It is the greatest fear anyone can face. The fear of losing a loved one. A child. A sibling.

Everyone here. Everyone who works in this great hospital. Everyone who works in the NHS, from the cleaner, to the consultants, to the chief exec.

You save people from their greatest fears. You do it every day. And you’ve done it for me. And I just want, from the bottom of my heart, to say thank you. To the Great Western Air Ambulance and everyone at Southmead.

Thank you for saving Emily’s life and putting her on the road to recovery.

I will never forget my time here. Not just today – it was wonderful to be able to thank Jas and the whole ICU team who we never got the chance to thank properly. But I’ll never forget the week we spent here, on the edge of the abyss. When Emily was falling into the jaws of death, you caught her and held her and brought her back to life and cared for her. And it’s not the first time or the only time the NHS has done this for me. You do it for everyone.

And I don’t care if you’re a porter or a receptionist or the finest surgeon in the land. A manager or midwife or pharmacist or physician. Every single person contributes to saving lives and improving lives every single day.

And the reason the NHS is so loved by so many is because you do this according to need, for everyone.

And for me, it’s deeply, deeply personal. And now it’s my great honour to be the guardian of health and care within government as Secretary of State.

Today I want to talk about you. The workforce of the NHS, and the social care workforce across the country.

Commitment

A few weeks ago, in my first speech in this job, I set out my early priorities, and what I want to do to engage with the 3 million people who dedicate their working lives to caring for others.

It’s another reason it’s so great to be here at Bristol Southmead, in a hospital that I know takes staff engagement so seriously. As a man known for my fondness for apps, I was particularly pleased you’ve a staff engagement app, which I had a demonstration of earlier.

I’ve been lucky enough in the past few weeks to spend some of my time shadowing people working on the frontline across the country.

And I’ve just come from one of the St Monica Trust care villages, and seen just what a difference the care workers there make to the lives of their residents. They’re dedicated. They’re skilled. And they bring light to the lives of the people they care for. It hasn’t taken long for me to see for myself the pressure that the health and care workforce are under, and how hard you work every day. And I’ve also seen that you feel undervalued, and that your voices haven’t been heard. I’m determined to turn that around.

Everyone knows the work you do is a vocation. But let’s be completely frank. Most people in the NHS love their work despite the system. They love their work not their jobs. Mission-driven jobs – yes. But sometimes very frustrating jobs too. I want to make health and care jobs the best jobs there can be.

A conversation

And I need your help. I need to know direct from you the changes you want to see. Today I want to start a new form of engagement. Like the best organisations, I want to start an open-ended, 2-way, frank conversation.

Today marks the start of that dialogue. A real conversation. And, like a true conversation, it will evolve based on what you say, what you think, and on the changing world of health and care. I want us to be realistic yet ambitious in what we can change for the better. And I want this exercise to reflect the real-time concerns and ambitions of the workforce, rather than take a snapshot of how you feel at one point in time.

The platform

As you may know I’m passionate about technology and, for me, technology isn’t just important in delivering better health and care, but can be a powerful tool for engagement. So we’re launching our new platform, TalkHealthandCare.

Government has never engaged with health and care staff in this way before.

This is about giving you a voice in the day-to-day creation of policy in government, and giving you somewhere to go with your ideas and questions, somewhere for you to challenge us and, equally, for us to ask something of you. Because, if the culture in health and care is really going to change, it will take all of us, working together, to make it happen.

That’s why this new engagement platform – or website, to you and me – will start by launching 5 challenges.

We’ll be exploring each of these in depth – inviting you to share your stories and ideas, and sharing our own ideas in the meantime, in the form of blogs, videos and more.

Then we’ll read what you’ve said and feed back to you. We’ll set out what we’ve learned from you and what we’re going to do about it. And – in case you’re interested – we’ll let you know what I’ve been up to, and I’ll share some of my personal reflections on the process.

And this isn’t the only new form of engagement I’m interested in. We’re also launching a brand new Workforce Panel, which I’ll meet with, physically and virtually, to hear, first hand, what’s happening in care homes, hospitals, board rooms, surgeries, ambulances, hospices and labs across the country. This is a personal sounding-board, intended to compliment and build on the excellent work of the Social Partnership Forum.

The challenges

Now before I touch on the first 5 challenges that I want your help with, I want to say this.

You can’t spend even 2 months in this job without realising one of the biggest things, if not the biggest thing, impacting on the morale are rota gaps and unfilled vacancies.

We have proposed, from next year, to increase the NHS budget by £20 billion a year, alongside a long-term plan for how we guarantee the NHS for the long term. And we will publish our green paper on the future of adult social care, with a strategy for its workforce, later this year.

