Managing HR at Scale | Season 2, Episode 5 | Recruitment and Beyond Podcast

In this episode of Recruitment and Beyond, we explore the challenges and opportunities in shaping a high-performing workforce within one of Scotland’s most complex organisations—NHS Scotland.

Host Ewan Anderson, Marketing Director at Eden Scott, is joined by Fiona Hogg, Chief People Officer at NHS Scotland, to discuss how HR and leadership play a critical role in delivering world-class healthcare. With responsibility for 22 health boards, Fiona provides unique insight into workforce planning, leadership development, and the importance of culture in such a vast and varied organisation.

We delve into how NHS Scotland is evolving its recruitment strategy to attract and retain top talent, how technology and people analytics are shaping the future of HR, and why investing in leadership development is key to long-term success. Fiona also shares how NHS Scotland is tackling workforce challenges, diversity and inclusion, and ensuring that employees feel supported, valued, and empowered to grow in their careers.

If you’re an HR professional, business leader, or recruiter, this episode offers real-world insights into building and sustaining a resilient workforce—whether in healthcare or any other sector.

🔹 How do you create a people-first culture in a complex organisation?
🔹 What role does technology play in modernising HR functions?
🔹 How can organisations attract and retain top talent in a competitive market?

Tune in now for expert advice and actionable takeaways that can help your organisation thrive.

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Transcript

Ewan (00:05):

Hi, and welcome to the Recruitment and Beyond podcast. My name's Yuan Anderson. I'm the marketing director here at Eden Scott. This is your essential guide to navigating the ever-changing world of human resources and recruitment. We chat with industry leading figures to give you the inside track on growing and developing the very best teams. Today we chatted to Fiona Hogg, chief People Officer at NHS Scotland about what it takes to set up a people function at an organization's large and its complex as the NHS. Hi, welcome back to the Recruitment and Beyond podcast. We are joined today by Fiona Hogg, who is the Chief People Officer at NHS Scotland. Fiona, great to have you with us.

Fiona (00:53):

Thank you, and lovely to be here.

Ewan (00:56):

So Fiona, what does the Chief People Officer at NHS Scotland, do you want to give us a bit of insight into your role there at NHS Scotland?

Fiona (01:04):

Yes, of course. And I say it's an interesting role because NHS Scotland is almost a sort of umbrella term for our 22 different health boards and employers that make up the NHS in Scotland. So each of those has their own leadership structure, their own people directors. And my role is really as the professional lead for the people function across NHS Scotland and working between government and the health boards as employers to move forward the people agenda and support them as best I can.

Ewan (01:40):

Okay. So there's, I mean, that's a huge task on your hands there. So when you're thinking about the core principles of what you do and your thoughts in terms of hr, obviously you've worked not just with NHS Scotland, but with other large organizations as well. When you're building and developing NHR function, what are the core principles that you like to work towards?

Fiona (02:03):

And it probably sounds a bit tri, but it's really important I think, to really put people at the heart of that. And I think even across our 22 organizations in NHS Scotland, each has got a very different culture. It does very different things. We've got small boards like NHS Orny that employ a few hundred people and support a very small population, whereas we've got greater Glasgow and cloud with over 40,000 employees.

(02:31):

And then we've got supporting boards in between. And I think that's a bit like organizations in our wider system. And I think really understanding both the people team that you've got and the services they provide and the capability that they have is really key. But also what does your organization and the people that you support expect from you? And making sure that then you can come up with a way of supporting that organization that you've got the people and the capability to support and that's what the organization wants and needs and understands. And it can be easy for people to say, and new people directors coming in, we want you to reshape the people function. That'll sort of everything out overcome. And actually the worst thing you can do on your first month or two in a new job is to do anything about changing structures or roles.

