How can the NHS make the most of temporary staff?

When Nicola McQueen describes the NHS’s need for temporary workers during the pandemic, she speaks of an ebb and flow but with one constant theme: demand outstripping supply.

Ms McQueen – chief executive of NHS Professionals, the largest temporary staff supplier to the NHS – says there have long been insufficient numbers of flexible workers to meet need. But since the emergence of covid, the situation has become more acute.

“At the moment, demand across our 50 staff banks is about just over five million hours, every single month, and about 3.5 to 3.8 million are being fulfilled. What we’ve seen across the pandemic is the gap [between supply and demand] widening. And we will continue to see that, I’m sure, as we go through the rest of this year and into some of the recovery targets that have now been set out.”

Ms McQueen was speaking at a recent HSJ webinar on temporary staff, her comments making clear how central this group is to delivering effective services. The key question on the agenda for the event, which was run in association with SAP: how can the NHS make the most of staff who make a conscious choice to be temporary rather than substantive workers? One of the main answers: make it clear how much the service values such employees.

According to Natalie Nightingale, head of temporary staffing at University College London Hospitals Foundation Trust, this has been particularly important given recent changes in the make-up of staff banks.

“At the start of the pandemic, what we found is we had more substantive staff than ever picking up bank shifts, and then that had a negative impact on our bank-only workforce,” explained Ms Nightingale.

“So [bank-only workers] who had historically had regular work within our organisation all of a sudden no longer had that. For us, it was really then about how do we engage with those workers, to say: ‘We know you’re temporary, we can’t guarantee you work but we still need you in some way, shape or form.’ And try to support them to maybe go and look at other banks within our ICS.”

That need to make it easier for temporary staff to find continuing opportunities was echoed by Ms McQueen. She said that NHS Professionals had recently conducted “a huge piece of work” exploring the priorities of such staff “and the key things that flexible and temporary workers wanted from us in the system was access to work. They want to have access to the right work at the right hours, at the right times, and all of the flexibility that flexible working brings for them”.

To this end, the organisation now “registers staff to a standard that means they can work anywhere; not just to an individual trust or ward”. Tricker for the NHS, she said, was guaranteeing access to continuing employment for temporary workers – “though we [the system] should be good at this because we’ve always seen that demand outstrips supply”.

“So I think we need to be more flexible about putting these workers into our rosters now for long lines of work, particularly as we go through these next busy months.”

New methods of management

For Vicky Revis, technology might be able to help here. Ms Revis is vice president and business manager – EMEA North at SAP, a firm which provides workforce management software to organisations across the public and private sectors. A rise in the number of people making a career choice to be a flexible worker is being seen across all areas, she said, and that means a need to refine how that resource is managed.

“Most organisations have systems to manage the permanent workforce but manage the flexible workforce with Excel and are then trying to plug that into their permanent workforce systems,” she said.

“The NHS needs to care for patients and have treatment ready and available at the point that patient comes in, be able to plan for future operations, be able to plan for preventative care as well. But to be able to do that with a complete view of the workforce is no longer about: ‘These are my perms and then I’ll top up with temporary staff.’ It’s: ‘How do temporary staff form part of my overall workforce strategy?’”

She suggested software could also help with another important issue raised during the webinar – making sure that temporary staff feel welcome when they start a new assignment.

“Having technology that can bring together information around who [you as the temporary worker] are going to see, where you’re going to go and standardising that set of information stops the onus being on the person who’s requested them. It takes the responsibility away from somebody who’s probably busy doing many other things at the same time.”

“We’re breaking down barriers around this separation between our substantive staff and our bank workers – because they are one and they’ve helped us through this pandemic”

At UCLH, that focus on making temporary workers feel like a welcome and integral part of the organisation has been stepped up over the course of the pandemic.

“We’ve got a really exhausted workforce,” stressed Ms Nightingale. “We’re now giving [temporary staff] access to benefits that, maybe historically, we wouldn’t have done for bank workers. We’re giving them access to our psychology and welfare services. We’re breaking down barriers around this separation between our substantive staff and our bank workers – because they are one and they’ve helped us through this pandemic.”

And, as Ms McQueen highlighted, they will continue to do so. “We’ve got a big task ahead of us to make sure that we can utilise the temporary workforce in the best possible way across the next number of years,” she concluded.

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