I want the response to these challenges to feed into those plans.

The challenges are about empowerment, safety, development, respect and getting the basics right.

I hope you will allow me a minute to go through each one.

Challenge 1 is about making sure staff in health and care feel empowered at work. It’s about spotting a better way of doing things, of innovating, in a way that improves the experience for both those we care for and those who care.

This is about organisations in health and care working with staff to develop a shared vision about what they’re trying to achieve, it’s about staff feeling empowered to innovate, and learn from the innovation of others, and it’s about all of us developing a culture of continuous learning and testing, and strengthening the pride you have in your job.

And while we are talking about pride, I also wanted to thank you for all those who care unpaid. Those who volunteer in our hospitals and to the millions who selflessly give up their time to care for their friends and family. I’m delighted we are formally working with HealthForce and urge everyone to harness its potential.

Challenge 2 will ask about working in an environment in which you feel safe and secure. An environment without fear of bullying and discrimination, and where victims of violence are taken seriously and supported. Health and social care jobs are fundamentally about caring for people and it’s unacceptable that there are still a worryingly high number of reports of bullying and harassment.

The Social Partnership Forum – made up of NHS employers and staff representatives – is developing proposals on how we can prevent and reduce violence against NHS staff and how we can support staff who experience violence. I’m clear that this partnership will bring real sustainable changes to issues like violence, bullying and harassment, which are too often put in the ‘too difficult’ pile and accepted as the way things have to be. Not so. It’s not acceptable and we will stop it.

I want to know about your experiences of bullying, discrimination and violence, and about good examples of what’s being done to tackle them.

Challenge 3 is about development – making sure staff have access to the training, development and support they need.

Staff at all levels should feel they are supported to access training that supports them to provide high-quality care and to progress in their career. Learning is a lifelong pursuit for everyone, but we know that staff don’t always feel able to access the development they need.

I want there to be a ladder of opportunity up which everybody can climb. So that someone who starts as a porter or a cleaner, and works hard, can climb that ladder and end up 30 years later as a consultant or chief executive.

This can be done. Peter Homa, for example, Chair of the Leadership Academy, started his service in the NHS in 1979 as a porter. We have added rungs to that ladder with nurse associates. Now I want every rung in place, and I want that ladder in social care too. I know that, just like in health, it can feel like there is never enough time, and not enough money, to prioritise training, but we know that the best social care providers with the most engaged staff recognise that this investment is worth it.

We need more people to feel they have had the support that allows them to get to the point where they can take on the critical registered manager roles.

I am so proud that in my first ministerial job, as Skills Minister, we introduced nursing apprenticeships. I think it is fantastic that we now have a complete pathway from entry-level healthcare support worker to nursing associate, registered nurse and onto postgraduate advanced clinical practice in nursing – all through the apprenticeship route.

That ladder must keep being built and I am so pleased that my fantastic colleague and the Minister of State for Care – Caroline Dinenage – is working to expand the number of nursing associates in social care. I believe there are more opportunities like this, and I want to hear what you think about them.

Challenge 4 is about belonging to an organisation that respects and values everyone’s contribution. All staff in health and care must feel included, valued and respected.

This challenge is all about people feeling trusted – belonging to a team, a group, an organisation who they identify with, feeling engaged by their employer, no matter where they come from.

It is about equal pay for equal work across all roles. It is about ending the gender pay gap and tackling bullying wherever it is found.

But it is also about doing what we can to ensure that the roles that you are asked to do are realistic and reflect 21st century working lives.

There must be more opportunities for flexible working and flexibility in training throughout your career. Medical training for doctors must be designed in a way that recognises that junior doctors have lives and commitments outside work. Why do you have to move trust every 6 months even if you could get the breadth of training in the trust you are in? Why don’t we have training that fits the need of the trainee?

We shouldn’t duck the issue of how to provide more stability and certainty when it comes to training placements. I am encouraged by the changes already made to accommodate the preferences of trainees with special circumstances and to minimise unnecessary movement for others, but there is much more to do.

And finally, challenge 5 is about getting the basics right – what should we do to make sure staff are equipped to do their job? We know that staff need their basic physical and emotional needs to be looked after before anything else can happen.

This challenge is all about staff having access to healthy food, places to rest and to emotional support. It’s ensuring you feel able to remain fit and healthy, or able to recover from illness or injury. And it’s about having access to equipment that helps you do your job and helps managers run their organisations as effectively as possible. And of course pay matters too. I’m glad we have agreed a long-term settlement for AFC staff, and I want to work with the doctors to do the same for them for the future.