(03:27):

You really need to understand what you've got, what people want, what you need, and actually take the time to sort of come up with something. But even then when you come up with what that looks like, you have to work really hard to make sure that the people team get it, can do it, support, it can influence it, and then that the organization, it's going to deliver what they need. They understand how to access the support they need in the services because if you don't do that, you could have the best theoretical model in the world, but actually if your team don't want to work in it, or if the people aren't getting what they need very quickly, you're going to have to start unpicking. So I think we learn through our errors and challenges in that respect, I think.

Ewan (04:09):

Yeah. Yeah, I mean, I guess that's what I was going to say, because so complex that do, from an organizational structure point of view, if you're pulling that together, how do you look at the different requirements for each area and pull together almost like key functions for that and how do you effectively deliver that, the services and support that each area needs? Because there's got to be some kind of commonality, presumably there's some areas that there's just key roles that are required, but then like you say, there's Scotland such a, it's so many different approaches in different areas or needs different to Glasgow's, different to the Highlands, different to enbr, the borders and whatever it might be. How do you pull together an organizational structure for that?

Fiona (04:58):

Yeah, and it is a challenge and I think the NHS has been in existence for a long time and there are elements of that that have historically been quite traditional. So typically within the NHS, there's always been a split between what they call HR and then the organizational development side of things. And so you've tended to have a lot of people who do the very sort of process and policy oriented stuff, then people that do more of the development interventions and stuff. And actually I think part of where we need to move to and are moving to gradually over time is that actually those splits become, for me, it's why I talk about the people profession because actually language is really important because there are connotations around how people use hr, OD personnel, all these different things. And actually it's about us trying to set that this is ultimately about people and it's about culture and the organization.

(05:59):

And actually it doesn't necessarily matter if your job is about employee relations or supporting policies. Actually in the future, we'll all need to have those skills in our tool set that allow people to allow us to have conversations with managers that try to help them resolve the problem without going down a policy route. So I think that being able to be flexible about what resources you have and how they're organized is key because as I say, a 600 person organization versus a 40,000 person organization, you can't have lots of specialists in those smaller organizations. But in some ways that's quite good because that can really give people opportunities to move around the people function and develop a range of skills that maybe in the past people have been quite siloed. If you start off in recruitment, you're probably going to get stuck in recruitment. Or if you're an employee relations expert, you're not going to go over into od. And for me, we really need to change that because that makes really rewarding careers for people, professionals as well.

Ewan (07:02):

Yeah, I mean, you've touched on this a wee bit actually about culture, and it's the same for big organizations, I presume when you worked in the bank and so on, is knowing that somebody walks into a bank in Emh or a bank in wherever it might be in Aberdeen in the same way they go into NHS Grand or they go into NHS, Reon Gallery, whatever it might be, there's a similar sort of approach in terms of the people, in terms of the care, in terms of that, the service they provide. Is that part of what you've tried to do in terms of, okay, there's different requirements in different areas, but as a culture and as an organization, do you have that core principle and that core culture at the center of it?

Fiona (07:41):

Yeah, and I think that is key because as you say, ultimately we must never forget in the NHS that our core purpose is there to serve our population and to support them at some of their worst times. And actually to the population whilst within the NHS, we're all very conscious that we might be employed by 22 different organizations to everybody else. We're just the NHS. And so it doesn't matter to us if it's T side or if it's Fourth Valley or if it's orley or whatever, to us, to our population, it's the NHS. And so I think over time we have tried to bring some consistency. We have a workforce plan across in a workforce strategy across health and social care, and we have the NHS Scotland values, which underpin a lot of what we do and we are trying to do more. We have, for example, we've developed a range of employment policies over the last four years rather than each board having their own one.

(08:45):

And that is all about how can we try and both, I guess, harness the benefits of having so many employees and not everybody having to do things individually, but again, to make that experience, I suppose, of our employees and our patients and communities as consistent as possible so that actually if something happens, it shouldn't be fundamentally different how you're treated or how you're supported across that. But it's a big task to gradually move towards that. Everybody has been doing things for so long on their own, but our need to reform is underpinned by actually the way we'll reform is by delivering services and therefore employment that is more consistent and more joined up across Scotland.

