pay gaps, or black and ethnic minority workers being paid significantly less for the same job, than you are in the private sector. I can share with you afterwards the OECD research that states that.
It also shows that staff are much less likely to have job-related anxiety in unionised workplaces, because they know they have those policies. They know that they might be able to take a day’s paid carer’s leave, if their child’s school calls or if they need to go to a hospital appointment because they have a long-term health condition. That differential is particularly significant, as the OECD said, for women with caring responsibilities.
Those are the basic fundamentals that trade unions advocate for, and we have got them right for a long time in the public sector. As I said in my submission, I have a worry, which we have backed up with evidence, that the outsourcing agenda is disproportionately impacting jobs occupied predominantly by women, disabled workers and black workers in the public sector, which is undermining the really good work that the public sector has been doing. It is leading the way when compared to the private sector but is being undermined by that outsourcing agenda.
Baroness Pinnock: I was going to ask about outsourcing, but the other issue, surely, is career progression, which, in the public sector, is still dominated by people from certain backgrounds. How does that glass ceiling break for people from minority groups, be they disabled people or people from different communities?
Sian Elliott: That is a really good question. A group that I have not mentioned is older workers, who are much less likely than younger workers to be offered training opportunities in the workplace. That is because of a perception that, if you are an older worker, perhaps you are no longer as ambitious, given that you are coming towards the end of your career. It is all about equality of opportunity. In the public sector, you have the public sector equality duty—the PSED—which is meant to and does require employers to be conscious of and constantly thinking about equality of opportunity.
In the Civil Service, the senior salaries review board has recommended for several years running now that we fix the structures that enable people to have equal access to training and a good, effective progression pathway. Specifically, when that is looked at, we need to make sure that the different groups that may or may not be getting opportunities to access training equal to others are actively thought about and proactively brought into those training opportunities.
Q37 Lord Bourne of Aberystwyth: Thanks to Kate and Sian for the fascinating evidence. This is a fairly short point but just a plea for some more evidence. Sian, you have mentioned the position on outsourcing. I could not find any stats on that. The stats that we have on the ethnic breakdown are quite surprising, in that they do not show a massive difference between Asian and white, although there is a slightly higher proportion of white than Asian, and African is higher, as you suggest.
If you have any stats on the breakdown of disability and women, and anything more granular on the ethnic background, it would be very interesting, because there is a remarkable lack of evidence, which might be one of the problems that we are up against, particularly in outsourcing. I do not know whether you have anything to say, but, if you have such evidence, it would be good to get it.
Sian Elliott: We have evidence that around a third of all public expenditure is on goods and services external to the public sector. In the public sector, the occupations that have seen the largest concentration of outsourcing are cleaning, catering and security, as well as defence, prisons and other areas. They are occupations that ONS has data on, which I can share with you, to show they are much more likely to be done by women. For example, the cleaning workforce is 80% women. Black workers make up 26% of security guards compared to 12% of the overall workforce. They make up around 16% of cleaners. They are much more likely to be in those occupations.
We are finding that those are the occupations that have seen the biggest concentration of outsourcing over not just the last 10 years but the last 20 to 30 years. We know that it is disproportionately those workers who are being moved out of the public sector into those outsourced contracts.
With regard to ONS data, I wrote a report in late 2020 on black and ethnic minority women’s experiences in the workplace. In that, you can trace the decreasing number of black and ethnic minority women working in the public sector and an almost identical increase in those self-employed or employed on zero hours and temporary contracts. Care workers, for example, are three times as likely to employed on zero hours contracts if they are employed within the private sector than they are if they are employed directly by local government.
I hope that gives you some of the evidence that you are looking for, but I should flag that I am in the middle of doing a big piece of work at the TUC on the scale of outsourcing in the public and the private sector. We will be publishing the findings of that later this summer, so I will make sure that I circulate it to you all as soon as I have it.
Lord Bourne of Aberystwyth: I am glad I gave you the opportunity for the plug. I wonder whether you have anything on disability as well.
Sian Elliott: I do not have anything on disabled workers to hand, but I can circulate something afterwards.
Baroness Pinnock: Do you also have any statistics about progression through the workforce? The figures that we have are just the overall ones. How many women, BME or disabled workers are in the upper tiers of local government or the Civil Service?
Sian Elliott: I did not bring those stats with me and, while I cannot ask you to take my word for it, we know that the senior management, particularly within local government and within the Civil Service, is predominantly represented by certain groups, and that those from working‑class backgrounds and from BME communities are much less likely to be represented.
There has been some really good work on pushing women through and pushing that glass ceiling. It is still not where we want it to be, but our unions are working hard with employers to come up with really good programmes. Women’s networks are an example of the simple, fundamental and practical things that we could be doing, but I do not have the exact data to hand.
Baroness Pinnock: That is all right. If you could send them, that would be really helpful.