Leadership

The key to getting all of this right, of course, is great leadership and ensuring that leaders of different functions or organisations work together in a united way, around a clear vision.

I want to do more to get great leaders and future leaders into health and care. The NHS graduate management scheme is already one of the most competitive grad programmes in the country. It is expanding, with a bigger intake of 200 graduates this year, rising to 500 next year.

In the past year, we’ve also taken the important step of bringing that together with the corresponding scheme in social care. There are now elements of shared training so that future leaders across health and social care have a better understanding of the challenges faced by each other.

And we want to nurture leadership talent too. In social care, Skills for Care continues to grow its registered manager network to offer support and guidance to those in this role that is so critical to the quality of care provided.

I’m going to put rocket boosters under the NHS Leadership Academy, which is going to do far, far more now than develop and deploy talent – both clinical and non-clinical. And the NHS Digital Academy is going to grow.

I want a more porous border between clinicians and management, and a more porous border between the NHS and elsewhere. It is really striking when you look at the pool of potential NHS leaders just how few have a clinical background or come from outside. Only a third of chief executives are clinicians. Nor do we tap into the skills of women and those from BME backgrounds: only 47% of chief executives or directors are female compared to 75% of the workforce as a whole, while a mere 2% of chief executives are from BME backgrounds compared to 17% of the workforce as a whole. And far, far too few managers in the NHS bring skills and experience from outside.

Change management is hard. Let’s get the best wherever they come from.

Summing up

So there we are – 5 challenges to kick off with. And these are challenges to all of us – everyone who makes a life of working in health and care. We want to know what’s working and where it’s working – what’s important to you? What has the most impact on your lives, and what are we missing?

And it won’t stop there. I want to keep talking, and keep listening. I want you to innovate, and I want the department to innovate too. Part of that means trying new things, learning as we go, and improving where possible. That’s no different for this platform.

Working in the NHS is not just a job – it’s a mission. I want to harness that passion.

I know that, if not for the people at this hospital, my sister might not be here today. I also know that our story isn’t unique, and that everyone in this country has been touched, at one point or another, by the incredible skill and compassion of our health and care workforce. And that’s why I’m launching TalkHealthandCare today. Because it’s time to hear what you have to say about the jobs that are at the very heart of this country.

The British Business Bank, the UK Government’s national economic development bank, hosted a discussion in Glasgow about how to support growth ambitions of small businesses – and get them exporting more.

SMEs are the backbone of the Scottish economy, providing 1.2 million jobs. They are particularly important to rural economies, where nearly half of all Scottish SMEs are located.

But Scottish SMEs are less likely to export than counterparts in the rest of the UK – just one in seven compared with one in five across the UK.

Scotland Secretary, David Mundell, said:

I’m very pleased to support the British Business Bank’s efforts to drive economic growth for small businesses, both in Scotland, and right across the UK.

SMEs are the beating heart of the Scottish economy, offering exceptional skills, products and services. The UK Government is determined to do all it can to support them.

I sincerely hope companies who are thinking about expanding into international markets engage with the British Business Bank and make it a reality.

The UK Government acknowledges the fundamental role of business in driving the economy and creating jobs – and also understand the challenges.

That’s why in the Budget last year, the Chancellor committed an additional £2.5 billion to the British Business Bank, along with a further £500 million for technology initiatives.

The bank already supports nearly 7,000 businesses in Scotland, providing hundreds of millions of pounds in finance and start-up loans to SMEs.

Economists at the British Business Bank estimate that, if the availability of ‘patient capital’ was increased to the same level as the US, Scottish businesses could benefit from up to £500 million of additional funding per year.

The Department for International Trade is also providing strong leadership in this area and working more closely than ever with the devolved administrations.

The Board of Trade has been reconvened, offering opportunities to engage with regional expertise and ensure that the benefits of free trade are spread more evenly across the country.

The recently published Export Strategy sets an ambitious target to increase UK total exports as a proportion of GDP to 35%.

Published 10 September 2018

• Defence Minister Stuart Andrew’s visit to WFEL in Stockport signified the completion of the final Dry Support Bridge which is part of a £53m contract with the Australian Army.
• The Defence Minister described the firm, which has benefited from £600m-worth of export orders, as ‘a model for how companies across the country can thrive on the global stage’.
• He witnessed a 90-minute demo build of a 46-metre bridge from the firm, who are renowned world leaders in the field.
• He visited with the Head of Australian Defence Staff London, Air Commodore Brian Edwards.

