Beyond recruitment: Five priorities for CPOs facing the NHS productivity challenge
With the imminent publication of the 10 Year Workforce Plan, Dean Royles, interim chief executive at NHS Employers, shares practical actions for chief people officers (CPOs) to prepare for the launch of the 10 Year Workforce Plan and address the productivity challenge.
Let’s be honest – the 10 Year Workforce Plan won’t just be another document landing on your desk with a thud. It’s a signal that the game is changing. With ambitions around shifting care from hospital to community, analogue to digital, and sickness to prevention, the pressure on productivity will be immense. We can’t simply recruit our way out of this. The workforce of the future must deliver more value, with greater efficiency, while maintaining the compassion and quality that defines the NHS.
Since 2010, the NHS full-time equivalent (FTE) workforce has increased by more than 36 per cent*. It probably doesn’t feel like it to staff, perhaps because the expansion hasn’t always translated into proportional productivity gains. Notably, growth in administrative, support to clinical, and infrastructure roles has been significant, with some non-clinical support areas seeing rises of 40 per cent or more. This imbalance underscores why we must get smarter, not just bigger over the coming years. We owe it to the staff in the organisation we lead.
Chief people officers (CPOs) and their teams sit at the heart of this. We are turning our HR functions from a support function into a productivity engine. I’ve been chatting to colleagues about how they are preparing for the launch of the 10 Year Workforce Plan and addressing the productivity challenge.
Here are five practical things from those discussions that you can do right now.
1. Develop headcount measures to include capability and output metrics
Most HR dashboards obsess over FTEs, vacancy rates, and turnover. The 10 Year Health plan demands we understand and measure what drives productivity: skills utilisation, digital fluency, multidisciplinary team effectiveness, and outcomes per staff hour.
Audit your current workforce data. Move beyond basic metrics to ones that link people practices to service delivery, things like time spent on direct care versus admin, adoption rates of new technologies, or productivity in community settings. Work with finance and operational colleagues to build a true workforce productivity scorecard. This isn’t about squeezing people harder; it’s about ensuring every role adds maximum value. Train your HR team to speak this language fluently with operational managers and at board level.
2. Ruthlessly redesign roles and skill mix for new models of care
The NHS plan talks about a left shift in where and how care is delivered, and HR has a key role in redesigning roles to support it. This includes accelerating apprenticeships, ensuring the registered and unregistered workforce are operating at the top of their skill set, embedding digital expertise, and creating hybrid clinical-administrative roles that make best use of expensive clinical time.
Don’t wait for national guidance. Pilot new job families now in high-impact areas like community care or outpatient transformation. Use workforce planning tools to model different scenarios. Partner with education providers to build pipelines that match tomorrow’s needs, not yesterday’s. The best CPOs I know treat this as organisational development, not just recruitment. It’s about building agile, multi-skilled teams that can flex with demand.
3. Embed productivity into leadership development and performance conversations
Productivity can’t be an HR bolt-on. It needs to be baked into how we select, develop, and appraise leaders. Update leadership programmes to include modules on lean processes, digital leadership, and performance coaching. Make productivity goals explicit in objectives for all team leadership roles, not just senior ones.
Line managers are the real productivity multipliers. Equip them with simple tools and training to have better conversations about workload, efficiency, and barriers to effective working. Recognise and reward teams that innovate ways to deliver more with the resources they have. In a values-driven sector, frame productivity as enabling better care, not cutting corners and cutting budgets.
4. Accelerate digital adoption and tackle the admin burden
One of the quickest wins for productivity is reducing the time staff spend on low-value tasks. HR should champion the rollout of AI tools, automation of rostering, e-rostering optimisation, and single sign-on systems that actually work. Audit administrative burdens across roles and lead a war on unnecessary paperwork and duplicated processes. Chief nursing officers will be allies in this work and the chief digital officer can be your best friend here!
This includes your own HR department. Streamline policies, digitise processes, and free up your team to focus on strategic work. Partner with IT and clinical informatics leads. The organisations that get this right will see staff spend more time on the work they are trained for and find most rewarding, improving job satisfaction and ultimately benefiting patients.
5. Build a culture of continuous improvement and staff voice
Sustainable productivity comes from engaged people who feel able to suggest improvements. Strengthen staff engagement mechanisms, particularly listening to frontline ideas on efficiency. Use pulse surveys, innovation hubs, suggestion schemes and rapid improvement events.
Use your wellbeing initiatives not as a nice-to-haves, but as a productivity strategy. Burnout kills output. At the same time, be honest about performance. Robust probation processes, clear expectations, and supportive management are essential. Turn employee relations from defensive to developmental.
The 10 Year Workforce Plan will herald big changes, but the fundamentals remain: great people practice drives great care. CPOs who lean into productivity as a people agenda and not a cost-cutting one, will position their organisation for success. We know it won’t be easy, but it’s necessary. This is an opportunity to get your HR teams facing the right direction, with realism, optimism, and a focus on what matters. I know you have done it before, and you know you can do it again.
The workforce of the future is already here. It will be a travesty if we end up losing staff or have unnecessary redundancies because we don’t equip staff with the skills they need for tomorrow. We, collectively, can make sure they’re set up to thrive and deliver.