Q38 Lord Hogan-Howe: Before I start on my quick question, following on from Lord Bourne’s point about getting more evidence, Baroness Pinnock’s question made me think about the impact of families on the ability to recruit. Most professions and organisations tend to recruit within their own families—police, lawyers and doctors. I could go on. I am not asking for an answer now, but it would be really helpful to get some evidence about the impact that has and what, if anything, the research has told us.
My question is about what I touched on earlier, which is about how you get co-design by users in two things: first, the delivery of the service that people are offering and, secondly, the training. It is back to that old chestnut: do you have any good examples? One good example, if there are million users, does not make a lot of impact. It is strategically unimportant, so I just wondered where you had seen it most and most effectively, either in training or in the design of delivery.
Kate Caulkin: In the NAO, we are focused on the design rather than the training. I could give you another example that we came up with during Covid, which was of rough sleepers. This plays to some recommendations from your last report about working with the voluntary sector rather than the end user on how we identify rough sleepers and get them into accommodation during Covid. That was very much about that local approach and knowledge to find out where sleepers were and, with the voluntary sector, what we needed to do to get them into accommodation. I can provide some more detail on that, but the training piece is an interesting one. I do not have a specific example of where the end user has been brought into training, but I note that it is an area of interest and I will take that away.
Lord Hogan-Howe: You offered the example of people who are homeless and getting voluntary bodies to represent their views. They are not always an easy group to get views from. Equally, representative democracy is okay but is not always perfect, so I just wondered how that is handled. The danger is that the voluntary sector says, “We really like this system” and that homeless people say, “I don’t like that very much”. Was it really effective?
Kate Caulkin: Yes, it was really effective. It helped 33,000 people into accommodation. It is a best-practice example.
Lord Hogan-Howe: I have a really hard question. How do you know it worked? Why was it better than what homeless people had before?
Kate Caulkin: That is an interesting question that I will have to take away.
Sian Elliott: To add to what I was saying earlier about co-production, I do not have an example of it in training. It is a really interesting area to think about. I reflect on education and how teachers and students could be involved much more in thinking about what the curriculum looks like and what training teachers go on. It certainly sounds like something that our members would be really interested in.
Often, as policymakers, we use language, but it is happening in our schools. Teachers are speaking to their students and responding to their needs, and they are coming up with far more creative ways of delivering the curriculum than is nationally set. They are responding to a meme or a moment. I have a 10 year-old whose teacher is fantastic. There might be a song that all the students are listening to at the moment, and she will respond to that. That is co-production in action. It is the users and the deliverers working together to get the best outcomes.
Building that into training pathways would be really interesting to do, and I would be really interested, if I cannot find any evidence for it but this committee does, in taking it back to our trade unions and sharing it with them.
Lord Hogan-Howe: Although there will be some good examples, and we have heard of some, is it widespread? My impression, although you probably know better, is that it is not widespread but there are good examples.
Kate Caulkin: We have fewer good examples than examples where perhaps we could do a bit better in terms of what are seeing.
Lord Hogan-Howe: It goes back to the earlier point about what drives things to get better across the board, not just from time to time when good people happen to be well led.
The Chair: The problem is that the examples proliferate among those very disadvantaged communities. The best work on user involvement and experts by experience being used is in that bit of the sector that deals with people with complex needs or with rough sleepers. We all have a bit more to learn on that.
Lord Hogan-Howe: That is a really good point. Where you have good examples, what is the common factor that joins them? Does it just happen to be a good leader or a good set of people? As the Chair has said, is it just very difficult circumstances that force people to be more creative?
Kate Caulkin: It is probably a number of things that we have touched on already. The good examples are where the end users have been involved up front. It is where you have asked staff for their opinion and involved them in the design of the processes. We also see good examples of systems thinking. What we see a lot of the time in departments is looking at it just through the lens of that department. Vaccines are a good example of where departments have worked really well together and thought outside of their own area about how they can join up end to end.
Lord Hogan-Howe: That is what the Chair was saying. In a crisis or when there is very great demand, it can drive people to be different.
Q39 Lord Porter of Spalding: This set-piece question is a little unfair, but it was given to me to ask and it was better than me asking anything about IT and technology, so I will ask this one.
You are allowed to make one recommendation to the Government. This sounds critical of the workforce, but I am not critical. I love my local government workforce and think that they have done a sterling job for the last two years in Covid. This is supposed to encourage you to give me the silver bullet that we all need—two silver bullets, ideally—because the werewolf is a bit bigger than we wanted it to be. What could we do to make a more effective public service workforce? What one recommendation would you give if you had a chance to tell Boris, “Just do this and it will be so much better”?
Sian Elliott: That would be lovely.
Kate Caulkin: My one recommendation, which will cover a lot of areas, is to implement the insights from the NAO. There are a couple of reports. I touched on our good practice guide, but we also did a report on efficiency recently, and there are a number of areas there that could be taken forward by government in relation to improving efficiency and a lot of what we have touched on today—customer insights, system thinking and that kind of thing.
