The Leeds Teaching Hospitals NHS Trust
The Leeds Teaching Hospitals NHS Trust is one of the largest trusts in the UK and is one of the largest teaching hospitals in Europe. We focus on providing quality services of both secondary care and specialist tertiary care to the population of Leeds and the surrounding area. We are also a regional centre for a number of specialist services such as cancer and cardiac surgery, and the Trust is recognised as a national centre of excellence for specialist services such as paediatric and adult liver transplantation. We operate via the following sites across Leeds: Leeds General Infirmary, St James’s University Hospital, Seacroft Hospital, Wharfedale Hospital, Chapel Allerton Hospital, Leeds Children’s Hospital, Leeds Dental Institute. The Trust has approximately 2,500 inpatient beds together with critical care and day care beds. In total, we employ over 16,000 staff across seven sites, treating around a million patients a year with a budget of £789m.
We have a number of human resource management issues in particular with people resourcing and talent planning within the Leeds Teaching Hospitals however the focus here will be on one of our sites Leeds General Infirmary (LGI) which is right in the heart of the city, has been saving lives for nearly 250 years. It is also a specialist regional centre for a number of complex conditions, as well as providing many general acute hospital services such as an A&E department, intensive care, state of the art operating theatres and a high-tech high dependency unit. The hospital has a large and busy Accident and Emergency department for adults, and next to it is a separate dedicated facility catering for children up of the age of 16, adjacent to the facilities of Leeds Children’s Hospital to ensure seamless care for youngsters. The hospital also has one of the best-known maternity units in the country thanks to its exposure on the award-winning Channel 4 series One Born Every Minute.
It brings together many of the country’s leading experts in caring for patients with serious brain injuries, heart and lung problems and major trauma, a helicopter deck on the Jubilee Building has seen thousands of flights by the Yorkshire Air Ambulance bringing sick patients from all across the Yorkshire region and beyond to be treated by experts at LGI. As one of the country’s leading teaching hospitals, LGI has an international reputation for its expertise in a range of specialist services for which the hospital is a regional centre.
On 1 April 2013, we moved from a Divisional structure to a clinically-led one, putting doctors, nurses (or other health professionals) and managers in a decision-making triumvirate. This new structure became operational with the creation of 19 new Clinical Support Units (CSUs) which deliver all the clinical services undertaken by the Trust, all reporting to the Board-level post of Chief Operating Officer.
LGI has an autocratic culture, with a divisional power base and a Chief executive who appears to make most the decisions, keeping tight control of the Trust and ruling by what amounts to intimidation on some occasions. He focuses mainly on the success of the Trust. Communication is very much a downward cascade. NHS policies and procedures are designed and agreed by the government and considered by the board before being implemented – there is other forms of consultation involved.
Morale within the LGI is very low and staff turnover is generally high in clinical and none clinical roles. The Leeds Teaching Hospitals NHS Trust has a central HR function which is devolved amongst the seven sites and comprises of a HR manager, a HR officer and three HR administrators at each site. They have responsibility for the HR issues of the entire site (except for payroll, which is incorporated into the finance & procurement) and report to the Director of Human Resources. There is a training function integrated within HR. The training manager’s reports directly to the Director of Human Resources from each site and has four training officers reporting to her. The training officers spend all of their time visiting the seven sites to assess knowledge and offering training programmes on effective management and basic skills.
The Trust follow all formal policies and HR practices. The HR function at LGI seem to rely on trial and error – for example, when things go wrong, a guidance document is issued. There is a guidance document in existence for managers relating to disciplinary activity, but no formal training has been provided. Most of the managers have worked their way up having started off working in junior roles. Managers are advised that they must always contact the HR department with any issues relating to discipline. All managers are aware that no one can be dismissed from the company without following appropriate HR process according to ACAS.
The HR department at LGI is thus necessarily reactive rather than proactive in nature and is constantly in ‘fire-fighting’ mode. The HR manager is the only qualified member of the department, and because the role is so extensive her availability to managers is minimal. Each of the administrators, have very narrowly-defined role – i.e. one is responsible for all new starters, one for leavers and references, and another for issuing contracts and new starter packs. Managers may therefore be required to speak to three different people with regard to the employees in their area. The HR officer also acts as office manager and oversees the work of the HR administrators. Responsible mainly to deputise for the HR manager in her absence.
All HR records are kept divisionally feeding into a central HR system, with a file for each individual employee. The HR department occasionally receives a copy of medical certificates but other than that has no knowledge of the sickness absence levels at LGI. A monthly report identifying long-term (six weeks or more) sickness is produced by the payroll department however formal policy for dealing with either short- or long-term sickness absence is not adhered to accordingly. This has resulted in extreme inconsistency in dealing with employees.
The chief executive has high hopes for LGI and has plans to expand in the coming years. He intends, to increase the number of staff due to the expansion of the hospital from porters, doctors, nurses and specialist staff over the next three years. Unfortunately, this has not been communicated fully to the employees however they are aware that recruitment is on the increase.
Each department manager decided when he or she needs a new member of staff in his or her section, although HR are responsible for advertising and collating the responses. All positions are arranged by the department management with very little input from HR. Departmental management are responsible for their own recruitment and are involved in all interviews –HR manager does not have responsibility for recruiting staff. Neither have they received any formal recruitment and selection training. HR are sometimes involved in the recruitment of staff, but this is at the discretion of the Director of HR depends on the level of the position. On several occasions, individuals have been appointed without HR becoming aware of the vacancy, interview process and so forth until the department is requested to issue an offer of employment.
Appraisals have been conducted for some time amongst all staff either on an annual or quarterly basis dependant on your role and performance is reviewed only sporadically, depending on the competence of the manager. Appraisal documentation was issued and the responses collected and filed. The information gathered has not been acted upon, which has adversely affected the morale within the LGI.
Your Task – Individual Report (70 % of the total mark)
You have just been appointed as the HR adviser within the HR department at LGI and have been made aware by the site HR manager of the human resource management issues at LGI. By using appropriate literature and models of recruitment and selection, performance appraisal and reward systems: Justify your answer by making appropriate references to current literature (journals, books on line sources etc.).
Questions for Individual Report
- In context to the case identify and discuss three key resourcing and talent planning issues, providing a rationale as to their impact on LGI. This will include consideration as to what people management policies need to be in place in order to complement their planned expansion.
- Evaluate LGI’s current recruitment and selection processes making recommendations as to any changes in strategy and procedures that will provide a more structured approach in recruitment and selection across different employee groups.
- Applying relevant theories, concepts and frameworks assess how you will overcome any likely resistance to implementing your proposed new recruitment, selection, talent planning strategy and procedures. Your discussion should highlight areas of good practice with a view to legal compliance.
