Working in the NHS: recruitment drive in progress.
The NHS in London is urging those looking to take up studies or those thinking about a career change to consider working for the NHS. There is a new campaign underway called ‘We are the NHS’ aimed at convincing the right candidates to take up the mantle and come work for the worlds 5th largest employer. This prospect has likely seemed unappealing to many as a result of how the NHS has been funded for the last 10 years. The NHS experienced nearly a decade of cuts, defunding and privatisation during the primary austerity period after the financial crisis of 2007-2008. This alongside an increased demand for healthcare – as the number of people over 75 rose has risen by 12%, an increase by 5.4 million people in 2019.
The NHS coped with these extremely difficult changes by keeping staff salaries below inflation (pdf: page 3), and reducing both the number of new employees, as well as cutting existing staff. This also led to a backlog in maintenance demands as there simply wasn’t funding to carry out routine repairs and improvements, with the current estimate being at approx.. 9 billion pounds…
This all lead to an NHS that was no where near at capacity to handle the catastrophic effects of the pandemic, and waiting lists for operations, outpatient appointments and other routine and emergency care started spiralling. This led to a gap for private hospitals to fill – and it has been going on since way before the pandemic. For instance, in 2019 NHS hospitals were routinely renting theatres and beds from private hospitals, with the total amount of NHS patients receiving hip and knee transplants privately increasing to 29% and 19% respectively. At one point NHS patients accounted for 50% of all private hospital beds and a third of private income – which also led to a loss of income for the NHS.
NHS dental patients are a different story all together, they have been told to pay for private treatment to avoid up to 2 year waiting lists…
So what does this mean for those considering employment in the NHS? Firstly let's look at what employees really want from a good job.
There was a study in 2019 investigating ‘Global talent trends’ – it included over 800 businesses, 1800 HR managers, 5000 plus employees, 21 industries, 44 countries. A big ol’ study for sure.
It highlighted in particular three trends employees are looking for in their jobs and can act as a baseline for our review of the NHS drive to increase employment. We wont go into details about each point – more information is available from the study website.
- Permanent flexibility:
Traditional 9 to 5 workdays are gone. The average existing NHS worker will likely agree they never had a 9 to 5 work day in the first place – especially since the pandemic. The most recent NHS staff survey lists some worrying statistics, too many to cite here, but an important one related to flexibility is the fact that over 55% of NHS workers are doing unpaid overtime every week. 40% cited 5 extra hours a week, approx.. 10% said 10 hrs.
The Global trends study showed over 50 % of respondents want more flexibility in work hours, pattern, scheduling, working from home etc. more than 80% of working parents listed flexible work patterns as more important than salary..
- Commitment to health and well-being.
50% of respondents wanted to see more focus at wellbeing in their companies. It is tempting to think of this as physical health – being more active and exercising. But the respondents were clear that this includes physical, psychological and (importantly) financial health. The latter has been associated with several issues, including stress, anxiety and absenteeism. This tableau of the NHS staff survey 2020 allows you to filter age, demographics, trust, themes etc (worth a look). The results from NHS workers in the ‘health and wellbeing’ category national average (for all age groups) is currently between 5-6 out 10.
- Working with a purpose
The final category in the Global trends study was related to finding your work fulfilling and that it gave you purpose. In fact, the study showed employees who found their jobs fulfilling were more motivated, productive, had better morale and overall job satisfaction.
NHS 2020 staff survey morale varied from 5.7 to 6.3 out of 10 (those above 66 years of age were outliers at up to 7/10 depending on speciality).
There were significant differences in the survey results based on how it is filtered, health and wellbeing broken down by sexuality, or by gender reveal further inequalities.
Not to mention the significant increase in MSK injuries since the pandemic (30%) – a figure that has been steadily rising since 2016 (25%). However, young workers are facing a significantly higher rate of unemployment and joblessness that the general population, so the NHS is in a good position to attract new staff.
So what is the NHS offering? Is it the same story with a different cover or are there tangible changes happening?
At the moment the We are the NHS website is encouraging people to fill in a form listing – sharing personal information – listing details about your current situation and what career you are interested in - to receive a guide via email with more information. An interesting tactic, if we are thinking pragmatically from their point of view, they are of course interested in being able to ‘market’ their offer to as many as possible, as directly and personally as possible, in order to convince people to sign up. Personally we feel strongly about the mass collection of data – so we took at their privacy and cookie policy, as in our experience most people don’t read it. They collect the information you provide (name, address, e-mail address, phone number, date of birth, your gender and your job title), along with information associated with visits to the site such as IP address, browser type, time zone, operating system, page interaction information etc. and any phone number you may use to call them. They also supplement that data with third party information from other companies.
