Addressing local inequalities through employment
This page explores some of the work already underway across the country to address local inequalities through employment.
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Northern Care Alliance NHS Group
The Northern Care Alliance NHS Group (NCA), worked with local partners to tackle health inequalities by delivering pre-employment programmes for local people furthest away from employment.
The NCA brings together four hospitals, specialist and acute services, a range of associated community services, across Oldham, Rochdale, Salford and Bury. With more than 18,000 staff, it is the largest employer in the places it serves. NCA’s ambition is to broaden its reach beyond providing caring services to understand the drivers of ill health and the impact of poverty.
Prior to COVID-19, current economics weren’t working for many local people and places. Regeneration in city centres has seen poverty pushed outwards. Working with other partner agencies the NCA is committed to supporting the concept of ‘inclusive growth’, where large organisations use their economic power through place to support poverty reduction and tackle health inequalities. This led to the creation of a social value ambition to:
- use power in a purposeful and intentional way to ensure sustainability through environmental actions
- support the reduction of poverty through employment and job creation
- anchor wealth to place through procurement processes
- challenge current local and national economic policies that don’t support vulnerable groups within the community.
By 2025, the NCA will triple the number of pre-employment learning opportunities available for those furthest away from employment. Fundamentally, it is not just about providing pre-employment or work experience opportunities, but about securing meaningful paid work particularly for those for whom structural inequalities have prevented their talent from shining. These pre-employment opportunities will be used as a talent pipeline not just for the NCA but for other health and social care providers across Bury, Rochdale, Salford and Oldham.
The board has also set out an intentional inclusion strategy which aims to ensure the diversity of talent through the NCA’s NHS Career Ambassadors. Career Ambassadors are available to support schools and colleges with career advice and importantly, to be positive role models in communities they can identify with.
The NCA has also adapted recruitment processes for pre-employment programmes, to focus on values and that counts as the interview for the organisation, so that if a learner successfully completes a pre-employment programme they are moved directly into paid work.
Localities are brought together twice a year to reflect, learn and challenge through a community of practice approach that helps to ensure a lasting difference is made to the lives of local people.
Lancashire and South Cumbria Health and Care Partnership
In response to rising redundancies as a result of COVID-19, the integrated care system (ICS) used existing volunteer and redundancy pipelines to recruit to the mass vaccination programme.
Lancashire and South Cumbria Health and Care Partnership serves a population of 1.8 million people. Nearly a third of its residents live in some of the most deprived areas across England and life expectancy is lower than the national average. The ICS has traditionally taken a system wide approach to recruitment to ensure health and care roles are developed in partnership with local NHS and social care organisations, education providers, the local enterprise partnership, and the Department for Work and Pensions. This shared vision enabled the ICS to recruit people within the local community to roles in the mass vaccination centres.
By August 2020 more than 15,000 people had been made redundant across the region. As numbers continued to rise, it became clear that action was needed to mitigate inevitable health inequalities as people got further away from the labour market. The mass vaccination recruitment programme provided an opportunity to fill vacancies using existing volunteer and redundancy pipelines.
The ICS was well placed locally to deliver this recruitment because of its pre-existing commitment to recruiting from the local community. The local Jobcentre Plus selected and signposted people based on their skills to fill administration and clerical roles. Learners then enrolled in a two-week pre-employment programme that was co-designed with Lancashire Adult Learning and People Plus. Following this, learners were encouraged to apply for vacancies, or to enrol in longer employability programme if they were not quite work ready. A streamlined recruitment process, focused on values, helped to break down barriers to recruitment and enabled the ICS, alongside the lead employer for the mass vaccination programme to recruit at pace and support local people back into work.
121 learners successfully secured role in the mass vaccination centres, helping to provide meaningful work for local people. The recruitment drive also provided an opportunity to showcase roles across health and care to people who had previously worked in other sectors. An important next step will be to retain those within the system.
The overall success of the recruitment programme came because of the strong relationships already in place between all local partners. Working collaboratively with partners across the employability agenda ensured better outcomes for the local community and for all partners.
Future plans include exploring new ways of working alongside partners to align approaches to health and social workforce planning.
Sandwell and West Birmingham Hospitals NHS Trust
Through its approach to widening access to quality work, the trust has helped to reduce health inequalities and by using buildings and spaces to support the local community, it has successfully developed a workforce representative of the local area and patients.
Sandwell and West Birmingham Hospitals NHS Trust (SWBHT) has a strong foundation as an anchor institution rooted in its local community and is very aware that it can use this position to have a positive impact on the outcomes of the population.
As a major employer in the Sandwell and West Birmingham area, which is the second most deprived area of England, it wanted to take action and go further than just providing health services and be a key source of employment for local people.
SWBHT developed one of its vacant properties to create The Learning Works which is a centre that delivers a diverse range of widening participation community projects and provides information for local people on how to access training and careers in the trust.
