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Skills Gap – an excuse to profit?
Most care service managers will tell you that when it comes to nursing staff, there is a small pool of talent and a huge amount of competition. As a consequence of reductions in numbers of nurses being trained – among other factors – recruiting qualified nurses has become nigh on impossible.
If your service is registered to deliver a high level of nursing care and you cannot fill vacancies, where do you go?
Recently, I had cause to make enquiries of a number of agencies to put in some short-term emergency staffing cover. This was to provide a fixed term nursing resource to ensure safe services during an acute, unforeseen staff shortage, not the usual shift-at-a-time arrangement many of us regularly resort to.
This seemed like a pretty pragmatic approach to a problem; rather than patching up the day to day shortfall, we would look to recruit a team of agency nurses for a fixed term, while we had chance to recruit and induct new permanent staff. This looked impressive, on paper.
In the past we have used this method to help with the start up of a new service and it has been largely successful, even culminating in the permanent employment of the agency workers concerned. We felt that the necessary consistency and continuity of care that people with profound and complex learning disabilities need could be achieved better in this way. Less coming and going in the staff team could only be a good thing.
From the agency’s point of view, one might think that a guaranteed booking of over 100 hours a week for three months would be an attractive prospect. Assuming that the agency takes commission on hours purchased, this would assure them a healthy cut of a sizeable fixed fee.
However, there was a big problem. The problem was the size of the fixed fee.
I will not give details, but if I say that the hourly fee quoted was around four times the cost per hour of permanent staff, you will probably be in the ballpark. To say this was steep is an understatement; it is in fact unaffordable. It is particularly galling when you realise that the staff will probably earn only a third of that fee. The rest is the commission.
Now, I am not so naïve to deny the right of independent companies to make a profit; as a businessperson I fully accept that this is what makes the world go round. But the margins in this sector seem to be spiraling out of control.
Recent news articles report the staggering cost to the NHS of agency staff. As a former NHS manager, I know that when you are up against targets or minimum staffing limits and have nowhere else to turn, you have to pay what they are asking. The cost to the NHS of agency workers has risen to £3.3 billion in 2014/15, which is a 31% increase on the previous year. This was in the same year that over 30,000 prospective nurse trainees could not get places in universities due to reductions in numbers on courses.
When services risk closure or regulatory breaches due to lack of adequate staffing, there is no choice but to commission agencies. This will only serve to perpetuate the pricing models they use. It’s time we recognise that the only way to curb this is to ensure there are enough professional staff to meet demand, now and in the future.
Ginny Tyler – QCS Expert Learning Disabilities Contributor