The recruitment issues facing the NHS continue to mount. Imminent changes to the IR35 tax system will affect public sector hiring and in particular the NHS.
From 6th April, public sector employers will be required to deduct tax and national insurance at source from the pay of their contract workers. Professionals working in the public sector may lose up to a third of their take-home pay as a result leading to concerns over the potential loss of highly qualified individuals from the public sector. Employers and recruitment agencies providing interim workers – rather than the individuals - will be responsible for ensuring professionals are paying the correct level of tax and National Insurance. The NHS in particular will be forced to absorb additional costs at a time when its finances face more pressure.
Read our sector focus on recruitment in healthcare
In terms of recruitment, it also faces ongoing crises in the following areas:-
- Nursing recruitment remains in a critical stage. One in three nurses is expected to retire in the next 10 years but the struggle to bridge the skills gap continues. Following the withdrawal of bursaries the Royal College of Nursing reported a 23% drop in nursing applications depleting an already diminished talent pool. The RCN has also called on the Government to fund additional staffing following a report by the Care Quality Commission (CQC) which suggests safety at 80% of hospitals is 'not good enough'. Newly released allegations of 'fat cat pay' in the NHS will only add to the pressure as it has been revealed that over 600 quango officials now earn six figure salaries.
- Growing numbers of nurses are turning to agency work to improve their work/life balance. Despite a cap, agency spending in the NHS is likely to remain high until staff recruitment and retention issues are resolved. Industry watchdog NHS Improvement recently identified over 100 agency workers earning in excess of £200,000 per year, many of which are already NHS employees. This practice is now being prohibited ahead of the introduction to the IR35 changes.
- Research from the British Medical Association published in February suggests that 40% of doctors qualified in the EEA are considering leaving the UK following the Brexit vote. A further survey from the General Medical Council suggests this figure could be as high as 60%. The outcome of Brexit on staffing shortages remains uncertain with interest in healthcare jobs from the EU already seeing a fall.
The NHS employer brand is seemingly staggering from one crisis to another. Additional concerns were also raised this week following the revelation that half a million documents containing sensitive medical information were placed into storage in error rather than being delivered to GPs between 2011-2016.
The issues facing the NHS are complex and not easily resolvable. The following strategies have been recommended but implementation takes time and collaboration. Effective, robust recruitment has never been more critical for the NHS. Our sector focus on recruitment in healthcare expands on the following issues:-
Develop compassionate and inclusive leadership : The Kings Funds proposes a compassionate and inclusive leadership across the NHS, putting an end to the culture of ‘blame and fear’. To achieve this means creating and nurturing a diverse pipeline which must be supported by effective HR technology to remove unconscious bias within the hiring process at all stages. Creating a robust talent management strategy means a complete review of hiring strategies and effective analysis of the data provided.
Increase flexible working : More flexible working is essential to both attract and retain talent in healthcare as demand for key skills continues to exceed supply. Concern was expressed over the lack of flexibility at a recent roundtable event for NHS Employers reported by the CIPD. Approximately three quarters (76%) of the NHS’s workforce is female. The introduction of flexible working would help to reduce the pressure on HR and talent management strategies that are failing to retain staff with key skills. The belief is that the introduction of flexible working would reduce the reliance on agency workers to fill vital gaps in the workforce. It was noted that two thirds of nurses also take on additional agency shifts in addition to the permanent roles.
Improved workforce planning : Collaborative workforce planning – proposed at a national rather than individual Trust level – is vital to ensure a pro-active hiring strategy which predicts upcoming skills gaps. Continual reliance on agency workers makes this goal difficult to achieve. Investment in recruitment software supports and streamlines hiring process to support workforce planning, enabling vital collaboration and clear visibility of qualified candidates within your talent pipeline.
Implementing strategies to improve retention : Issues including bullying, pressured staff working long hours and the inflexible approach to working hours will continue to drive staff into the private sector or towards agency work. Our previous article highlighted the success of Frimley Health NHS Foundation Trust which adopted a number of ‘HR led’ interventions in areas such as employee behaviour to win the best employee engagement initiative at the CIPD’s People Management Awards. A further example was University College London Hospitals (UCLH) NHS Foundation Trust which became the first NHS employer to agree to the National Living Wage in London.
Adapt to the gig economy : As the IR35 deadline approaches, efforts must be made to retain the skills provided by contract workers in key areas. Effective training, a wellbeing policy and a formal performance review strategy which incorporates ‘gig economy’ workers will become increasingly more urgent.
Incorporate onboarding : Onboarding is the final and equally essential part of the candidate experience. Previous research carried out by PwC found that one in three new hires leave their new job within a year, with 22% of these leaving within six weeks. Integrated onboarding is proven to boost time-to-productivity and employee engagement and reduce staff turnover.
Investment in HR technology : The adoption of technology throughout the healthcare industry must extend to the hiring process in order to offset the broader issues facing the NHS. Modern recruitment software provides detailed insight into problematic areas of the hiring process, automates key elements of recruitment and enables rapid sharing of information. With the introduction of the IR35 changes, NHS Trusts can no longer afford to be complacent.
Advorto works with NHS trusts to identify and resolve critical hiring issues, including:-
- Sifting imported applications with full auditing to confirm relevant checks have been carried out, ready for inspection by the CQC.
- Provision of flexible and cost-effective configuration to meet the requirements of frequent regulatory changes.
- Importing candidates applying via NHS Jobs into a compatible system.
- Provide an interface with the electronic staff register.
- Facilitate rapid approval and posting of vacancies.
Contact us today to discuss how we can help your Trust to hire better people faster.
For an in-depth examination of the issues facing the NHS, our healthcare sector report is available to download here.