Bridging the gap

Reforms recommended by the Francis inquiry and Keogh review could cost healthcare providers up to £1.2bn, several times the originally anticipated cost, according to new research by the Foundation Trust Network. Health Education England recently announced they were conducting Skype interviews with doctors in India in a desperate bid to tackle the alarming shortage of A&E specialist doctors coming through.
For Recruitment and Employment Confederation (REC) members who work daily with NHS as trusts across the UK who are facing ever decreasing budgets and staff shortages, these recent headlines are particularly frustrating. We have long called for an overhaul of procurement but continue to face a fixation on reducing agency spend rather than innovation in cost-effective workforce management and planning. Faced with spending cuts and increasing demands for better value, it is imperative for recruiters and employers faced with the challenge of resourcing the public sector to work together more effectively than ever before.

In order to achieve this, the Department of Health’s ‘Better Procurement, Better Value, Better Care’ report published last summer also recognised the need for a new approach to supplier engagement; that recruitment agencies and their clients should “jointly take waste out of the system and smooth the pathway for innovation.”
The REC agrees that nurturing a genuinely flexible and sustainable NHS workforce is going to require a shift from simply supplier engagement to genuine collaboration with recruitment agencies. Unfortunately, progress in this regard has been slow.

In our recent correspondence with the Health Minister Dan Poulter, we argued that side-lining agencies risks creating a void that alternatives such as staff banks are unlikely to fully cover.

Recruitment agencies continue to the bridge the gaps left by the crisis in NHS workforce management. Our data shows that demand for both temporary and permanent nursing/medical/care staff is strong and it is the second highest sector for both permanent and temporary demand for candidates according to the latest REC/KPMG Report on Jobs. Demand for both temporary and permanent staff in the sector has been on a steady increase since 2011.

Report on Jobs also reveals that there are some specific roles where recruiters are struggling to find candidates to fill the positions that they have on offer, including registered general nurses and registered medical nurses, and are subsequently looking abroad. However, other agencies are finding talented health and social care professionals with ease; with many long-term NHS employees turning to agency work citing poor remuneration and workplace cultures as the key motivations for making the move.
The good news is that agencies are slowly starting to be seen as partners in the difficult project of building a flexible but sustainable NHS workforce. The Department of Health recently commissioned the NHS Commercial Alliance to assist with phase one of a Temporary Agency Staffing project to help NHS trusts deliver £450m of efficiency savings towards the NHS’s total £1.5bn to £2bn efficiency savings target. The REC’s Health and Social Care sector group has welcomed the opportunity to contribute to this development of a national temporary staffing strategy, and will be sharing insights on how to effectively manage agency spend as well as making the case that temporary agency staff are indispensable to any cost‑effective workforce strategy in the NHS.  

We continue to champion the commitment and compassion of agency health and social care professionals. Specialist recruitment agencies provide a 24/7 service to the NHS, ensuring suitably skilled and properly vetted staff are placed into front line roles, often at extremely short notice. Many agency workers are former or current direct employees of the NHS and have gained invaluable experience working in a number of care settings. Yet despite the crucial role agency workers have played ensuring safe staffing levels, they continue to be treated as second-class citizens within the NHS. This is something the REC’s Health and Social Care group will continue to challenge.
We also believe that a strong focus on quality and viable opportunities for SMEs – in line with Government commitments in this area – has to be part of any procurement strategy to build sustainable supply chains that deliver value for public services. This is particularly crucial within social care. Many recruitment agencies involved in complex umbrella and other supply chain arrangements struggle to not only navigate the tendering process but also to receive crucial feedback and references from clients about the performance of their workers.
NHS trusts should also be assured that the REC continues to drive professionalism and standards in the recruitment industry. All our members must abide by the REC Code of Professional Practice. When agencies join the REC they sign up to the REC code, which requires basic statutory compliance as well as higher ethical standards. REC members must also pass the REC’s compliance test on entry to the REC and then must pass again every two years to retain membership. If an agency uses the REC logo it means that they have passed the initial compliance test and are required to adhere to the REC code.

On the ground, many of our members enjoy working partnerships with trusts based on mutual support and trust. REC member HCL worked with Worcestershire Acute Hospitals NHS Trust that provides hospital-based services to a local population of around 550,000 through three main sites in Redditch, Kidderminster and Worcester. To deliver sustainable services to that population, the trust identified the need to optimise its resources, governance of risk and demonstrate true value for money. Spend on medical locums was one area of significant cost – in the last financial year the trust spent over £7m on this staff group. Although vital in supporting the delivery of safe patient care, the trust felt it was not realising value for money from its temporary staff supply chain.
Claire Billenness, Managing Director Client Solutions at HCL: “We acknowledge the complex nature of the NHS and the pressures trusts are under – we want to help trusts become better informed about their supply chain, ensuring value for money and efficiencies that can then be reinvested into the provision of frontline care. In just one year HCL Clarity, our managed services division, helped Worcestershire Acute Hospitals NHS Trust to save an indicative £1.3million through working with the trust to streamline their preferred supplier list, renegotiating framework rates, building a case for permanent recruitment through real-time reporting and significantly increasing the bank size. By working with HCL Clarity, the trust can now make informed decisions about their supply chain, enabling further financial savings and freeing up medical resources.”
We want to champion these stories and support other members to achieve similar partnerships. But building a cost‑effective temporary staffing strategy for the NHS is going to take genuine openness and commitment from both sides.


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