Niche In-Brief Spring 2018 - Flipbook - Page 6
Ending ‘pot-luck’ interim support
Revolutionising short-term supply – Tom McCarthy
As all NHS providers know, the days of interims
commanding breath-taking day-rates are much diminished.
The huge (and some would say long-overdue) focus on
agency spend led to the introduction of the agency cap,
reinforced tax differentials for contractors and new rulesbased frameworks for interim supply.
The increased scrutiny on agency pay-bill reduction and the
introduction of NHSI agency spend league tables have
undoubtedly shifted the focus on how providers obtain
temporary support. However, the fundamental market
forces of supply and demand underlying the continuing
need to recruit non-permanent staff remain. Whilst over
70% of trusts have reduced their agency spend, with the
overall pay-bill having reduced by 20%, the NHS is still
spending around £250million a month on short-term
support. This is for three main reasons:
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Capacity - The operational and strategic
demands/challenges facing trusts is expanding faster
than the capacity to deal with them. Only by adding
capacity can trusts ‘keep up’ with their ever expanding to
do list.
Capability - The evolving requirement for PMO leads,
transformation operatives, quality improvement experts,
modelling technicians, governance/quality assurance
leads and business process leads, to name just a few,
has meant the NHS needs to look to an external supply
of capable professionals who cannot always be ‘grown’
in-house.
Supply - Many operationally/financially/geographically
challenged trusts continue to be unable to recruit to
permanent posts when good candidates are in high
demand. Interims can ‘pick and choose’ when market
forces are in their favour.
Decision makers are often forced to bow to the wrong type
of pressure:
Whilst some interims have a good ability to promptly
identify issues and promote change, many have their
own issues in dealing with ‘wrong-fit’ placements.
Often, they have accepted contracts where providers
have not fully understood the gap they are trying to
address or identified the outcomes they wish to see as
the result of the placement.
Being an interim can be a lonely place where
individuals are trying to resolve issues which are
fundamentally outside of their sphere of influence or
mandate; many (but by no means all) interims have
undeservedly had a ‘bad-rap’. They have accepted
projects or placements which have been poorly
devised (let’s face it, it is a huge undertaking to
objectively evaluate the gap that needs filling and to
devise measurable outcomes).
Interims can be placed into contracts which have been
poorly scoped, received little support during the
placement and then are often criticised for not
delivering against (what may have been) an opaque
and unrealistic brief in the first place.
Taking a different approach
For NHS providers the real challenge is to try and use
interim support in a much more strategic, less shortterm way. To do this requires a completely different
mind-set and a pronounced commitment to move
away from ‘pot-luck’ placements. Strategic
partnerships between consultancy and placement
agents represent a step-change in how short-term
staffing solutions can be delivered.
Niche, together with the market leading Sthree, have
developed a unique approach to supporting the NHS
and social care with expert interim placements.
Our model of ‘InterimPlus(+)’ combines the specialist
consultancy input and delivery of Niche with a pool of
accredited and experienced interims from Sthree.
Specifically, our combined model will provide support
in core areas such as company secretariat,
complaints, investigations, risk management, medicolegal and broader governance. In addition to this we
support transformation, strategic and analytic staff,
capacity, demand and PMO support.
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