Putting the Trusts back in agencies

04-Feb-2009 | By Colin Cottell

Last month NHS Professionals announced it is to stop booking doctors supplied by recruitment agencies on behalf of NHS Trusts from 1 April.

In a bulletin issued to recruitment agencies, Fiona Thomson, director of Doctor Services at NHS Professionals, wrote: “It simply means Trusts will then deal directly with your agency in regards to the booking of you staff.”

The initial reaction of recruiters was not short of euphoric, expressing the view that this is a long overdue change that will improve the service and free them from the shackles of unnecessary bureaucracy.

The response of Kate Harris, commercial director of healthcare recruiter Pulse, was typical. “This is great news for agencies trying to provide a great service for Trusts, for patients and for tax payers,” Harris told Recruiter. “We have been campaigning for this for five years,” she added.

Craig Tibbles, chief executive of Orion Locums, told Recruiter: “At long last agencies will be able to speak to clients and ascertain their true requirements, build a relationship and provide an efficient and responsive service.”

Steve Porter, operations director at Mediplacements, added: “It’s a lot easier when you can talk to people and they can tell you what they need. Taking the middleman out will help the whole process speed up, and help us provide the people they are looking for.”

Harris said that the removal of NHS Professionals as an intermediary would put an end to a number of inefficiencies and bottlenecks. “The process for notifying agencies is complicated and long-winded. Basically, you end up with doctors’ positions not being filled,” she claimed.
Harris said that “another source of relief” is that by being able to deal direct with NHS Trusts, agencies will get paid quicker. Harris said that getting paid when dealing with NHS Professionals can take months.

However, despite the initial welcome, some recruiters are concerned that the change is no panacea for the industry. For although NHS Professionals will no longer be providing a booking service for agencies supplying doctors, it shows no signs of withdrawing from providing locum doctors from its own bank.

NHS Professionals’ statement to Recruiter that it now believes that its resources “would be better spent on enlarging the supply of high quality doctors through our own bank” is hardly a clear signal it intends to lessen its recruitment-related activities overall.

Salim Shahul, chief executive of dr-locums, told Recruiter that to gauge the impact of the change on agencies, the decision had to be looked at in a wider context.

Shahul said he was concerned that despite the change, recruiters could be at a competitive disadvantage. He pointed to substantial increases in the rates NHS Professionals pays doctors, as well as the abolition of the VAT staff hire concession on 1 April that at a stroke will increase agency rates by 15%.

When combined with doctors on NHS Professionals’ locum bank having the option of a pensionable salary, “basically, NHS Professionals will have access to the pick of the bunch, leaving very little for agencies”, Shahul warned.

The outcome for agencies will also depend on the precise relationship between NHS Professionals and NHS Trusts after 1 April, Shahul argued.

If NHS Professionals operated as a tier one supplier, Shahul said, he is confident that agencies will be able to supply doctors as tier two or tier three, or standard business rates at better rates than at present, particularly in areas of skill shortage. “We will make more money on each placement. The question is how many placements we will get?” he said.

However, he said that a more likely scenario is that NHS Trusts that used NHS Professionals as a master vendor will enter into a new master vendor relationship with an agency.

An NHS Professionals spokesperson told Recruiter that any change in the relationship “will be a matter between ourselves and our partner Trusts”, adding: “NHS Professionals will continue to be an HR function within the NHS and our locum bank will continue to operate
within this framework.”

However, Harris has no fears about competing with NHS Professionals “Bring it on,” she said. However, she admitted that a truly level playing field can only exist when NHS Professionals no longer “has government money poured into it”.

NHS Professionals (and its predecessor) received around £100m in subsidies from the tax payer since 2001, though admittedly this has fallen in recent years, and NHS Professionals promises to move to self sufficiency “in the near future”.

Harris also saw no reason why NHS Professionals should not withdraw from providing booking services for nurses and for admin and clerical staff, nor why it shouldn’t be on the NHS Purchasing & Supply Agency framework agreement.

While NHS Professionals’ decision is, on the face of it, good news for agencies, it cannot be seen in isolation, and it will be some time before the full impact becomes apparent.