NHS Risks Patient Safety and Higher Costs Unless Approach on Hiring Temporary Staff Changes

 

In a letter to the Secretary of State for Health and Social Care, Matthew Hancock, Britain’s leading recruitment body sounded an alarm bell over the NHS’s ability to maintain high quality care at affordable prices. 

REC Chief Executive Neil Carberry said that if the frameworks that the NHS uses to procure temporary staff remain focused only on buying the cheapest option, quality of care may suffer. Firms with high standards are increasingly finding they can’t afford to work with the health service. Agencies leaving the market would mean staff shortages that will cost more to fill through high cost, emergency routes.

Pointing to the high level of cost savings that agencies have already delivered for the health service, Carberry said: “Increasingly, agency providers deliver at rates below [those of] NHS banks” and noted that “fees paid to agencies have come down substantially as we reach the fourth year of caps.”

Delivering high standards of patient care at good value is at the heart of what NHS staffing firms do. But there comes a point where firms simply cannot supply at the prices offered, leading to market exit – a trend we have seen in social care and public sector infrastructure already.

In the letter, the REC points out that where government enforces unrealistic frameworks it creates instability and an unsustainable market. This always ends up leading to higher costs for the taxpayer in the long term: “Government learned from the Carillion collapse what happens when unsustainable contracts are forced through by public procurement – only firms willing to take uneconomic business remain... Some recent procurements are pitched at levels that are likely to drive firms to exit NHS on-framework supply.”  This could have especially serious consequences as we run up to high demand winter months.

 

The REC have asked the Secretary of State to engage with NHS staffing partners and our health and social care sector members to find a solution which means the NHS can achieve great value – delivering high standards of patient care and avoiding gaps in service or very high cost emergency options.        

 

Full text of the letter below:

14th October 2019

Rt Hon Matthew Hancock MP

Secretary of State for Health and Social Care                                                                  

Department of Health

39 Victoria Street

London

SW1H 0EU

  

We share a goal of delivering timely, efficient and – most importantly – safe temporary staffing in the NHS. This was the basis of our discussion last year at Conservative conference, and it has been built on in meetings with your officials, departmental visits to our members and in a discussion with our Health & Social Care group this week.

The REC is the UK’s association for staffing and recruitment. As such, we appreciate the stronger relationship built between us and your department over the last year – acknowledging that agency and bank providers both have a role to play in delivering great care. Increasingly, agency providers deliver at rates below NHS banks.

But to maintain stability of supply and quality of patient care, all staffing providers need predictability and the ability to invest in innovation and compliance. This is clearly in the interest of the NHS, as it avoids emergency placements that cost far too much and damage the reputation of the system. In the longer run, it enables our members to bring forward the big ideas you need to boost efficiency and patient care. 

Ensuring that NHS frameworks are fit for purpose is essential to this. Despite the media focus on outlier examples of high rates for specific locum shifts, fees paid to agencies have come down substantially as we reach the fourth year of caps. Yet recently, we have seen further attempts to reduce agency margin – to the point where it is increasingly unsustainable to provide to the NHS in a cost-controlled, on-framework environment.

Government learned from the Carillion collapse what happens when unsustainable contracts are forced through by public procurement, and only firms willing to take uneconomic business remain. Some recent procurements are pitched at levels that are likely to drive firms to exit NHS on-framework supply, increasing the reliance on off-framework and loading contracts onto a few providers. This was not in the Government’s plan – and it is not what we want to happen either, especially as we run up to the higher-demand winter months. 

The REC is here to help find a solution to this – but it requires public sector procurers to acknowledge that buying on price alone risks the quality of the service, and is likely to lead to gaps that other, very high-cost, options fill. We want to work with you to achieve maximum efficiency from your spend. But that needs us to work in partnership. I would welcome a wide-ranging discussion involving the Department, REC and our members, as well as intermediaries and would be happy to help to arrange it. 

At a time of intensifying recruitment challenges, we want to shift the dial on the way that our market is managed – so that the contribution of healthcare staffing firms is maximised rather than marginalised. 

 

We would be happy to arrange a meeting to discuss this further. 

Neil Carberry

Chief Executive

ENDS

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The REC is all about brilliant recruitment, which drives our economy and delivers opportunity to millions. As the voice of the recruitment industry, we champion high standards, speak up for great recruiters, and help them grow. Recruitment is a powerful tool for companies and candidates to build better futures for themselves and a strong economy for the UK. Find out more about the Recruitment & Employment Confederation at www.rec.uk.com.