Defence Minister Stuart Andrew today visited a Stockport company which is world-renowned in building tactical military bridges. While there, he marked the completion of a multi-million-pound deal to supply the Australian Army with the vital logistics equipment.

The £53m deal with Australia is part of £600m-worth of export orders that WFEL has amassed over the past decade. The Defence Minister described the firm as ‘a model for how companies across the country can thrive on the global stage’ at a time when defence exports have surged by over 50% to £9bn.

The workers also demonstrated their world-class reputation by constructing a 46-metre Dry Support Combat Bridge in just 90 minutes whilst the Minister toured the factory.

The bridges will be used in combat situations providing rapidly-deployable temporary infrastructure ensuring vital equipment and soldiers can navigate their way through the most challenging terrain. The military bridges can also be used in times of crisis during natural disasters maintaining essential lifelines to those who need it the most.

Defence Minister Stuart Andrew said:

Through WFEL, Stockport is leading the world in military bridges which help troops defeat our enemies and provide essential aid to people in disaster zones. Not only does WFEL bring hundreds of jobs and millions of pounds of investment to the UK, but it enables relations with some of our closest allies to flourish. As they finish an order for Australia, kick one off for America and look towards more opportunities to build British bridges, they are a model for how companies across the country can thrive on the global stage and play a key role in the defence of our nation.

Work continues at WFEL following the completion of this Australian order as the company has now turned its focus to new orders for the US Army, building upon the 116 military bridges that the company has already built for US forces.

Whilst 90% of its Stockport production is exported overseas, WFEL’s contribution to UK defence can be traced back as far as 1915. The company has been designing and producing bridges for the UK military since the 1970s, and the relationship remains to this day – the British Army has over 50 sets in service. They have been proven in the field in the likes of Iraq and Afghanistan.

There are also potential UK opportunities in the pipeline for WFEL, with the company currently bidding to update and replace some of the MOD’s military bridging systems. It could become part of the Mechanised Infantry Vehicle (MIV) programme’s supply chain, which would support the current 227-strong local workforce.

The opportunities could mean a further boost to investment in the North-West, which already benefits from £2 billion of defence spending – supporting over 12,000 industry jobs in the region.

Ian Anderton, Chief Executive of WFEL, said:

As the leading tactical military bridge maker globally, WFEL continues to work to provide solutions for customers like the Australian Defence Force. Our long-standing relationship with the ADF first began over 30 years ago, when they chose our Medium Girder Bridges. We have been delighted to continue to support them again today, not only with the supply of further MGBs but also with a significant capability enhancement with the latest mechanised Dry Support Bridges.

The adoption of the DSB not only provides the ADF’s Manoeuvre Commanders with the ability to cross significant wet or dry gaps quickly and efficiently, it allows a level of inter-operability with an ever-growing user base. We have worked collaboratively with the Commonwealth’s Managing Contractor to reduce risk for this contract and are pleased to be providing an off-the-shelf solution to the ADF’s wide-gap tactical bridging requirements.

The Minister was also accompanied by the Head of Australian Defence Staff London, Air Commodore Brian Edwards.

Head of Australian Defence Staff London, Air Commodore Brian Edwards said:

The Australian-UK bilateral defence relationship has been forged over many years and is incredibly strong and enduring. In recent times, we have seen an increased emphasis in opportunities for collaboration from a defence industry standpoint. This project introduces into service the latest addition to the Australian Army’s suite of combat bridging. It will ensure that the Australian Defence Force has an enhanced gap crossing capability which will enable land forces, both mounted and dismounted, to cross wet and dry gaps in support of operations.

The Australian deal was made up of two contracts, following an internationally competed tender. As a result, WFEL supplied its leading Medium Girder Bridges (MGBs) and Dry Support Bridges (DSBs) to the Australian Defence Force (ADF). This has resulted in a huge boost for the 132 organisations who have benefited from contributing the WFEL supply chain.

The UK enjoys a very close bilateral relationship with Australia, which has strengthened over recent years, with the introduction of annual conferences and close co-operation on many international issues – including a shared commitment to fighting extremism on coalition operations, especially in Afghanistan and Iraq.

Australia also recently decided to choose BAE Systems to build nine British-designed Type 26 warships. The deal, which could be worth up to £20 billion, has been hailed as the biggest Naval ship deal for a decade. It is not only another clear example of Britain’s world-leading defence industry, but has been described by the Defence Secretary as ‘the dawn of a new era in the relationship between Australia and Great Britain, forging new ties in defence and industry in a major boost as we leave the European Union’.