Workforce burnout and resilience in the NHS and social care

Health and Social Care Committee Closed Inquiry
Opened: 30 Jul 2020 Closed: 22 Feb 2022 Parliament page
This inquiry will focus on workforce burnout and resilience across the NHS and social care. It will look at: burnout, resilience and stress levels before and during the covid-19 pandemic the impact of workforce burnout on service delivery, staff, patients and service users workforce planning and projections the measures set … Read more
26 Recommendations
7 Conclusions
1 Report
4 Oral sessions
2 Letters
4 Events
Activity timeline 8 events
17 Feb
2022
Report published
8 Jun
2021
Report published
16 Mar
2021
Correspondence
24 Feb
2021
Oral evidence
12 Jan
2021
Oral evidence
17 Nov
2020
Oral evidence
22 Oct
2020
Correspondence
20 Oct
2020
Oral evidence
Oral evidence sessions 4 sessions
24 Feb 2021
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Anita Charlesworth · Health Foundation Helen Whately MP · Department of Health and Social Care Oonagh Smyth · Skills for Care Prerana Issar · NHS England and NHS Improvement Rob Smith · Health Education England
12 Jan 2021
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Chris Hopson · NHS England Dr Henrietta Hughes, National Guardian Helené Donnelly OBE · Midlands Partnership NHS Lord Victor Adebowale · NHS Confederation Professor Jeremy Dawson · Sheffield University Shilpa Ross · The King's Fund Tricia Pereira · London Borough of Merton
17 Nov 2020
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Denise Crouch, Macmillan Lead Cancer Nurse Dr Adrian James · The Royal College of Psychiatrists Dr Chaand Nagpaul · Council of the British Medical Association Paul Farmer · Mind - on behalf of Our Frontline Professor Dame Clare Gerada · NHS Practitioner Health Vic Rayner · National Care Forum
20 Oct 2020
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Bernie Miller · Lancashire Teaching Hospitals NHS Foundation Trust Caroline Waterfield · NHS Employers Claire Murdoch · NHS England Jo Da Silva · Agincare Prerana Issar · NHS England and NHS Improvement Professor Martin Green · Care England Professor Michael West · The King's Fund
Title HC No. Published Items Response
Second Report - Workforce burnout and resilience in the NHS and … HC 22 8 Jun 2021 33 Responded
Recommendations & Conclusions
33 results
1 Conclusion Acknowledged
Second Report - Workforce burnout …
Burnout is a widespread reality in today’s NHS and has negative consequences for the mental...
Burnout is a widespread reality in today’s NHS and has negative consequences for the mental health of individual staff, impacting on their colleagues and the patients and service users they care for. There are many causes of burnout, but chronic … Read more
Government Response
The government agrees on the importance of monitoring staff wellbeing and describes existing efforts like the NHS Staff Survey and a new Wellbeing dashboard for NHS staff. They commit to working with social care stakeholders to understand their workforce but do not plan a direct extension of the NHS Staff Survey to social care.
Department of Health and Social Care
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2 Recommendation Rejected
Second Report - Workforce burnout …
Understanding the scale and impact of workforce burnout can only be achieved with a metric...
Understanding the scale and impact of workforce burnout can only be achieved with a metric for staff wellbeing and staff mental health that covers both the NHS and social care. We therefore recommend that the Department for Health and Social … Read more
Government Response
The government rejects the direct extension of the NHS Staff Survey to social care, citing structural differences and lack of HR functions in many social care providers. While agreeing on the importance of monitoring staff wellbeing, they instead commit to increasing engagement with the social care sector and supporting NHS organisations through existing mechanisms like the People Plan and Wellbeing dashboard.
Department of Health and Social Care
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3 Recommendation Accepted in Part
Second Report - Workforce burnout …
We further recommend that the NHS Staff Survey and any social care equivalent includes an...
We further recommend that the NHS Staff Survey and any social care equivalent includes an overall staff wellbeing measure, so that employers and national bodies can better understand staff wellbeing and take action based on that understanding. The Staff Survey … Read more
Government Response
The government states the NHS Staff Survey already assesses burnout through its 'safe and healthy' theme and uses a Wellbeing dashboard to monitor progress. However, they do not consider a direct extension of the NHS Staff Survey to social care feasible but commit to working with social care stakeholders to understand their workforce's lived experience.
Department of Health and Social Care
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4 Recommendation Accepted
Second Report - Workforce burnout …
We welcome the additional support provided to health and care staff during the pandemic.
