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SarahBell

Not Enough Staff So Use Agency Staff

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http://www.bbc.co.uk/news/health-35667939

In England, many hospitals are having to rely on expensive agency workers to make up the shortfall in staff.

Erm, doesn't this mean that agency staff should be directly employed by the hospitals to solve the expense of agencies.

NHS needs it's own internal agency to manage the allocation of staff on shifts they'll like.
Then they need a big LED display outside to let people know when staff are at work and when you can be ill.

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Here's the perennial problem...employees have no incentive to work hard over time (except a meager pay increase which barely covers cost of living). Agency bosses work for their profit and are far more incentivised to get out there and find the right person (or any person!) that fulfills requirements. In any organisation these days you put people of a promotion track with a view to giving them below market salary increases (before you say inflation is low, think about what the majority of your earnings will be spent on..i.e housing/ food/ healthcare). If you want to test this ring a recruiter and tell them your salary is 20-25% more than it currently is and see if their are similar jobs available.

The dirty secret for sometime now is, its better to be agency staff from a tax and income perspective than to be an employee. The Conservatives are fine with this, they want people to take personal responsibility for how they make their income. Labour would like someone else to pay for workers rights because they are downtrodden (which also has some merit, as some people will never have the wherewithal to start their own enterprise or risk they guaranteed monthly salary for extra risk/reward).

Ultimately its a zero sum game. You go to work for a finite time, you either take home more and pay less tax or you take home less and pay more tax. If you want to spend your own money in the economy then the choices are fairly obvious. Its fine to pay tax for general needs in society, but I think the fact that we have borrowed are general spending for the last 30+ years shows that we don't really spend our tax money very well, and certainly don't spend it on what people think we do e.g hospitals, schools, defense, roads, legal system (all of which face cut backs...whilst MPs salaries rise - who pays for the champagne lifestyles of the MPs and senior civil servants? Are they worth it when they are simply borrowing more and more each year?)

As we move forward to a Gig economy e.g Uber / Amazon. Businesses will increasingly want defined results for their money. Employees will increasingly find they will not be able to buy a middle class existence with their income. The sense of camaraderie is being lost at work as more and more conglomerates simply hire/fire people with no interest in long term planning or heritage e.g Cadburys, NHS etc. I've always said - you can't pay people to CARE. It doesn't work, you can pay them to do a repetitive task ad infinitem (e.g banking) but you can't pay them to check on someone whose sick because you know they might need you; or test a child a little bit more because you know they are capable to don't realise it. The same is true at work, people will come in take a pay check and sit there, but actually improving productivity (which is woeful in this country) requires people to actually care.

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http://www.bbc.co.uk/news/health-35667939

In England, many hospitals are having to rely on expensive agency workers to make up the shortfall in staff.

Erm, doesn't this mean that agency staff should be directly employed by the hospitals to solve the expense of agencies.

NHS needs it's own internal agency to manage the allocation of staff on shifts they'll like.

Then they need a big LED display outside to let people know when staff are at work and when you can be ill.

They have bank staff.

One of my friend is a consultant surgeon. If he works through the bank system he gets about his normal day rate + 50%. Total cost to the NHS about £600.

If he works through an agency he gets 2.5x his day rate plus the agency get a fee. Total cost about £1500.

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They have bank staff.

One of my friend is a consultant surgeon. If he works through the bank system he gets about his normal day rate + 50%. Total cost to the NHS about £600.

If he works through an agency he gets 2.5x his day rate plus the agency get a fee. Total cost about £1500.

So they need more bank staff?

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There was the Appointments Commission

It started life as a specialist organisation to recruit the best possible people for senior public sector roles - many of which were NHS managers

There was a plan that it would grow to take on the recruitment of senior frontline staff (senior nurses, pharmacists, etc. in the NHS) and then, perhaps, handle more and more recruitment for the public sector

But it soon became apparent that it was run by fools and that it was destined to fail . Commercial recruiters ran rings round it and the processes it was using were lengthy, convoluted and ineffective. Someone involved with it said that it seemed that no one wanted to be the one that recommended a candidate in case it didn't work out - no one wanted the accountability.

A good recruitment person (there are a few) earns a very low salary, even if recruiting very senior roles, and only earns decent money if they make a lot of placements. If they make only few placements, they are soon gone.

The people in the Appointments Commission had massive salaries in comparison, no financial incentive to fill jobs and a very, very slow pace. The offices they were in were, by any standards, very well appointed and it was an all round gravy train. With biscuit wheels and a large dessert to follow.

It was closed in October 2012. Not a moment too soon.

An in house recruitment operation for the NHS, with a little bit of tweaking of the rules to make sure it had a very slight advantage over the commercial suppliers, would save many millions of pounds per year and deliver a better NHS. I know several people that have suggested such things to the NHS leadership and Sec of State, but it goes nowhere.

Meanwhile, hospitals are paying 4x normal salaries to nurses and agencies are taking hundreds of pounds a week on top too.

It is broken. It could be fixed. But there is no will to fix it.

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Alot of workplaces keep a small "core" staff usually enough to meet the criteria of being awarded a contract etc

Then use agency staff to make up the numbers so they can pay them off when they no longer need them without going through all the redundancy faff.

I worked at quite a few places where agency staff were always trying to get full time but rarely ever did.

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Clearly the important thing is to increase debt - so efficiency and care are only fine up to a point.

That's the bind - inefficiency/uncaring/irresponsible creates more debt.

