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It has been calculated that the bill for temporary nurses within the NHS in Scotland has now reached more than £110 million.
The amount spent on hiring agency nurses and other workers amounted to £6.4 million during 2012 and 2013, which was an increase of £2.5 million on the previous year. There has also been an increase in spending on bank midwives and bank nurses of 15.1%. This information has come from the latest figures for the NHS workforce, which also show a small increase in the number of full-time employees.
It is noted that the NHS in Scotland had the equivalent of 132,541 full-time workers in December 2012, with this figure reaching 133,205 at the end of March 2013; however, the SNP has been criticised by all of the major political parties for the amount of money that is being spent on temporary staff in light of other cutbacks on staffing levels. The SNP has defended the use of agency nurses, as they are seen as essential in ensuring a flexible service that can cover when there are staff absences and other shortages. The Royal College of Nursing has stated that the rise in the use of temporary nurses shows the pressure that hospital boards have come under in recent years.
The NHS in Scotland has been subject to the same changes as the health services in other parts of the UK, and cost improvement programmes are in place across the board. A&E waiting time targets are still not being met.
Healthcare in Britain is changing so rapidly that it is hard to keep up at times. This applies to healthcare recruitment as much as anything else, and experts believe there are four trends that will change the way that the recruitment and retention of healthcare staff operates.
At the moment, for example, an agency nurse may be notified by telephone or email about potential vacancies in a local hospital or clinic, or perhaps a posting will be made on an agency’s website.
Experts believe that this year, with the development of internet telecommunications and cloud-based solutions, recruitment of talent – nurses, doctors and other allied professionals – will take place by one or all of these new methods. These include Skype, mobile technologies, mapping of talent and cultural selection.
Skype is a free service that allows anyone to speak over a telephone or contact each other via video link. This will enhance the recruitment process, especially for overseas jobs, as interviewees can be interviewed quickly without either party having to travel.
Similarly, since mobile technologies such as smartphones and tablet devices are being used more and more, it seems pertinent that messages and even video interviews could be carried out on the go. At the very least, a simple text message or email can be sent to individuals offering a position with candidates responding in the same manner.
Cloud based technologies offer both parties the chance to access information on the web easily. This talent pool helps employers to make more informed decisions, including about cultural aspects.
Finally, all of the above changes will cut down on the amount of paperwork required.
Primary care in the NHS is changing from April, with the introduction of Clinical Commissioning Groups (CCGs). CCGs are at the heart of the government’s Health & Social Care Act, which gives local GPs responsibility for a huge chunk of the money spent on providing primary care services.
The government introduced this new system as it believes that GPs know their patients best and therefore can offer a better service to them. It also believes that CCGs will offer better managed healthcare services at the local level.
One of the CCGs given the green light two months ahead of schedule is the NHS Greater Huddersfield CCG, which will replace the existing NHS Kirklees Primary Care Trust. The chairperson and clinical lead of the Huddersfield CCG, Dr Steve Ollerton, said: “We’re delighted – authorisation means that we have the official seal of approval for the arrangements we have put in place to make sure we can achieve our ambition of commissioning the best possible NHS services for the people living in the Greater Huddersfield area.”
Not everything will be controlled by the new commissioning group, however. It seems that acute services will continue to be operated by the Calderdale and Huddersfield NHS Foundation Trust, which is responsible for Huddersfield Royal Infirmary and the Calderdale Royal Hospital.
The Health & Social Care Act is considered one of the most divisive pieces of NHS legislation passed by any UK government. The opposition Labour Party has vowed to repeal it.
A row is brewing over controversial plans allowing private health care providers to opt out of paying corporation tax. Vendor managed services such as Virgin Care have been steadily increasing their presence within the NHS. While the pros and cons of this are a separate argument, the suggestion that these same companies may be allowed exemption from paying tax on their profits is another matter, it seems.
The announcement was made by Monitor, the newly created overseer of the NHS. Monitor suggested that it was unfair that private companies such as Specsavers, InHealth and Virgin Care should pay tax while public sector hospitals are exempt.
Exempting private providers puts them on a level playing field, a spokesperson from Monitor said; however, the proposals have been attacked by the opposition. Jamie Reed, the shadow health minister, said that allowing this to go ahead will “risk undermining trusted NHS services and could in time destroy the core public service ethos that sets our health service apart from others.”
He is urging the government to think again and stop “tax avoiders [getting] into the NHS.”
A spokesperson for the Department of Health, however, said that it has always made it clear that any income made by private providers must also benefit the NHS.
The spokesperson added: "We have commissioned Monitor to carry out their Fair Playing Field Review. Once it has been completed and submitted to the Department, we will consider how to respond."
Although the government’s reforms are said to be about improving the NHS, there is a growing feeling among NHS doctors that vendor managed services from private health businesses will affect the care of patients.
The private sector under the reforms is being allowed greater scope in offering services to patients, with the NHS paying for these outsourced services. For example, information released from the Department of Health reports that 105 private health care companies have been granted any qualified provider status (AQP). This allows these firms to compete directly with the NHS on who is offering the more cost-effective service on certain basic treatments, including dermatology, hearing aids, physiotherapy, MRI scanning, and psychological therapy.
Senior doctors are unhappy. While accepting that the private sector may help, the scale of its involvement is worrying.
They even go as far as calling this atomisation, meaning that the NHS will be forced to disintegrate and stop providing specialist services altogether.
One such company granted AQP status is InHealth, which provides adult hearing services. Patrick Carter, managing director of InHealth’s community healthcare services division, said: “Clearly AQP represents an opportunity for significant geographic expansion.”
This worries doctors such as Dr Clare Gerada, chair of the Royal College of General Practitioners, who said: "AQP will help to atomise the NHS. It's causing the NHS to be split up into thousands of different providers of health services.”