Jay Thinsa, Chief Services Officer at healthcare staffing agency Kingdom Healthcare, discusses the recent NHS recruitment freezes affecting nurses, doctors and other healthcare staff.
With NHS trusts in England busy balancing the books and wiping out a reported £7 billion financial shortfall, the cuts to clinical and non-clinical jobs and recruitment freezes are being felt across the industry.
Resident doctors are struggling to find placements, student midwives are putting in hundreds of hours of work with no job lined up, and understaffing is leaving nurses and doctors overworked and stressed. Years ago, training to be a nurse, doctor or midwife – a gruelling three to five years of school and years of further training and work experience – would land you a job for life.
But now, this is no longer the case. Reports of hospitals being short-staffed are so commonplace that it seems to become synonymous with UK healthcare, but likewise, are tightening budgets and stalled recruitment that lead to worsening the problem, rather than improving it.
Doctors, notoriously, choose their vocation early, and the UK education system demands it. With many making the decision to go into medical school by the time they choose their GCSEs at 15, over a decade before fully qualifying, many set their sights on a dream that won’t be a reality by the time they graduate. Newly qualified healthcare staff find themselves competing with more experienced candidates, and experienced staff are choosing between entry-level pay, having to uproot their lives to another area, or turning to working for an agency that will offer them higher pay and more flexibility.
Stress and burnout
Competition for jobs has risen due to recruitment freezes and cost-cutting, paired with the growing demands of an ageing population, with the British Medical Association saying more than 33,000 doctors applied for fewer than 13,000 speciality training posts this year.
It’s a challenge to see how widespread recruitment freezes imposed on trusts can align with drives to cut patient waiting times for NHS care. It’s likewise hard to see how cutting down the use of agency staff, as NHS England says it has done by almost £1 billion in the last financial year, would do anything but leave hospitals further understaffed.
For all healthcare staff, agency or not, staff shortages inevitably lead to stress and burnout that affect efficiency and performance. Low morale due to underfunding can impact how people feel about their job, and for a job that many are doing for the rewarding feeling of helping others, lack of motivation and morale can affect the NHS for years to come. As well as this, many healthcare workers may struggle to look ahead, with career progression and pay rises likely stalled in a country gripped with a cost-of-living crisis.
For agency staff, if recruitment freezes limit new permanent hires, the demand for staff will still be there – to cover peak periods, staff absence and more – so the NHS may need to turn to agency workers more to fill critical roles. If trusts find that their hands are tied, it could lead to further understaffing, which would impact the quality of care patients receive through the NHS.
Agency staff may also experience instability due to new rules that curtail the use of agencies, with agencies that offer reasonable costs that work to benefit both the NHS and the worker being lumped together with agencies that charge much higher fees that cost the NHS more. While in the short term, this is challenging for any agency and staff, in the long term it may signify more opportunity for reasonable, reliable and high-quality agencies to shine through. Agencies should always be working around the needs of their client, whilst also offering the benefits that no doubt incentivise the best nurses and doctors possible.
The value of agencies
For the NHS, understanding the value of agencies and why so many nurses and doctors move to them could help in creating a stronger, brighter NHS. Agency staff often fill urgent staffing gaps to avoid service delays and cancellations, so the NHS can cope better with seasonal surges in demand. The flexibility they offer is ideal for seasonal demand as well, with agency staff being able to be brought in as needed, allowing trusts to scale up or down.
As well as this, understaffing leads to significant staff burnout; supplementation can reduce stress and burnout and protect patients. One Unison survey revealed that 69% of shifts were understaffed across 42 UK hospitals, a shocking statistic that would no doubt leave anyone scrambling for immediate solutions. While pledges are made for change in the next decade, progress is often too slow to meet the rising healthcare demand – we need to be open to other solutions, rather than close doors.
While Wes Streeting has pledged to cut the amount spent on agency staff, this will lead to further understaffing. As well as this, concern over agency pay is rightly scrutinised, for agencies that charge the NHS very high fees, which signifies how many healthcare staff are struggling to get by on NHS wages, and have to turn to agencies in order to make ends meet.
