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UK - Recruiting nurses "distracting, frustrating and expensive".

28 July 2015

According to Dr Keith McNeil, Chief Executive of Cambridge University Hospitals, it is "distracting, frustrating and expensive" to have to recruit large numbers of nurses from overseas. Cambridge University Hospitals NHS Foundation Trust, which includes Addenbrooke's hospital, has taken on 303 foreign nurses in the past year. Half were from the Philippines - with significant numbers from Italy, Spain and Portugal.

Dr McNeil told BBC News: "Nurses are the backbone of the NHS. You can't run services effectively in an acute hospital like this without adequate numbers of trained nursing staff. It's distracting, frustrating and expensive to do international recruitment. It would be nice not to have to do it... [and] to have a more targeted approach."

He added: "We don't have enough home-grown nurses, but we know the demographics. The health service has to figure out what resources are needed for our activity. We need proper planning; I think the people at Health Education England are doing that now.

Addenbrooke's believes it costs £3,000 to recruit each nurse from elsewhere in the EU. New arrivals are given their first month's accommodation and also £400, so long as they stay for 18 months. They are also sent on a language course if they need to boost their conversational skills in English - as well as being given ten weeks of support in the hospital to help their technical and clinical language.

The Cambridge hospital believes their recruitment drive is paying off because it is now using fewer temporary staff from agencies. But there have been concerns that some overseas nurses leave the UK after just a short period here.

Commenting on the need for more UK nurses, the head of the Royal College of Nursing, Dr Peter Carter, said: "Last year there were 57,000 applicants for 20,000 nurse training posts.

"Isn't that a matter of huge regret that you've got people in the four countries of the UK, who want to train as nurses. They're being turned away while we're going off and raiding the often impoverished workforce of other countries."

He added: "It's hugely regrettable and the UK is not exactly covering itself in glory in this."

According to Andrew Preston, Managing Director of de Poel health+care: "Dr McNeil’s comments paint a stark picture of total reliance on overseas recruitment and out of control costs – the real challenge for NHS providers is to balance quality, safer staffing and slimmer budgets with workforce supply and demand. In practical terms, how will reductions to spend and a focus on attracting only “home-grown” talent be implemented, policed and sustained? Additionally, how will the latter make for a multi-skilled and diverse NHS workforce, capable and proficient in delivering this 24/7 service?

Whilst I am in full agreement with McNeil’s call for a more targeted approach, I do not believe the NHS is able to exist on “home-grown” staff alone – it is simply unrealistic. As we look overseas to recruit all types of people who make up the NHS workforce, the use of agency workers is emerging to be more vital than ever, as continuity of care moves even further towards shift work.

What McNeil also failed to acknowledge is how expensive it can be to recruit British nurses. As Managing Director of de Poel health+care, a temporary labour procurer in the health and care sector, I am acutely aware of the continual challenges faced in this sector involving staff shortages, compliance and patient safety.

I believe that NHS Trusts need to engage their temporary workforce in a completely different way. This is not directly through recruitment agencies with a vested interest in higher fees, nor even through managed service providers, but through a neutral vendor model – not affiliated to any recruitment agency. As a truly independent neutral vendor, de Poel health+care has no interest in maximising an agency’s margins – our job is the exact opposite. A neutral vendor is paid on its ability to minimise those margins and increase client savings. We earn our fee from what we save a Trust, not what we cost it.

This model is widely adopted in the private health care sector and has been proven over the last 14 years where standardised, transparent pay rates and fixed pound agency margins have been implemented, putting a stop to continuing variation. The net effect is a lower agency bill – typically 20% lower – that can be sustained over the long term. Eliminating competition on price then ensures a temp is hired on quality alone.

 Following McNeil’s comments today, I would implore NHS to adopt a more long-term strategic view on how best to tap into temporary labour and recognise that this is an integral part of the UK plc’s workforce, regardless of workers’ countries of origin. Rather than sensationalising headlines, McNeil and NHS urgently need to recognise that this diverse workforce will be relied upon to plug the gaps in the coming months and years. By addressing this, not only will NHS ensure it is  cost-effective, but more crucially that safe staffing levels are maintained, aiding the “transition to patient power”, as NHS so strongly envisages for the next 25 years".