We welcome the additional support provided to health and care staff during the pandemic. However, we conclude that such additional support will need to be maintained during the recovery period and beyond to stop further staff from leaving. Furthermore simply … Read more
Government Response
The government commits to providing mental health and wellbeing support for the workforce both now and in the future, stating that Integrated Care Systems are encouraged to enhance and integrate system-wide wellbeing services for all health and care staff.
Department of Health and Social Care
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5 Recommendation Accepted
Second Report - Workforce burnout …
We recommend that Integrated Care Systems (ICSs) be required to facilitate access to wellbeing support...
We recommend that Integrated Care Systems (ICSs) be required to facilitate access to wellbeing support for NHS and social care workers across their systems, and that they are accountable for the accessibility and take-up of those services.
Government Response
The government outlines existing investments and a package of wellbeing support for staff, stating ICSs have been encouraged to integrate and make use of system-wide assets for staff wellbeing. It does not commit to requiring ICSs or making them formally accountable as recommended.
Department of Health and Social Care
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6 Recommendation Accepted
Second Report - Workforce burnout …
We further recommend that the level of resources allocated to mental health support for health...
We further recommend that the level of resources allocated to mental health support for health and care staff be maintained as and when the NHS and social care return to ‘business as usual’ after the pandemic; and that the adequacy … Read more
Government Response
The government commits to providing mental health and wellbeing support for the workforce both now and in the future, stating that Integrated Care Systems are encouraged to enhance and integrate system-wide wellbeing services for all health and care staff.
Department of Health and Social Care
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7 Recommendation Accepted in Part
Second Report - Workforce burnout …
It is imperative staff have the opportunity and the confidence to speak up.
It is imperative staff have the opportunity and the confidence to speak up. However, this needs to be matched with a culture in which organisations demonstrate that they are not just listening to, but also acting on, staff feedback. While … Read more
Government Response
The government recognises the importance of staff speaking up and commits to exploring with the social care sector whether and how Freedom to Speak Up Guardians could be created, citing a previous commitment in the adult social care White Paper to pilot this in the sector.
Department of Health and Social Care
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8 Recommendation Accepted
Second Report - Workforce burnout …
Improvements to workplace culture have been made, but equally, there is more work to be...
Improvements to workplace culture have been made, but equally, there is more work to be done. Embedding and facilitating cultures which support compassionate leadership must be at the heart of that work. There is a strong appetite for that leadership … Read more
Government Response
The government recognises the importance of compassionate leadership and describes ongoing work by NHSEI, including the development of ‘Our Leadership Way’ and updates to the NHS Oversight Framework and CQC Well-Led Framework, to embed desired leadership behaviours and measure performance.
Department of Health and Social Care
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9 Recommendation Accepted
Second Report - Workforce burnout …
We recommend that NHS England undertake a review of the role of targets across the...
We recommend that NHS England undertake a review of the role of targets across the NHS which seeks to balance the operational grip they undoubtedly deliver to senior managers against the risks of inadvertently creating a culture which deprioritises care … Read more
Government Response
The government agrees on careful consideration of targets and reports that NHS England has already led a clinical review of Urgent and Emergency Care standards within the Long-Term Plan, incorporating workforce retention and wellbeing measures to ensure quality care without compromising staff wellbeing.
Department of Health and Social Care
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10 Recommendation Accepted
Second Report - Workforce burnout …
We further recommend that the Department of Health and Social Care work with stakeholders to...
We further recommend that the Department of Health and Social Care work with stakeholders to develop staff wellbeing indicators, on which NHS bodies can be judged.
Government Response
The government states that it already uses the annual NHS Staff Survey and a new Wellbeing Dashboard, incorporating various metrics, to monitor and measure staff wellbeing across NHS trusts, addressing the recommendation through existing mechanisms.
Department of Health and Social Care
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11 Recommendation Accepted
Second Report - Workforce burnout …
The Committee welcomes the Workforce Race Equality Standard (WRES), along with the People Plan, as...
The Committee welcomes the Workforce Race Equality Standard (WRES), along with the People Plan, as an important step towards an NHS which offers equal opportunities to all its staff. We were pleased to hear in our oral evidence session that … Read more
Government Response
The government agrees to include Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES) data in ICS indicators and targets for model employer goals. They detail ongoing support for action plans and a long-term strategy for WRES implementation, including its phase 1 implementation in social care.
