Poor workforce planning createcd NHS reliance on agency staff

      The government has announced it will introduce new rules to set a maximum hourly rate for NHS temporary doctors and nurses, ban the use of agencies that are not approved and cap the amount struggling trusts can spend.

Official figures show that NHS spending on agency staff has rose from £1.8bn to £3.3bn over the past three years. 

Jeremy Hunt said: “Expensive staffing agencies are quite simply ripping off the NHS. It’s outrageous that taxpayers are being taken for a ride by companies charging £3,500 a shift for a doctor”.

The NHS is dependent on temporary workers to fill the gap between an ever increasing demand and supply of labour. 

Difficulties in recruiting, employee retention, a lack of investment in training and increased sickness absence due to stress are some of the reasons why the NHS are lacking sufficient permanent employees and consequently using agencies to hire core-staff.

It has been reported that many NHS trusts have become reliant on agency staff and between Christmas Eve and New Year’s Day more than half of the shifts worked in some A&E departments were worked by locum medics. 

Junior doctors are reluctant to train as A&E consultants and many doctors who choose this path are dropping out before completing their training. Reasons for this include the anti-social working hours, fatigue, late finishes and the intensity of the work.

Mark Porter, the British Medical Association Council Chairman, says reliance on agency staff is a “sign of stress on the system and the result of poor workforce planning by government”. 

If hospitals are going to reduce their agency spend, this initiative will need to be supported by long-term solutions such as increasing training places and numbers of permanent staff, as well as robust retention policies.

However, increasing core staffing levels needs to be coupled with appropriate rostering strategies. Working time change strategies that enhance work-life balance and increase productivity need to be at the heart of workforce planning improvements for the NHS.

Kevin White, Managing Director at Working Time Solutions said:“The NHS recognise that demand for their services fluctuates, peaking over weekends and during the winter months, yet roster patterns seem so often to remain unchanged. 

"Designing working patterns that match predicted demand will reduce the support required from agencies, increase visibility and predictability of working patterns and reduce the cost of overstaffing during quiet periods when rosters are feeding in more staff than are actually required to achieve targeted service levels”.

The 'art' or 'science' of developing shift patterns which meet the predicted demand for labour and focus on acceptable work and leisure time patterns has developed to a remarkable degree in recent years. 

Multiple shift pattern and rota options can be generated that focus on benefits such as improved ‘white’ space (time off between shifts), reduced travel time, fewer handovers, and increased flexibility enabling staff to make working time adjustments and book time off as their own situation changes day by day. 

This approach could aid employee retention within the NHS while also reducing the requirement for expensive agency staff.



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