Mon, 10 Aug 2015

The Recruitment & Employment Confederation (REC) is calling on government to harness the expertise of healthcare recruiters – not just to plug staff gaps but also to help with workforce planning.

REC policy adviser Vicky O’Brien told Recruiter increased patient demand and an ageing population were putting more strain on the NHS and trusts were increasingly turning to recruiters for staffing help. 

This included during the hours of midnight to 8am.

“And this is really the product of years of poor workforce planning by the government,” O’Brien said.

Lord Carter, who was asked by the government to look into how the NHS could improve its productivity and be more efficient, said in his June interim report the NHS could save £2bn a year by improving workflow and containing workforce costs, including better management of rosters and improved guidance on appropriate staffing levels.

A recent REC webinar found 22% of members polled said they fielded more than 200 requests for staff from NHS Trusts a week, with 28% reporting a 75-100% fill rate.

While most placements are made via framework agreements, 31% of respondents said 60-100% of their NHS business was conducted outside the agreement terms, or off-framework. 13% said they did not work off-framework at all. 

Most NHS trusts manage agency spend through framework agreements that cap rates. Rates are negotiated by central government and recruitment agencies must adhere to them.

But in times of urgent need, agencies are forced to go off-framework to secure the staff they need.

As one webinar participant commented: “NHS clients I have spoken to simply said ‘we have been told not to use off contract suppliers for years, but... if you need a nurse you need a nurse; I’d rather get my wrist slapped by procurement than be on the front page due to poor frontline care’.”

One in 16 (6%) respondents believed trusts were contracting three-quarters or more of their agency staff via off-framework arrangements.

Frameworks are not currently mandatory but Jeremy Hunt, secretary of state for health, announced in June the possibility that frameworks would be made mandatory under a number of caps and controls as to how NHS Trusts could procure staff. 

The REC is “feeding into that work”, O’Brien said, adding it was particularly pushing for an improvement to frameworks, should they be made mandatory, including making them more easily accessible for smaller recruiters.

While all framework agreements were different – some capped pay rates, some capped commission rates – an average price for a junior to mid-grade ward nurse was about £20-25 an hour, just a few pounds more than a permanent employee would get, O’Brien estimated.

An agency would also take a commission of 10-20%.

And in the cases when staffing arrangements are made off framework, it is the trust choosing to do so rather than the agency pushing, she said. 

A trust would choose to go off framework usually when it had a short-notice vacancy to fill and its framework suppliers were unable to help. In some cases it might have to pay more than it would on framework, but that was not always the case.

In some cases, trusts choose to go off framework if they find they can get a better deal than offered by their on framework suppliers, she added.

The widely-reported healthcare candidate shortage was hitting both trusts and recruiters but part of the reason why trusts were more affected was down to staff retention. 

“I think the NHS is struggling to provide the flexibility and the working conditions for its perm staff, which is why so many professionals are choosing to work on an agency basis.”

But agencies could help trusts plan by giving advice on the local job market, as well as advising on how trusts can effectively manage staff banks, or how to set up a bank, O’Brien said.

An average of 62 agencies responded to each question during the REC’s webinar.

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