We have not touched on leadership capability and technical capability, which would be another area. I must just do a plug for a piece of work that we are doing at the moment, where we are looking at workforce skills across the whole economy. It is a really interesting piece of work that is in progress, and we will share that with you. We did a piece on the nursing workforce. In that study, we provided some recommendations about what you should be looking for in a long-term workforce strategy, the skills you need for the future, how you can plan for those and how long it would take to develop those skills until someone is up and running. Those are some of the things that I would point to.
Lord Porter of Spalding: My maths is not very good. They were three silver bullets as opposed to one.
Kate Caulkin: Implement our insights. There you go—that is my one.
Sian Elliott: What we need is what we have been getting at throughout this conversation, which is a really joined-up, systemic, long-term workforce strategy designed with workers and their representatives, with co-production from service users, which looks at the public sector as a whole because it is an ecosystem. Local government workers are dependent on health workers and education workers. We are all connected, as are the communities that they serve.
With that long-term workforce strategy, building slightly on one of the questions that Lord Hogan-Howe asked, people need the space and the capacity to think about how to meet a community’s needs. During the last 10 years, and particularly during the last two, we have had a crisis in our public services, because the reduction in public spending has forced everything to crisis point.
It has stripped away those early preventive services, and we need to build that back in so that workers, employers, providers and the communities they serve have the space to think about what a long-term strategy is. Exactly as this committee is setting out to answer, what is our vision for a public sector workforce that meets the needs of our population, both now and in the future? That has to be done through co-production, with employers, providers, users, unions and workers around the table, problem solving and putting that work in together.
Q40 Lord Bichard: Sian is a fantastic advocate for unionisation and I agree with much of what she said. On the other hand, just to add a degree of reality in the conversation, when I have been involved in trying to introduce equality programmes and to redesign jobs in the past, sometimes the unions have been a barrier rather than a facilitator. People do not always like to see their job redesigned, even if the users say it would be a better way of delivering. I understand what you are saying about unions being a powerful force for good, and I hope that they are, but that is not always the situation that we encounter.
The Chair: There is a challenge, Sian.
Sian Elliott: It is a very welcome challenge.
Lord Bichard: I could not resist it, Sian, and I hope you take it in the spirit in which it is meant.
Sian Elliott: I do, absolutely. Funnily enough, it builds into lots of the points I have been making. Sometimes you have somebody at the top redesigning something because of what they think somebody at the bottom needs. If you have not brought everybody along in that journey, people are not going to be bought into that change. If you have not engaged the unions, the workers and their representatives in such a way that they buy into that change, you will meet resistance, which is often fairly well founded.
I was speaking to the Royal College of Midwives before I came here. One of its concerns is that, at the moment, we have a crisis in midwifery, as we have across the NHS workforce. Nurses have been moved across to deal with postnatal care of mothers and babies. Although really welcomed by their midwifery colleagues, those nurses do not necessarily have the skills or training to respond to some of those needs. We are robbing Peter to pay Paul, because we need those nurses elsewhere in hospitals and within the system.
Sometimes that resistance is borne out because people on the ground can see that this is fixing one problem but that we have a great big hole opening up somewhere else. I take that on the chin, but I hope you will appreciate my challenge back, which is about that long-term workforce strategy, designed with workers, unions, employers, providers and service users, so that we do not have those situations and so that we are looking at everything in the round. You should then have a smooth sailing.
Lord Bichard: That is a good answer and I will take it on the chin.
Lord Hogan-Howe: I know the spirit in which Michael asked the question, but, to be fair and balanced, sometimes managers can be equally challenging. I have certainly had experience of this when we were trying to give people the opportunity to work night shifts permanently. That might sound unattractive, but for childcare, if you are fortunate enough to have two carers, it can be quite helpful for a period. The block was the managers, but when it was exposed to the workers they were prepared to do it. It is sometimes a combination of the two.
Lord Bichard: I totally agree with that.
The Chair: I am desperate to come in on that last question, but I am not allowed to, because I have had some interesting experience of trying, in a workforce that has been predominantly male and white, to do different things with it, and that has been a real issue. I come from a trade union background, but I see the problems as well as the strengths, and the same is true in number counting. Sometimes it can really help us and sometimes it is a real challenge. We are not here to criticise you but to give a bit of challenge, do some thinking and see if we can come with ways forward.
Can I thank you both enormously? I hope that you will do what you have been talking about. As your ideas are being refined and as you are thinking about new issues, if you really think that it would have any relevance for us or that we would find that interesting, by all means let us have that. This is an area that has all sorts of difficulty and, as Lord Bichard has said, we are probably going to have to narrow down what we are looking at, at some stage, but you have been very useful to our thinking this afternoon. I hope that we are able to reflect that in our future deliberations. Thank you very much indeed.