Ewan (09:40):

Getting that consistency across the service is so important, isn't it? And it comes from the people because ultimately it's a people service. Pretty much every business is, let's face it. So getting that right and getting people to buy into that culture is so important. And has technology helped, I mean, does technology play a role in terms of modernizing that HR function now across the NHS? Is it a key part of what you're looking at as well?

Fiona (10:03):

Definitely. It's definitely one of our biggest opportunities. We've been notoriously slow, I thinking as a lot of big organizations are in terms of actually the effort that's required to try and develop systems and is huge. But also our context of the 22 individual employers has meant that historically people could opt out. So we would start off with something that was going to be for 22 and then maybe only 10 boards take it forward. And then you've got, so we are, as part of our reform agenda, that is one of the key areas where on certain things we are going to have to be in a position where every board in Scotland, every employer signs up to certain things because they won't work unless we all do it. Recruitment is probably one of the areas where we do have a single platform that we use for recruitment across the NHS.

(10:59):

That's been really good, and it's a really good enabling technology. But actually part of the challenge we have with that is how do we join up behind the systems? Because that would make you think if you're an applicant that actually there's something really quick, coherent set behind the technology that your application for that job in that area goes in and you've registered an interest with NHS Scotland. But actually behind that technology, we're still 22 entirely separate employers and actually probably hundreds of different recruiting managers in that organization. So I think there's definitely a focus on that. And for a lot of the transactional services we provide, it's critical. We harness technology also in how people access information and are able to self-serve. But I think we're, we're on a journey with that, but it's going to take time and it's as much about changing how we work behind the technology and how we join up as the systems themselves.

Ewan (12:04):

Yeah, I mean, technology is changing every industry, isn't it? The introduction of artificial intelligence as well as automation and other things are really having an impact on all these areas and they can help with efficiency and so on. But it's actually, for you, that role across all those different boards is quite a challenge, especially if there's still a level of autonomy amongst them all. You've got to have that, like you say, consistency and requirement for everybody to buy into it. And it may not always work for everybody, but I think getting that consistency really helps. Again, going back to that customer service, that there's a patient coming in anywhere knows that there's going to be a consistency in terms of that delivery and the staff know that as well. So it is key, isn't it? And this is slightly off the questions we were talking about, but does that include likes of things like people analytics? Is that part of what you've got involved with in terms of technology in the NHS? Is that somewhere where you're going towards just in terms of helping people develop and grow as individuals?

Fiona (13:06):

And I think our ability to have good data from our people systems is key. It is probably one of our key barriers at the moment that mean that actually being able to understand in real detail our workforce and some of the key measures that we'd like to have is definitely needs to be improved. We can access quite a lot of data and that can give us indications about could things like turnover and vacancy levels, and we have some information and things like people processes our things like our quality and diversity information can be quite difficult and we really need to, but actually I think part of the commissioning of the new systems that we're going to develop has to make sure that we do think about that and how we commission it because we can't continue to rely on the fact that we don't have good data as almost like an excuse why we can't measure things. That's not where we need to be. So I think it is key for us, and again, it's better for us to try and get to a point where we've got something that's standard across the whole of our 22 employers rather than individual boards investing both the time and resources in custom systems, which they've sort of had to do in the past.

Ewan (14:32):

No, absolutely. Absolutely. Having that data, so excuse me, will be so valuable to help people develop and grow and help the service grow as well. And I suppose going on from that, in terms of attracting retaining talent, obviously it's a real challenge out there to bring in the right people at the right time. And is there a lot of work going into the back of that in terms of your vision and your values to really sell what it is to the NHS? Because I think it's very much a vocation, isn't it? It's very much coming to work for the NHS. A lot of what we do now talks a lot about companies need to have that purpose, that purpose and their vision and value should be upfront and centered, and that's what sells the job to people. Is that what you're working on in terms of trying to attract and retain the very best talent for the NHS?

