The challenges of Brexit and healthcare staffing shortages continue as the latest NHS staffing level figures (November 2018) reveal a shortfall of 41,722 nursing roles, alongside wider doctor and allied health professional vacancies.
The Cavendish Coalition, an alliance of 36 health and social care organisations, estimates that as many as 51,000 nursing staff will be needed in 2021, when the UK leaves the post-Brexit transition period. This means the equivalent of 45 hospitals’ worth of nurses will be required to fulfil the estimated shortage under traditional deployment models.
The NHS Long Term plan, which outlines its strategy to improve patient care over the next ten years, aims to address the problem by increasing the NHS workforce by training and recruiting more professionals.
HealthTrust Europe has put together some key actions to help mitigate some immediate risks: This will include thousands more clinical placements for undergraduate nurses, hundreds more medical school places, and more routes into the NHS such as apprenticeships, as well as efforts to support improvements in retention. Meanwhile, the Nursing and Midwifery Council (NMC) has proposed an easing of the level of English writing skills required of nurses from outside the UK to encourage more overseas staff to work in the UK.
However, faced with complex challenges caused by staff shortages and Brexit, it can be difficult to support your overall workforce aspirations and strategy. We have put together some key actions to help mitigate some immediate risks:
- Retain your existing EU staff
In the run-up to Brexit, make sure you are talking to existing members of staff who are from the European Union and the Europe Economic Area. Make sure existing staff have applied for residence under the indefinite right to remain which is offered by the British government. Reconsider the pastoral care you offer employees and find out if they are happy at work and feel reassured that there will be a role for them post-Brexit. Check if they need help and guidance to feel settled, such as setting up a British bank account, and ask if they are in regular contact with family back home.
- Improve your recruitment strategy
Start by looking at how well you sell yourself to potential candidates, for example do you highlight the benefits of working for your organisation and any prestigious specialisms you offer that will appeal to potential employees? If you use a recruitment agency ensure your recruiters are fully briefed about the benefits of working for you so they can convey this to potential candidates.
Have you considered international recruitment for key worker vacancies such as doctors and radiographers? If you are looking to employ overseas workers, ensure you set your recruitment suppliers clear deliverables and ensure these are adhered. Measuring your recruitment strategy will help you evaluate if your recruitment tactics are effective at converting your contracted workers to substantive posts.
- Use IT to improve your recruitment success
Creative use of IT can help you improve your recruitment processes. Developing something as simple as a database of healthcare workers who are available on a flexible basis could help you avoid using expensive agency staff. Rather than contacting an agency as soon as a staff shortage is identified you would be able to consult your database of known workers to help you fill your vacancies, helping to keep your salary costs down.
A lot of time and money is spent by organisations merely scheduling their staff, however technology can help you improve your workforce planning. Rostering software can help you produce optimal rosters that meet safe staffing levels, quickly and easily. They can help your managers oversee flexible shift patterns, provide a real time view of staff on duty and the skills available within the workforce to drive performance and control costs. As well as enhancing care quality and safety for patients, rostering IT can increase productivity and improve staff morale.
- Manage staffing agencies better
Most trusts rely on agency nursing staff to some extent. Whilst agency nursing staff have an important role, they are normally more expensive than the equivalent permanent or bank staff. Approach staffing agencies as a last resort. If you must use an agency or agencies try not to leave staff requests until the last minute because you could be forced to agree less favourable terms. Also try to save money by negotiating lower rates of pay for nurses on longer contracts.
If you have to rely on agencies, take control from the beginning by setting performance targets based on quality, safety, service, and price. Check if your trust has a clear policy that it will not pay rates higher than the rates agreed via a framework and stick to it. As already mentioned, using e-rostering services can help you monitor patterns to forecast and plan for staffing shortfalls and display visibility of purchasing
- Don’t work in a silo
Pool your resources with other trusts within your region, sustainability and transformation partnerships (STPs) or group purchasing organisations (GPOs) to reduce silo working. Significant savings can be made by working collaboratively, and this can also be done across wards and units, for example, by sharing staff banks or agreeing prices for some agency staff.
Finally, review your workforce practices. If current systems aren’t working, explore other systems and adapt your strategy rather than applying methods that you have found aren’t suitable for you.