Department of Health and Social Care
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12 Recommendation Accepted
Second Report - Workforce burnout …
We therefore recommend that WRES data be made part of the ‘balanced basket of indicators’...
We therefore recommend that WRES data be made part of the ‘balanced basket of indicators’ we suggest for Integrated Care Systems, with the result that they become accountable for progress across their domains. As part of this process, organisations should … Read more
Government Response
The government agrees to include WRES and WDES data in the 'balanced basket of indicators' for Integrated Care Systems, and states that organisational targets should align with ICS Model Employer goals. They are providing bespoke WRES metrics and supporting ICSs in developing action plans, with Phase 1 of WRES implementation already underway in social care.
Department of Health and Social Care
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13 Conclusion Deferred
Second Report - Workforce burnout …
We heard that colleagues from Black, Asian and minority ethnic backgrounds across the NHS and...
We heard that colleagues from Black, Asian and minority ethnic backgrounds across the NHS and social care continue to face additional challenges. As stated above, we welcome the commitments of the People Plan to a truly inclusive workforce, and the … Read more
Government Response
The government states it will consider the committee's recommendations for a social care People Plan within the broader reform of the adult social care system and has commissioned HEE to refresh workforce supply and demand frameworks for both health and social care.
Department of Health and Social Care
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14 Recommendation Deferred
Second Report - Workforce burnout …
We recommend that adult social care have its own People Plan, which includes parallel commitments...
We recommend that adult social care have its own People Plan, which includes parallel commitments to those for the NHS on diversity and inclusion.
Government Response
The government states it will consider the recommendation for an adult social care People Plan within the context of its broader reform of the adult social care system. They have also commissioned HEE to undertake a refresh of 'Framework 15' for workforce supply and demand.
Department of Health and Social Care
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15 Recommendation Accepted
Second Report - Workforce burnout …
Staff from overseas play a key role in enabling the NHS and social care to...
Staff from overseas play a key role in enabling the NHS and social care to function. Whatever role overseas staff will play in the long-term, they are essential to the health and social care system in the short-term and medium-long … Read more
Government Response
The government highlights its existing international recruitment strategies, including the 50k nurse programme and expansion of the Health and Care Visa. It states it will consider the value of a recommended framework as part of the next stage of the People Plan and awaits findings from a Migration Advisory Committee review on the adult social care workforce.
Department of Health and Social Care
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16 Recommendation Deferred
Second Report - Workforce burnout …
We recommend that the Department develops an NHS and social care national policy framework around...
We recommend that the Department develops an NHS and social care national policy framework around migration to support national and local workforce planning and identify the balance between domestic and international recruitment in the short, medium and long-term. (Paragraph 91) … Read more
Government Response
The government states it will consider the value of the recommended framework as part of the next stage of the People Plan. They also note that the Home Office has commissioned the Migration Advisory Committee to deliver an independent review of the effect of EU Exit on the adult social care workforce, and they will await those findings.
Department of Health and Social Care
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17 Conclusion Accepted
Second Report - Workforce burnout …
Covid-19 has exacerbated existing problems with staff welfare, but also brought some benefits, including higher...
Covid-19 has exacerbated existing problems with staff welfare, but also brought some benefits, including higher levels of recognition and different ways of working. While enhanced recognition of the work of health and care staff is welcome, adequate and holistic support … Read more
Government Response
The government acknowledges the ongoing need for mental health and wellbeing support post-pandemic and outlines existing provisions, including national emotional and psychological resources, £60 million for local adult social care, HEE's learner surveys, the MindEd Hub, and continued implementation of the 2019 Mental Wellbeing Commission recommendations.
Department of Health and Social Care
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18 Recommendation Accepted
Second Report - Workforce burnout …
We recommend that national bodies must continue to monitor the impact of covid-19 on the...
We recommend that national bodies must continue to monitor the impact of covid-19 on the NHS and adult social care workforce and ensure that workforce planning builds in time for recovery after the pandemic is over.
Government Response
The government acknowledges the importance of monitoring COVID-19's impact and commits to continued monitoring, describing ongoing support packages, wellbeing initiatives, and past funding for workforce wellbeing, without committing to specific new future actions for workforce planning for recovery.
Department of Health and Social Care
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19 Recommendation Accepted
Second Report - Workforce burnout …
We recommend that the Department of Health and Social Care, the national bodies, and individual...