Edited by billybong

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So the market rate for a consultant surgeon turns out to be 1500 per day. Pretty cheap considering the expertise and responsibility when compared to lawyers, bankers etc.

But if you bother to do proper workforce planning, and treat your staff properly, you could have the same surgeon for 400 a day on a permanent contract.

Perhaps we could pay a management consultant 1500 an hour to work out which is the better deal?

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They have bank staff.

One of my friend is a consultant surgeon. If he works through the bank system he gets about his normal day rate + 50%. Total cost to the NHS about £600.

If he works through an agency he gets 2.5x his day rate plus the agency get a fee. Total cost about £1500.

One of my friends is a consultant anaesthetist and relies on bank work. He'd been happy working a handful of surgeons lists as and when but had a spat with management over 3 months ago handing his pass in. Normally they contact him about returning to work and he is understandably getting tetchy. It's the managers at fault.

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The NHS is as good as gone. I will be surprised if it lasts another 5 years in its current form.

My partner works in the NHS and last night half the wards she covers had no running water or air suction. How is that even possible?

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The NHS is as good as gone. I will be surprised if it lasts another 5 years in its current form.

My partner works in the NHS and last night half the wards she covers had no running water or air suction. How is that even possible?

Gross incompetence?

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We'd better all look after our own health and hope we never need the NHS the way it's going........

The boomers have had the best of everything...it's down hill from here...till the war starts

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Gross incompetence?

Deliberate incompetence so it can provide the political justification for 'rentierisation'

For example we are about to loose our HRI here in Huddersfield.

The plan is to rent an old mill for £0.5M a year. It doesn't need to rent anything, it already has a site.

The main function of the NHS seems to be to bail out Tory donors and PFI participants!

Edited by RentierParadisio

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The NHS is as good as gone. I will be surprised if it lasts another 5 years in its current form.

My partner works in the NHS and last night half the wards she covers had no running water or air suction. How is that even possible?

It's a background service, something which has been neglected in lots of places. It's hidden, and taken for granted by managers, and costs are cut to the bone. Not just at time of specification, but during implementation.

Where I work we had a similar issue with the electrical system, a critical component (the transfer switch, which connected the building to either mains or generator power) shorted out leaving no electrical power to the building, until emergency electricians could run temporary cables to splice the generator into a main switchboard which took about 4 hours. When a specialist firm of electrical consultants turned up to investigate and advise, they basically condemned the entire electrical system as inadequate. It's been normal practice for decades to have some level of redundancy (e.g. dual mains supplies, dual generators, dual switchboards), but somehow this idea had never been implemented on this site, and no one had really thought to investigate until there was a serious incident.

One thing that the PFI projects did get right, was big penalty clauses if there is a building/infrastructure problem (like a power failure, or suction/water failure). As a result, many of the PFI new builds were equipped with top-tier infrastructure with high levels of redundancy and fault-tolerance.

Edited by ChumpusRex

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Ah yes, the problem of problems caused by trying to solve frontline operational issues with more managers.

Management begets management.

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Here's the perennial problem...employees have no incentive to work hard over time (except a meager pay increase which barely covers cost of living). Agency bosses work for their profit and are far more incentivised to get out there and find the right person (or any person!) that fulfills requirements. In any organisation these days you put people of a promotion track with a view to giving them below market salary increases (before you say inflation is low, think about what the majority of your earnings will be spent on..i.e housing/ food/ healthcare). If you want to test this ring a recruiter and tell them your salary is 20-25% more than it currently is and see if their are similar jobs available.

The dirty secret for sometime now is, its better to be agency staff from a tax and income perspective than to be an employee. The Conservatives are fine with this, they want people to take personal responsibility for how they make their income. Labour would like someone else to pay for workers rights because they are downtrodden (which also has some merit, as some people will never have the wherewithal to start their own enterprise or risk they guaranteed monthly salary for extra risk/reward).

Ultimately its a zero sum game. You go to work for a finite time, you either take home more and pay less tax or you take home less and pay more tax. If you want to spend your own money in the economy then the choices are fairly obvious. Its fine to pay tax for general needs in society, but I think the fact that we have borrowed are general spending for the last 30+ years shows that we don't really spend our tax money very well, and certainly don't spend it on what people think we do e.g hospitals, schools, defense, roads, legal system (all of which face cut backs...whilst MPs salaries rise - who pays for the champagne lifestyles of the MPs and senior civil servants? Are they worth it when they are simply borrowing more and more each year?)

As we move forward to a Gig economy e.g Uber / Amazon. Businesses will increasingly want defined results for their money. Employees will increasingly find they will not be able to buy a middle class existence with their income. The sense of camaraderie is being lost at work as more and more conglomerates simply hire/fire people with no interest in long term planning or heritage e.g Cadburys, NHS etc. I've always said - you can't pay people to CARE. It doesn't work, you can pay them to do a repetitive task ad infinitem (e.g banking) but you can't pay them to check on someone whose sick because you know they might need you; or test a child a little bit more because you know they are capable to don't realise it. The same is true at work, people will come in take a pay check and sit there, but actually improving productivity (which is woeful in this country) requires people to actually care.

I disagree in many parts but a top post.

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One thing that the PFI projects did get right, was big penalty clauses if there is a building/infrastructure problem (like a power failure, or suction/water failure). As a result, many of the PFI new builds were equipped with top-tier infrastructure with high levels of redundancy and fault-tolerance.

It's just a shame the ongoing costs of PFI will mean that taxpayers will be paying for those lovely fault tolerant systems many times over instead of just once.

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So they need more bank staff?

they need quality management...

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