For example, The Learning Works provides workshops, run in connection with local education providers and the local Jobcentre Plus on how to complete a winning job application. This has helped to break down barriers and support people to continue with what can be a daunting NHS recruitment process.
Another initiative developed, the live and work scheme, has helped young homeless people. The trust turned one of its empty properties into self-contained, fully furnished apartments for up to 32 young homeless people aged 16-24. Working with local homeless prevention charity St Basil’s, the accommodation was offered on the condition that residents complete an apprenticeship to give them employment opportunities.
This work is part of the trust’s wider widening participation strategy and demonstrates how the trust uses its role as an anchor to provide good work for people who might not have considered their local hospital as a place for them to find employment.
The live and work scheme has provided permanent employment for vulnerable local young people and given them an opportunity to develop their skills in the workplace and achieve their aspirations. It has also ensured they have the necessary lifelong skills needed to manage in the future. The scheme has delivered over 100 apprenticeships since 2014, most young people are in full time employment and two have graduated as nurses.
Working collaboratively with local partners, securing senior leadership buy in and investing in infrastructure has had a positive impact on the trust as well as the wider economy and community and enabled SWBHT to deliver as an anchor institution.
Somerset Integrated Care System
The ICS worked with local partners to provide work for 2,000 people in the region through the mass vaccination and testing programme.
The COVID-19 pandemic had a large, negative impact on the Somerset economy. Unemployment rose by 1.3 per cent to 5.1 per cent in 12 months, 4.7 percent of the local population claimed Universal Credit in January 2021, and the region saw a 60.3 per cent drop in graduate job adverts and a 50 per cent drop in apprenticeship adverts in 2020.
The Somerset ICS joined the Somerset West and Taunton Council redundancy task force, set up with the aim of reducing or avoiding redundancies through strategic advice offered to businesses and assistance towards finding alternative employment for employees already facing redundancy.
The ICS identified the mass vaccination and testing effort as an opportunity to provide work for 2,000 people in the region. The ICS worked with partners across the region, including the Local Enterprise Partnership, further education colleges and the Department for Work and Pensions, to develop a programme targeted at three groups: those at-risk of redundancy, those unemployed with transferable skills, and final year nursing students. The programme included:
- A sector-based work academy to rapidly train people over four weeks to become staff on the mass vaccination programme, then support people into health and social care roles, once the population is vaccinated.
- A prepare to care 12-week distance learning course to upskill people with no prior experience.
- Guaranteed interviews for those worst affected by redundancy.
- No barrier to entering health and social care through a commitment to funding pre-employment checks for Debenhams and Oscar Mayer staff, who had been subject to vast redundancies.
The programme gained board approval through data displaying the economic picture described above, the demand for jobs in the region, deprivation data, and workforce data, provided by Health Education England, which was used to illustrate the impact the programme would have on the region.
The programme has provided employment to 2,000 people in the region and a trained workforce to support the mass vaccination and testing effort. The ICS will collect quantitative and qualitative data in a structured way to assess the impact of the programme going forward.
It is intended the jobs provided through the mass vaccination programme will lead to future careers in the NHS, mirroring the ICS’s strategy to retain and transition talent in the Somerset region by offering high value career pathways which deliver work ready employees to the areas of most need across the system. This will further cement the health service’s role as an anchor institution and a key part of the region’s economic strategy to make Somerset a more attractive place to live and work.
North East London Health and Care Partnership
By creating opportunities in the health and care sector for care experienced young people, North East London Health and Care Partnership (NEL HCP) is fulfilling its anchor commitments.
NEL HCP covers eight local authorities, five large provider organisations, many primary care network (PCNs) and GP practices and voluntary sector organisations and serves a population of approximately two million people.
COVID-19 has created many challenges for local people, particularly for those aged under 25 in terms of their emotional wellbeing, financial stability, and a sense of disconnection from communities and networks of support. A survey of local young people reflected these challenges as well as future challenges.
Considering these challenges, in January 2021, the NEL HCP set about developing a project to shine a spotlight on the most vulnerable young people in North East London, those either in care or those who are care experienced and consider what more could be done across health and social care to collaborate, join up pathways and create opportunities for them. From a system perspective the project resonated with the values of an anchor institution by widening access to employment, training, and a better working experience for local people.
NEL HCP engaged with young people from day one of the project, listened to their concerns and involved them events. Linking up with the local authority provided expertise and insights that have energised and driven this work forward. Young people shared that trusted and sustained adult relationships help to keep them on track, whilst the local authority shared that young people had little knowledge of the range of opportunities available to them including entry level jobs, training, and career development in health and care system.
The project is co-designed with young people to offer an end-to-end package of support and guidance from pathway planning within the local authority to pre-employment support and training onto work experience and ring-fencing interviews and job opportunities for this group.
This collaborative approach, working with local partners to test and learn ideas and using their expertise of working with care experienced young people has ensured learning is shared across all providers. It also demonstrates one of the ways NEL HCP fulfils is anchor commitments to create opportunities in the health and care sector for care experienced young people, helping them to build a brighter future.