We recommend that the Department of Health and Social Care, the national bodies, and individual organisations across the NHS and social care commit to capturing and disseminating the innovations—in particular giving greater levels of autonomy to staff and new forms … Read more
Government Response
The government acknowledges the need to systematically adopt successful new ways of working and commits to providing national support for systems to embed innovative approaches and local solutions, referencing relevant White Papers and policies like the NHS People Plan that promote flexible working.
Department of Health and Social Care
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20 Recommendation Acknowledged
Second Report - Workforce burnout …
It is clear from the evidence collected by Government, the NHS and other organisations that...
It is clear from the evidence collected by Government, the NHS and other organisations that staff from Black, Asian and minority ethnic groups have been disproportionately affected by the pandemic in a way that has shone a light on deeply … Read more
Government Response
The government describes ongoing cross-government work led by the Minister for Equalities, including published quarterly progress reports on disparities in COVID-19 outcomes for ethnic minorities. They also mention an independent review into health inequalities in workplaces and efforts to address vaccine hesitancy, but do not provide a specific implementation plan with a timeframe for the original reports' recommendations.
Department of Health and Social Care
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21 Recommendation Acknowledged
Second Report - Workforce burnout …
We further recommend that Integrated Care Systems have a duty to report on progress made...
We further recommend that Integrated Care Systems have a duty to report on progress made against those recommendations made to improve the support for their staff from Black, Asian and minority ethnic backgrounds. (Paragraph 134) Workforce planning
Government Response
The government recognizes the importance of ICS involvement in improving support for ethnic minority staff but does not commit to a specific duty to report, instead referencing ongoing ICS development and a System Workforce Improvement Model.
Department of Health and Social Care
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22 Conclusion Acknowledged
Second Report - Workforce burnout …
It is clear from our witnesses that although the People Plan presents comprehensive ambition to...
It is clear from our witnesses that although the People Plan presents comprehensive ambition to address the failings in the culture of the NHS, and address the needs and wellbeing of NHS staff, its delivery will depend on the level … Read more
Government Response
The government describes the People Plan's delivery oversight, past achievements, and priorities for 2021/22 and 2022/23. They state that following the Spending Review, the Department will work with NHSEI and HEE to identify future investment needs and shape priorities for the People Plan program from 2022/23 onwards, without committing to specific funding levels.
Department of Health and Social Care
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23 Recommendation Acknowledged
Second Report - Workforce burnout …
We recommend that the Department published regular, costed updates along with delivery timelines for all...
We recommend that the Department published regular, costed updates along with delivery timelines for all of the proposals in the People Plan.
Government Response
The government outlines the People Plan's delivery oversight, past achievements, and future priorities for 2021/22-2022/23. It states that following the Spending Review, the Department will identify future investment areas and shape priorities for the program from 2022/23 onwards, but does not commit to publishing regular, costed updates with delivery timelines.
Department of Health and Social Care
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24 Recommendation Deferred
Second Report - Workforce burnout …
The absence of a People Plan for social care serves only to widen the disparity...
The absence of a People Plan for social care serves only to widen the disparity in recognition and support for the social care components of health and social care. The Government should rectify this as a matter of urgency in … Read more
Government Response
The government states its commitment to adult social care reform and will consider the committee’s recommendation for a People Plan for Social Care within the context of this ongoing work.
Department of Health and Social Care
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25 Recommendation Deferred
Second Report - Workforce burnout …
We therefore recommend that, as a priority, the Department produces a People Plan for social...
We therefore recommend that, as a priority, the Department produces a People Plan for social care that is aligned to the ambitions set out in the NHS People Plan.
Government Response
The government states it will consider the committee's recommendation to produce a People Plan for social care within the context of the broader adult social care system reform and has commissioned HEE to refresh workforce supply and demand frameworks.
Department of Health and Social Care
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26 Conclusion Accepted
Second Report - Workforce burnout …
We have made recommendations to the Department on the reform and funding of social care...
We have made recommendations to the Department on the reform and funding of social care in previous Reports. We believe that they are worth restating. Those recommendations are as follow:
Government Response
The government has published the "People at the Heart of Care: Adult Social Care Reform" White Paper, outlining a ten-year vision for social care with significant investments including £300m for housing, £150m for technology, and £500m for workforce training, wellbeing, and occupational health.
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27 Recommendation Accepted
Second Report - Workforce burnout …
(a) Alongside […] a long term funding settlement we strongly believe the Government should publish...