Fiona (15:19):

Yeah, I think it is really important for us. I mean, it's the reason that I joined the NHS in 2019 when I came to NHS Highland, having primarily worked in the private sector, I was looking for a role that would challenge me, but also give me some purpose and some sense of working for an organization where I could feel I was genuinely contributing and making a difference and supported the values of the organization. And I think, again, this is one of the areas where we have a number of our employers are leading on their recruitment on an individual basis, and there's some great practice going on out there. We've also done some things where we've joined up collectively. International recruitment over the last few years has been one of those things. And we've really been able to come together. But actually a key part of what we need to do moving forward is to collectively use all the talents we've got across the system and really make more use of the brand of NHS Scotland and how can we use that. We currently things like nursing, graduate recruitment, most boards individually will lead on that. And if we had the resources and then actually being able to do NHS Scotland recruitment, the individual employers make their own decisions, but actually we bring that together,

(16:45):

That

(16:45):

Would make it much more effective for us. But more importantly, for candidates to sort of apply once and to work through that, our young workforce is another key priority for us. And again, some boards are doing amazing things in terms of engaging with young people and with wider and people who struggle to access employment in the community. But again, collectively across the whole of NHS Scotland, using our collective brand and resources to try and get a better profile for the kind of careers and particularly the careers that aren't about the ones that people think about. So

(17:25):

We're very well set up with nurses and doctors and the traditional roles, but actually we don't have programs where people who might in school where young people could say, oh, I'd quite be interested in working in the NHS. What kind of jobs do you have? How do I get into finance in the NHS or into people or into support functions or into caring. So I think there's a huge amount we can and need to be doing because we have an aging workforce, and we also have not just a responsibility to ensure we provide employment to our local communities, but actually from a sustainability perspective, the more that we can recruit and train people to do roles that they want to do within their local community, that helps us because actually that's a workforce that are going to want to stay working for us to grow their careers. And that's particularly important for some of our more remote and rural communities as well, where actually that sustainable workforce needs us to do training and development and find qualification pathways that maybe don't involve people going off to university.

Ewan (18:34):

That retention of a local workforce is so important. Is it because it's people they know, they buy into that they buy into the supporting their local community, and it's such a vital thing, and I think a lot of organizations have tried to get that, is to get that purpose. So you've got the skills, but you need that purpose. You need something else. And I think the NHS has that in abundance. I mean, obviously the great work that you guys do is phenomenal, and I think it makes a massive difference to people when they're looking for that role. If they have a finance background, well, actually there's real opportunities there to work for the NHS and I get the added value of some added purpose as well, I suppose. So that NHS Scotland brand really comes with, I suppose, additional benefits as well. There's more than just the role. There's a whole experience where working for the NHS, would that be right?

Fiona (19:24):

Yeah, absolutely. And I think it's often easy to listen to all the media reports and politics about how dreadful things in the NHS are and how difficult and challenged it is. But actually the reality is lots of people coming to work every day determined to do a good job and actually relatively speaking, being well rewarded through good pay and particularly strong terms and conditions, things like pension and sickness absence, and also the support that people have in terms of family friendly policies, wellbeing, et cetera. But I think both for colleagues who don't currently work in the NHS, we're not very good at really drawing out that wider package. But also sometimes I think we're not, we need to do more in the retention space and actually how do we make sure that people have a good experience and understand that actually the grass isn't always greener on the other side, and moving into different sectors of employment may offer different financial rewards, but actually some of those things that become more important, particularly as we get older in terms of stability, in terms of support with pay if you are sick, and I say the family friendly policies are things that often people don't think about until they need them.

