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NHS workforce planning - the important role of the recruitment industry - Neal Suchak

As the NHS celebrates its 70th birthday, Neal Suchak, policy advisor at the Recruitment & Employment Confederation, analyses the workforce challenges facing the NHS, and the evolving role of specialist recruiters.

The NHS is a people organization

The NHS is a complex organisation that has been through countless structural changes since its creation in 1948. It is also a huge employer in the UK with around 1.6 million staff. With over 4.5 million people having contact with the NHS every week, the system has had to adapt over the last 70 years to meet increased demand. An ageing population and the associated increases in co-morbidities of patients has meant that more and more patients are being admitted to hospital. However, the UK still lags behind other developed nations in the ratio of staff to patients.

Poor planning

The problems facing the NHS never seem to go away; tight budgets, cancelled operations and the annual ‘winter crisis’ are ever-present. But arguably the most significant issue underpinning these challenges is the skills and recruitment crisis. For decades the NHS has struggled to fill vacancies across the board, mainly as a result of long-term underfunding, inefficiencies and poor planning. Previous governments failed to predict the health needs of an ageing population and the necessity to build up a social care system that is fit for such a large number of older people. The uncertainty posed by Brexit is already starting to compound staffing challenges. According to a 2017 British Medical Association survey of EEA doctors working in the UK, 45 per cent said they were considering leaving the UK, with 18 per cent having already made plans to leave. The Royal College of Nursing reported a 92 per cent drop in registrations of nurses from the EU27 in England in March 2017.

The need for agency staff

No matter how good the NHS’s workforce planning is, there will always be gaps in rotas. In addition to unfilled vacancies, substantive staff take sick leave and holidays, as well as maternity and paternity leave. The REC’s monthly Report on Jobs consistently shows that nursing, medical and care employees are the most in-demand type of short-term staff. Agency staff have provided a vital life-line to the NHS for decades and continue to provide the NHS with the extra support that it needs in times of increased demand. The REC’s research with the National Institute of Economic and Social Research (NIESR) found that agency staff have skills on a par with substantive staff and often have many years’ experience working in the NHS as full-time employees. Many of these staff have chosen agency work in order to find a better work-life balance, and avoid the inflexibility of rotas and poor management within the NHS. It is essential that these highly qualified staff are recognised for their professionalism, are treated fairly and are made to feel part of the NHS family.

NHS Caps and Controls

In 2015 price caps on the supply of agency staff to the NHS were introduced in an effort to reduce the amount of money that the NHS spends on its workforce. Whilst cost-savings are necessary, the introduction of these controls have resulted in fewer staff working through agencies and subsequently fewer staff available to cover shifts, especially at short notice. The impact has been to drive staff towards working through hospital banks, and so spending has simply been diverted to another budget rather than being reduced. What’s more, evidence is now emerging that bank rates are starting to escalate above the rates paid by some agencies.

The role of specialist recruiters

Recruiters are experts in workforce planning, and those working in the health sector see first-hand the shortages that the NHS has to contend with. Recruiters are perfectly placed to identify where problems lie, and are able to offer immediate solutions. Many recruiters specialise in particular areas such as the mental health sector, radiography or dentistry, and their knowledge of their sectors, including a detailed understanding of candidate expectations and availability, should be used by workforce policy makers to help make planning decisions.


It is essential that the NHS invests properly in recruiting the next generation of workers, as well as retaining and re-training the staff that it already has. The need for agency staff is not going to go away, and so the NHS must ensure that it seeks to create a working environment that is favourable to all staff, regardless of how they choose to work. Creating an environment in which all staff are paid appropriately for the work they do, are made to feel valued, and receive the training, flexibility and support they need, will be crucial in producing a workforce that is healthy, happy and able to deliver the best possible outcomes for patients.

Content provided by Neal Suchak, policy advisor at the Recruitment & Employment Confederation 

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