It has become increasingly taboo over the past few years to be considered an agency worker within the NHS; however, it is important to understand that over 100,000 workers (or 6.6% of the NHS workforce) are employed through agencies. For one client of ours, over 80% of shifts filled via agencies were shifts starting in less than 24 hours. Without agency workers, these shifts would have gone unfilled and resulted in closed beds, cancelled surgeries and inadequate staff cover. Agency workers provide last minute and long term care to patients, allowing trusts throughout the UK to maintain compliant staffing levels. Given this, it seems unreasonable that the Government continues to make condemning statements such as “for too long staffing agencies have been able to rip off the NHS by charging extortionate hourly rates which cost billions of pounds a year and undermine staff working hard to deliver a high-quality public service.”
The current NHS deficit is the largest in history; the Government’s main focus has been on cutting costs in the agency market, where £3.3 billion was spent in 2014/2015. However, this high agency spend is a direct result of the inadequate strategic workforce planning in the NHS by previous governments over the past 20 years. In the present market, demand is exceeding supply due to an ageing population and rising hospital admissions, which has led to a steady increase in agency pay over the past five years. Likewise, there has been a severe lack of investment into the NHS from the Government in the last 15 years and, although the Government is trying to reverse agency pay, Jeremy Hunt isn’t targeting ‘rip off’ agencies, but is actually hurting the pay pockets and morale of our flexible workforce that ensure safe staffing levels in wards up and down the country.
Agency candidates provide a better service than they are credited for
Agency candidates choose to work through an agency as it provides them flexibility that the NHS cannot facilitate or afford; a fact which has been highlighted by the recent junior doctor strikes over changes to their core hour working patterns. Last October, the Telegraph featured an article written by an agency nurse, Amy. Amy defended her choice to work via an agency and explained that, although she is paid a premium over permanent staff, it is important to remember that she misses out on benefits such as:
- The guarantee of work
- High pension payment
- Sick pay
- Career progression
Furthermore, the cost of training agency workers is not required to be subsidised by trusts, as is the case with permanent (substantive) employees. The agency worker and/or agency suppliers are governed by clear compliance guidelines and qualification requirements that cost hundreds of pounds a year to adhere to. The compliance and training costs required to work within the NHS are substantial and form part of the cost of the agency fee. Also, trusts would typically change rotas and review their internal database of bank workers before turning to agency suppliers. If the agency industry was not available and workers decide to go abroad or change profession, what alternative would trusts have?
Agency candidates need more protection
Having worked in recruitment for the healthcare sector and a number of other sectors, including telecoms, manufacturing and the financial services sector, I’ve never come across an industry that criticises agency suppliers and candidates like the NHS. A lot of the rhetoric from senior politicians, trade unions and senior executives in the NHS would be considered discriminatory in other sectors and often there is an ‘us’ against ‘them’ mind-set, even at ward level, within the NHS.
Agency staff on the frontline are able to cover shifts on short notice, especially in the nursing sector where agency workers are often notified of a cancelled shift just two hours before the shift is due to start. Agencies provide candidates to hospitals and wards that are severely understaffed because the NHS hasn’t received investment in their staff for the past decade.
Change is required
In the Telegraph article cited above, Amy admitted she felt ashamed about writing the “dreaded A word” in front of her job title and highlighted the external opinion about agency candidates in the market as “the greedy scum of the health care system”. Agency workers should be treated as partners in the NHS, not the enemy; agency recruitment is a solution to the understaffing problem. The staff supplied by our sub-contractors provide valuable, first-class care to the industry. The perception of agency staff needs to change, but this change has to start from the top, with Jeremy Hunt and the NHS chief executives showing support for such a pivotal part of the NHS workforce. It should be made clear to the public that tweaking, rather than removing, the agency staffing solution will result in far greater benefits, not just for agency staff, but also for wards, trusts, the Government and, ultimately, patients.