Staffing is the issue keeping NHS leaders awake at night – and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce.
It often seems strange to outsiders – or perhaps just Londoners – but car parking is undeniably one of the most emotive subjects in the NHS. One of the (very few) silver linings of the pandemic was that NHS trusts offered free car parking to all staff, a policy which was carried on for some into 2022.
With many staff suddenly working at home, the pressure on NHS car parks was temporarily eased and some trusts took this opportunity to make other changes, such as making it permanently free for staff, or reviewing historical “inequity” in their parking policies.
Nottingham University Hospitals Trust was in the latter camp and – perhaps unsurprisingly – the process has become controversial and fraught with difficulty. Locally it has made news headlines, and has now been described by the (relatively new) chief executive Anthony May as “a marathon” and one of the “most sensitive issues”.
First, some context. Donna Jones, who is in charge of parking for the trust as its head of facilities, tells me that before the pandemic there were around 2,000 staff members on a waiting list to try and get a permit on site. She said covid had been an opportunity to step back and reevaluate how parking was arranged for its 18,500+ staff.
“We set about doing two surveys for the organisation. This wasn’t just me and my team sat in an office thinking about what criteria we’re going to come up with, we went out to the organisation, we did one survey that asked them what they felt they wanted to see that was important. And then the second survey went out to ask them to rank them in order of priority,” Ms Jones explains.
This has resulted in the introduction of a points-based system, which prioritises certain criteria (for example, a blue badge holder, living further away with no access to public transport, regularly working long shifts).
But as a result of this new system, thousands of staff have been denied a space, of whom 1,200 need to find another way to travel to work. A recent NUH board paper stresses there will be a staggered process over the next 12 months, and Ms Jones says the trust is supporting people to find other ways to travel. This includes extended-hours park and ride, reduced-price tram passes, and increased bike spaces, among other schemes.
Driving staff away
Unison has said many of its members in NUH have raised serious concerns, particularly about the weighting, arguing that staff with non-clinical responsibilities seem to be disproportionately losing out; and that their caring responsibilities (in their personal/home life rather than at work) do not carry enough weight.
“Members are angry and we have been told many are looking for jobs elsewhere,” argued Unison regional organiser Rachel Perry-Doyle.
A nurse at the trust, who wished to remain anonymous, described how undertaking the parking review in the middle of a recruitment and retention crisis was “absurd”.
“Telling clinical staff they can add up to two hours a day on travel time, on an already busy 12-hour shift, feels wrong,” they told me. “I know of countless experienced nurses who have lost their right to park on site. Walking down this path will drive them away.”
Teresa Budrey, Royal College of Nursing director for the East Midlands, said the parking changes were unsettling and must be handled sensitively.
“It’s a reality that at this trust there aren’t enough parking spaces for staff who want one but it’s equally true that in other parts of the NHS staff can park at work and, in some cases, it’s free, and that doesn’t feel equitable,” she added.
However, Ms Jones described how before this project, staff on the permit waiting list were “suffering in silence”.
“Nobody more than me would have loved to have given everybody the outcome that they wanted,” she said. “And to be quite honest, it feels a bit soul destroying, that we’ve put so much effort and hard work into it and we’ve still got a group of people that are really unhappy with the outcome.”
As part of the exercise, NUH researched the parking pressures at nearby trusts. At University Hospitals of Leicester, the trust found 20,000 staff members were competing for a limited number of spaces not actually on-site, and at Sheffield Hospitals, there are just 1,000 spaces for 18,500 staff members.
The fallout arguably speaks to the limitations of many NHS estates for their staff, as they are simply not fit for purpose for the staff who work there, whether it’s enough parking, bathroom facilities, or spaces to rest and do quiet work. But much of this isn’t in the control of local leaders.
At NUH, there are more tough times ahead for management and staff on the car parking. It will take time to repair this rift.