Ewan (20:48):

Yeah, yeah, absolutely. The retention part of it's really interesting. It kind of leads us on a wee bit in terms of employee wellbeing, but also retention around career development and progression. I think you touched on it slightly, but it's just highlighting that again, some of the research we've done is that people will move a for purpose, they will move in terms of the job because they feel there's a bigger purpose there in terms of the role that they're going to do, but secondly about their own career progression. And I guess is that something, again, that you're looked at across the NHS to ensure that people know they're coming in for a career, for life, there's an opportunity to grow and develop with the NHS?

Fiona (21:26):

Yeah, I think it's definitely a key area for us. And over the last couple of years, we've particularly been focusing on our executive and aspiring chief executive cohort across Scotland to try and make sure that we're supporting boards to identify people who are at that level and who may be ready to progress. And both looking at particular development centers for them, we've developed a leadership success profile that helps understand what skills and capabilities are needed and a development center that matches their progress against that. But it's not just about that formal development, because having identified people potentially who have the ability and the aspiration to progress, we can also help expose them to opportunities to participate in pieces of work or get involved in collaborations that give them something that they may not be able to get within their own board or within their own role.

(22:28):

So that kind of more senior level piece is being key. But the other thing is that at a local level, everything tends to come back to how good a manager people have at a local level. Do they understand how to have good support and supervision conversations? Do they understand how to discuss people's development needs? Do they understand how to help people resolve conflicts or concerns? And I think that's part of what we really need to make sure, because what we will often see is that if people don't understand at a local level that opportunities are available or that they can be supported not having those conversations, they will probably go off and look for a job rather than being supported to sort of stay. And I think that mindset of that comes back to the whole NHS Scotland piece actually. It's not about losing people to different employers, it's actually about going collectively.

(23:30):

How do we try and make sure that we share the talent across NHS Scotland and make it support people to move? Because sometimes, and again, I go back to maybe some of our remote and rural boards or our boards that do very specialist things like the NHS education for Scotland, that's all about training or about N hs 24 that supports the one service if people may ultimately want to go back into those boards and continue their careers, but they might not be able to get the fully rounded experience by staying in that board, even with their support. So actually how we as NHS Scotland support people to move around to get the skills they need to then be able to take up some of those more senior and specialist roles later on is a really important area.

Ewan (24:23):

Just going on from that, the leadership part of it is really vital, isn't it? Leaders are so important to organizations, and I think that makes a massive difference that people really understand there's opportunities here for them to grow with NHS Scotland, not always necessarily within the same board, but there's real opportunities across the board. Isn't that right?

Fiona (24:40):

Yeah, yeah, absolutely. And I think that whole theme of leadership and culture is, it becomes more and more important. And obviously my own personal experience in joining the NHSI joined NHS Highland at a time when we'd just had the static report into issues around poor culture and behaviors. And as a people professional, I learned so much from being part of that situation, but it really brought home to me that actually that of the importance at a very local level of how people experience work and is entirely driven by the people that they work next to and the person that manages them. And often the narrative around the NHS being broken, and we talk about these huge, big cultural and leadership and resource issues, but actually what you find on the ground is that if you've got someone who is a good manager, who supports their team, who encourages them, who listens to them and tries to resolve concerns, that is what people will work within those difficult situations because they're supported. Whereas you can be in exactly the same situations, but without that good management support at a local level. And actually, that's often where people tip over into that not being a good experience, not being heard, and not because anybody gets up in the morning thinking, I don't want to be a good manager. But actually we haven't supported and invested in them. We haven't made it clear what we expect of them, and we haven't given them the tools to do that. So for me, that local hands-on management is absolutely key to our colleagues' experience.

Ewan (26:25):

Yeah, yeah. No, absolutely. I suppose just to touch on the insights that you talked about before, the HR insights and effectively managing and understanding where there's success and where there's requirements, what sort of HR strategies are you putting in place from NHS Scotland point of view? Just to truly understand the needs and requirements of going across all 22 boards.