(a) Alongside […] a long term funding settlement we strongly believe the Government should publish a 10 year plan for the social care sector as it has done for the NHS. The two systems are increasingly linked and it makes … Read more
Government Response
The government has published the "People at the Heart of Care: Adult Social Care Reform" White Paper, which includes a ten-year reform vision for social care, backed by significant investments in housing, technology, and the workforce, directly addressing the recommendation for a long-term plan.
Department of Health and Social Care
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28 Recommendation Accepted
Second Report - Workforce burnout …
(b) The social care sector needs reassurance that both the structural and financial problems it...
(b) The social care sector needs reassurance that both the structural and financial problems it faces will be tackled by the Government in a timely way. For that reason, we recommend that a duty is included in the Bill for … Read more
Government Response
The government confirms its ten-year reform vision for adult social care in the 'People at the Heart of Care' White Paper, detailing substantial investments including £300 million in housing, £150 million for technology, and £500 million for the workforce, addressing the call for a 10-year plan with costings.
Department of Health and Social Care
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29 Conclusion Accepted
Second Report - Workforce burnout …
The emergency that workforce burnout has become will not be solved without a total overhaul...
The emergency that workforce burnout has become will not be solved without a total overhaul of the way the NHS does workforce planning. After the pandemic, which revealed so many critical staff shortages, the least we can do for staff … Read more
Government Response
The government details a new duty in the Health and Care Bill requiring the Secretary of State to publish a workforce planning report every five years, led by HEE, to provide transparency and accountability regarding long-term staffing solutions.
Department of Health and Social Care
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30 Conclusion Accepted
Second Report - Workforce burnout …
The way that the NHS does workforce planning is at best opaque and at worst...
The way that the NHS does workforce planning is at best opaque and at worst responsible for the unacceptable pressure on the current workforce which existed even before the pandemic. (Paragraph 183) 58 Workforce burnout and resilience in the NHS … Read more
Government Response
The government acknowledges concerns about opaque workforce planning by outlining a new duty in the Health and Care Bill for the Secretary of State to publish comprehensive workforce planning and supply reports every five years, led by HEE, to enhance transparency and accountability.
Department of Health and Social Care
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31 Recommendation Accepted in Part
Second Report - Workforce burnout …
It is clear that workforce planning has been led by the funding envelope available to...
It is clear that workforce planning has been led by the funding envelope available to health and social care rather than by demand and the capacity required to service that demand. Furthermore, there is no accurate, public projection of what … Read more
Government Response
The government notes a new duty in the Health and Care Bill will require the Secretary of State to publish a workforce planning report every five years, which differs from the recommended annual frequency. They also mention HEE leading work for a Spring 2022 publication and Skills for Care producing annual reports on adult social care workforce for the Department.
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32 Recommendation Accepted in Part
Second Report - Workforce burnout …
We recommend again, that Health Education England publish objective, transparent and independently-audited annual reports on...
We recommend again, that Health Education England publish objective, transparent and independently-audited annual reports on workforce projections that cover the next five, ten and twenty years including an assessment of whether sufficient numbers are being trained. We further recommend that … Read more
Government Response
The government refers to a new duty in the Health and Care Bill requiring the Secretary of State to publish a workforce planning report every five years. They also state that Health Education England (HEE) will lead work, in collaboration with DHSC, NHSEI, and Skills for Care, to understand future drivers of supply and demand for both health and social care, with a final publication planned for Spring 2022.
Department of Health and Social Care
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33 Recommendation Accepted
Second Report - Workforce burnout …
We further recommend that those projections: • Are informed by the future shape of services...
We further recommend that those projections: • Are informed by the future shape of services and anticipated demand. • Take into account the labour market as a whole. • Make clear the opportunity cost of not training, employing and retaining … Read more
Government Response
The government refers to a new duty in the Health and Care Bill requiring a workforce planning report every five years and states that Health Education England (HEE) will lead work, consulting widely, to understand future drivers of supply and demand for both health and social care by Spring 2022. They also note that Skills for Care already produces annual reports on social care workforce demand projections.
Department of Health and Social Care
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Government Response AI assessment · 33 of 26 classified
Accepted 18
Accepted in Part 4
Acknowledged 5
Deferred 5
Rejected 1
Total 26 recs + 7 conclusions
Correspondence 2 letters
16 Mar 2021 To committee Letter from the Minister of State for Care on improving accountability across adult social care
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22 Oct 2020 From committee Letter to the Chief People Officer on Workforce projections
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