Workers on temp contracts are significantly more costly than those in permanent contracts, so why is the NHS still hiring temporary workers for up to 13 years at a time, when it would be more cost-effective to recruit permanent nursing jobs and doctors?
The NHS has spent £16.9 billion on agency staff since 2012/13 at an average of £2.8 billion per year and other data shows that 3700 agency workers on temp contracts spent more than a year with the same employers. Clearly, these are all NHS and nursing jobs that would be more cost-effectively as permanent roles. And it isn’t a trend that’s just associated with areas of high employment such as London. There are examples of the practice all over the UK with nursing and RGN jobs in Liverpool, jobs in Leeds, jobs in Manchester and jobs in Birmingham all going to workers on temp contracts.
Why are there so many temporary contracts in the NHS?
At a time when then NHS is under severe budgetary restraints with growing calls to cut spending, why is this happening – and can anything be done to cut costs when it comes to the number of temporary workers employed across the health service.
The main reasons for the problem, according to experts such as David Carter, the chief executive of the Royal College of nursing, are a shortage of qualified nurses and short-sighted workforce planning. With not enough trained nurses, trusts are turning to recruitment agencies to source staff for them. Certainly, some reports back this up, citing that the use of agency staff is not a deliberate strategy of public sector employers, but a response to recruitment and retention difficulties caused by local and national skills shortages. These surveys also found that workers taking up these temporary roles do so to avoid permanent employment as a result of the bureaucracy, target setting and lack of work-life balance that comes with them.
Will government action be enough?
A pay cap introduced on temporary workers in 2015 has worked to some extent. NHS Trusts have reduced their annual spending on temporary agency staff by a third (£1.2 billion), according to Ian Dalton, chief executive of NHS Improvement. However, in 2017, data obtained from two-thirds of NHS Trusts found that £1.46 billion was spent on agency nurses – enough to pay for 108,000 newly qualified permanent nursing jobs. On average the NHS paid £18.41 per hour for nurses, much of which went to agencies – 63% more than would have been paid to newly qualified nurse on £11.32 per hour.
While the cap has had an effect, the government is now pledging to introduce more measures to clamp down on the practice of hiring so many workers on temp contracts. Trusts are being asked to make further cuts to the budget put aside for the recruitment of staff on temporary contracts with chief executives having to sign off personally on any agency shifts costing more than a specified amount per hour. But, at the same time, funding promised last year for 10,000 new nursing training placements scrapped seems to have disappeared. As a result, there were fewer applications to universities for nursing courses, so the government may not have gone far enough yet. NHS Trusts still need to go to agencies to source enough staff for their needs.
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