Fiona (26:50):

And so what we've tended to do is focus BIA, we published our health and social care workforce strategies in 2021. And obviously we've been living through the pandemic and financial crisis, but actually there's a

(27:04):

Few

(27:04):

Key things there that we've really focused on, and leadership and culture has been a key part of that. Colleague wellbeing is another area where we've tried to work across the system to support boards in that space. Inclusion is another big area for us. And obviously as boards as a system, we have very clear policies and standards and expectations in terms of being inclusive and promoting equality and diversity. But equally, we know that actually our insights tell us that particularly our colleagues from minority ethnic backgrounds typically experience more challenges in recruitment, particularly in progression and promotion. There's a real it. We're not representative of our populations, especially at the more senior levels. And so we've had a real focus on how can we support that? We've set up a national forum and all of our employers in this sort of financial year, all of our board executives have been charged with creating and delivering an anti-racism plan.

(28:24):

And that's a bit of a unique thing because it's twofold. What we've done is we've joined up the employment experience and inclusion aspect, but also as providers of health and care services, there are clear known and documented health inequalities that ethnic minority populations are experiencing. And so our anti-racism plans that each board will be delivering against is a combination of both the care that we deliver, but also what we do to support our workforce. And that's really key because whilst we want overall everything that we do, we want people to be inclusive. We want people to understand the unconscious bias and be inclusive, but sometimes you have to focus in on a particular area that you know is particularly which to start that sort of change and to start developing a better understanding. Because we've moved, I think we still have a little bit of a sense that as long as we're following the law and we're doing X, that should be okay.

(29:34):

And actually where we've had to get with this is about explaining that actually it's not about intentional actions. It's about the fact that the evidence and the data and the experience is telling us that things need to change and we need to do things differently. So I think we will then move on to areas like disability, but we've already found that by focusing on a particular aspect of inclusion, people generally build the skills then to recognize what is inclusive behavior, what are their biases, and how do they overcome them? So I think it has the desired effect.

Ewan (30:13):

So yeah. So Fiona, so I mean, we've gone through quite a bit there, and I just wondered what's next? What do the next five to 10 years look like in terms of from a chief people officer point of view, what would success look like over the next five to 10 years for the NHS fund?

Fiona (30:30):

Yeah. No, and it's a huge amount to do, and I think we're on the cusp of a sort of fundamental reform and transformation of our services that's required because of the financial challenges, because of the population demands on our services, but actually also because we need to make sure that as well as just responding to the demand for services, that actually we play our part in terms of helping the population to live healthier lives and focus on prevention. And so that fundamental shift in how the NHS is going to have to work and how people access services and how we deliver services for the population of Scotland, which is only 5 million people, that will require us to make fundamental change in our people functions. So actually, we need to become much, much more able and equipped to support vertical transformation and change. We need to be in a space where we're really delivering added value, where we're not just responding to the needs, but we also need to support our organizations and be able to deal with that fundamental level of change and transformation in roles and services, and I guess in working collaboratively across the NHS, but also working collaboratively in our health and social care partnerships locally, because actually that system level working is the only way that we're really going to change the nature of the demand that we have.

(32:09):

So I think there's real opportunities and the people function. It needs to be equipped and will be able to be equipped to support that in a very proactive way rather than just traditionally, we've maybe been a little bit more of the responding to the needs and the asks of the organization. So I think it's a really exciting time. It's going to be challenging, but I think it's a good thing for us as a profession and as an organization, ultimately, it'll benefit our population as well.

Ewan (32:43):

Well listen, thank you very much for your time today, Fiona. It was excellent, great insight into what's going on at HS Scotland and the challenges, but also the successes that you have there in terms of the people function. So thank you much your time, and hopefully I'll speak to you again soon.

Fiona (32:59):

Thank you very much. It's been great chatting.

Ewan (33:06):

Thanks for listening to Recruitment and Beyond podcast. Hopefully there was plenty of insight for you to take back to your teams, so don't forget to subscribe and never miss an episode. And if you can leave us a review, we really appreciate all the feedback and support we get. It makes a massive difference.