The NHS Interim Market – The impact of the NHS Improvement Caps

Posted on Monday, December 12, 2016 by Venn GroupNo comments

The demand for greater value from agencies and the pressures to cut down on interim spending has always been a looming issue. There have been numerous news articles covering the occasions where off-framework agencies have abused charge rates for Trusts in desperate need of clinical staff at short notice. Sadly assumptions are then made about all agencies that hold little truth when applied universally. With this in mind it was therefore no surprise when the NHS Improvement caps came into play November last year.

Fast forward to the present day and NHS organisations are now required to report, on a weekly basis, any breaches to these caps, both wage and charge.

It is no secret that the NHS (and indeed all organisations) pays a premium for interims which often gets highlighted. What we do forget is that these interims do not receive numerous benefits that a permanent member of staff does, such as job security, paid sick leave or an NHS pension to name a few. Since the caps have been introduced I have seen the impact that this has had on both clients and candidates across the market.

While hiring managers are put under more pressure than ever to deliver, the significant drop in daily rates for interims has meant that the time taken to secure a candidate with the right competencies has increased substantially. This is due to a combination of the increased time and paperwork that needs to be completed before getting budget sign off and then finding the right candidate for the role. Finding the candidate with the right skill set required has also posed problems due to the lack of budget available. While candidates have become far more competitive and understanding of the condition of the market, there have been cases where hiring managers have had to reassess budget or compromise on skill sets in order to secure a plausible solution. There are of course times where there is no room for negotiation in terms of budget. In these cases, we have seen the growth of flexible working across the market to offer candidates a better work-life balance.

Furthermore, we have also seen the increase in candidates considering permanent roles and potential moves into the private sector. The reality is that many interims have both personal & family commitments and due to the reasons above it is not viable for them to be out of work for long periods of time. For contractors that are already engaged we have also seen a delay in extensions being approved. While contractors are perfectly aware of the lack of job security that goes hand in hand with contracting this has also caused them to look into exploring other options.

On a more positive note, the most skilled candidates have found no drop in demand for their services – as of course would be inevitable with a universally applied cap, so at least the application is being adhered to.

In conclusion, while it is clear the NHS improvement caps have had a significant impact on the NHS interim market, I believe that the market will eventually reach equilibrium where supply equals demand and both candidate and client rates are restored to meet the skillset required.

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