NHS Professionals: what's it all about?BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7453.s239 (Published 12 June 2004) Cite this as: BMJ 2004;328:s239
Peter Cross finds out more about this non-profit making “in-house staff agency”
On 1 April this year, NHS Professionals (NHSP) was relaunched as a Special Health Authority. So what's it all about? Essentially, in addition to some other services (see box), it is a non-profit making in-house staff agency which both complements and competes with commercial agencies providing staff, including locum doctors, for English health trusts. It has been set up to manage temporary and flexible workers in the NHS in England.
According to NHSP's chief executive, Carmel Flatley, “NHS Professionals provides a single-minded focus on temporary workforce management, delivering a flexible workforce that meets the requirements of the local labour market.” She also states that the organisation will free up trusts, allowing them to concentrate on their core business of caring for patients.
“It's the duality of NHSP that is interesting,” says David Jones, chairman of the medical division of the Recruitment and Employment Confederation, a trade body representing recruitment businesses. The Recruitment and Employment Confederation's medical division is responsible for at least 85% of all locums supplied to the NHS.
He explains: “NHSP has two roles. One is to act as a gatekeeper of all bookings so they can make sure that they are not being given out unnecessarily to the commercial sector for things like maternity leave and waste money on locums. Secondly, they are trying to compete with the commercial sector, which they are never going to be able to do, because they are not set up to do that, and they are also acting as a quality assessor. It begs the question: who's assessing the quality of NHSP?”
Services offered by NHS Professionals
A “not for profit” high quality NHS locum service
Register of locum activity
Appraisal and revalidation
Flexible Careers Scheme
Support for doctors new to the United Kingdom
Managed Placement Scheme
New Consultant Entry Scheme
Training Credit Scheme (for personal study leave)
White knight or white elephant?
Will NHSP be a white knight or a white elephant? Helena Verwey, a general practitioner who arrived here from her native South Africa, is satisfied with the service she has been given by NHSP. “They are very professional. You get a medical check up, your CV is checked every time you go for a job, and they make sure that you are compliant with the standards.”
According to Helena, these basic requirements are not always followed by commercial agencies: “I find it reassuring to work for NHS Professionals. I asked whether they have an appraisal scheme. They were really helpful and an appraiser was appointed to me and it's free. It's working. I usually deal with one person. When I couldn't get through for my appraisal appointment I phoned this guy who is getting work for me and he came back to me having set it up. It was just so easy.”
During 2004-5, all locum doctors registered with NHSP will receive a free appraisal. But some are not impressed: “NHSP are making a big song and dance about appraisals, but they're actually no big deal,” says David Jones, who believes locums recruited through NHSP may be missing out: “Because NHSP are run from the public sector they are not going to have the more `frilly' services.”
He continues, “As soon as appraisal becomes an issue, all that will happen is that the commercial sector will mobilise themselves and make it happen.” Not a difficult process, in David's opinion—“We're not building spaceships.”
“Great hopes” or “poppycock”
Currently, NHSP has over 50 000 staff on its database and it estimates that they receive an average 200 000 requests a month from wards short of staff.
“We are using NHSP as our main supplier of locum medical staff,” says David Curtis, director of nursing and corporate development of Pennine Care NHS Trust, which provides specialised mental health services to Bury, Rochdale, Oldham, and Stockport in the north west of England.
“And we have done that as part of the national framework agreement on locum staff. Prior to this we used a range of local agencies. Some of the things that concerned us were around clinical governance issues and standards of employment. And what NHSP offer us is a standard that we all know and can sign up to. They will do all the ringing round and check references, providing HR [human resources] support, ensuring we get doctors who are appropriately qualified with suitable experience. The system we had before was not as well governed as it should have been and we are now trying to proactively cover for vacancies. We've got great hopes.”
David Jones is more sceptical: “I'm sure that NHSP will say that they recruit a different calibre of people to do it; at the end of the day it's all poppycock. We know how it is: if you give people incentives, they will go the extra mile.”
The NHS for the NHS?
“We're the NHS for the NHS,” claims Kwee Matheson, NHSP's regional clinical director. “The NHS is not just about locums; there are other components like flexible careers in the managed placement scheme and the new consultant's placement scheme.”
However, as David Jones points out, “NHSP rely on the private sector. When they are unable to fill a job themselves they rely on the commercial sector.” Even Kwee Matheson concedes, “If you want a locum in a week's time NHSP will spend a few days looking for one from our own bank, but if it's with an hour's notice then we cascade it to all of the private agencies.”
Yet more bureaucracy
Some see NHSP as adding an unnecessary layer of bureaucracy. “The problem is that you have just put another hoop into the process,” says David Jones, “which is detrimental to the ability to fill the job. You're wasting more time and money in the process.
“The argument against is that by putting all the bookings through one organisation, they can act as a quality control so that rogue doctors don't get through and agencies don't cut corners. But that is just making an arrogant assumption that NHSP are doing the job properly, bearing in mind that they have the same limitations as every organisation has: they have human beings in the process. People make mistakes and people cut corners. Organisations don't cut corners, people cut corners.”
Gamekeeper and poacher?
Has NHSP taken on too many roles? “Gamekeeper and poacher—they don't know which one to do,” says David Jones. “They're not trying to save money, they're sucking in loads of taxpayer's money to set everything up and at the moment they're not getting there.”
However, Kwee Matheson remains positive: “We are going to be much more robust in ensuring quality. We are using end of placement assessment reports in building up a profile. If there are any adverse comments or poor ratings we will investigate.
“It is not always about a doctor being a poor performer, sometimes it's cultural differences and expectations of trusts. It works both ways.
“We will support the locums. People who do locum work all the time feel very isolated. This is where we need the cooperation of everybody in the NHS. Trusts want good locums, don't they? In order for us to be able to provide quality we need the cooperation of everybody because we can't do it without the help of trusts.”