They use this information to provide you with information directly, but also to allow other third parties to provide you with marketing information, products, careers, services they feel would be relevant to you. Third parties can contact you through the information you have provided, unless you specifically do not consent to this.
Now that you know a bit more about what you are signing off on and what happens to your data if you do we can take a look at what they are actually offering.
Financial support at university level:
The NHS Learning Support Fund offers eligible students the following options:
Training grant of £5,000 per year (for new and continuing students)
Parental support payment of £2,000 per student per year to help with childcare costs
Specialist subject payment of £1,000 per year for students on degrees that struggle to recruit, including mental health and learning disability nursing (for new students only)
Help towards additional travel and accommodation costs to clinical placements over your normal daily travel costs
An exceptional hardship fund of up to £3,000 per student per academic year
They link to eligibility criteria but again for ease of reading we shall give an overview here:
Firstly if you are in receipt of an NHS bursary you are not eligible for this support. Other students need to be eligible for: tuition fee and maintenance support from the Student Loans Company. You need to check a different company for England, Scotland, Wales and Northern Ireland. We took a look at England student finance as an example: you need to be a UK resident or have settled status, live in England and have been living there for 3 years prior to commencing study – there is a list of other exceptions you may qualify for if these don’t fit. Students starting or continuing their course at a University in England from Sept 2020 can apply if they are on any of the following pre reg undergrad or post grad courses:
- dental therapy or dental hygiene (level 5 and 6 courses)
- dietetics
- midwifery
- nursing (adult, child, mental health, learning disability, joint nursing and social work)
- occupational therapy
- operating department practitioner (level 5 and 6 courses)
- orthoptics
- orthotics and prosthetics
- paramedics (DipHE and FD courses are not eligible for NHS LSF)
- physiotherapy
- podiatry/chiropody
- radiography (diagnostic and therapeutic)
- speech and language therapy
There is also extra funding (specialist subject payment of £1000) available in other specialisms struggling to recruit at the moment:
- mental health nursing
- learning disability nursing
- radiography
- prosthetics and orthotics
- podiatry
So all in all this could be a big financial help to get people starting on their careers (including those who already have a degree) and we consider it a positive step from the NHS in assisting recruitment at University level. It will require strong organisation, minimal bureaucracy and a proper IT developed application process but all in all this is a good start.
Pay and benefits in the NHS
The agenda for change dictates the annual pay for the vast majority of NHS workers (exc. dentist, doctors and most senior managers).
Agenda for change salaries start in the low range of a Band 1 (£18, 546) and goes up to Band 9 (£108, 075).
The average UK salary is £29, 600 – to give an example it would take a newly qualified physiotherapist (first job starts at band 5 level) approx. 5 years to reach the UK average salary – or the first year as a band 6 (first senior role - £32, 306).
This is definitely the area where the NHS has the most amount of work to do – for it to take a health care professional approx.. 5 years to reach the average UK salary is a poor incentive for financial growth and financial health.
It is worth noting many physiotherapists end up supplementing their income with a second private job at a clinic or other private provider – but considered what we covered above; that over half of NHS workers are already doing 5+hrs of unpaid overtime per week, and 10% are doing more than 10hrs, an average 37.5 hr week can quickly turn into 50 or 60 hrs, in order to get slightly above the national average.
There is also the issue of job progression – not only is it difficult to progress clinically into a band 7 (specialist) role, but (and we cant point to specific data here) anecdotally from our experience as trainers and mentors of NHS staff, there aren’t a wealth of specialist B7 roles available, which can therefore cap a physiotherapists pay at £39, 027 after 5 years of work.
After 5 years as a band 7 the same issue arises, your pay is now capped at £45, 839 and the next band 8 role is even harder to get into – these jobs are scarce, competition is fierce.
Worth noting there are high cost area supplements to salary depending on where you work: inner London, outer London and ‘fringe’ are eligible for 20%, 10% and 5% of basic pay respectively.
The NHS Pension Scheme
A key finding from the 2020 reward in the NHS survey was the NHS pension scheme. All respondents agreed that the NHS Pension Scheme is useful in attracting, recruiting, and retaining staff as well as supporting long-term career development. The Scheme has a good reputation and the employer contribution rate of 20.68 per cent of pensionable pay is favourable when compared to other work-based pensions.
There aren’t any other specific benefits noted on the website but there are a lot of resources available for those interested in learning more about working in public health, regulation, membership, the workforce, as well as real life stories, info on UK health systems and information for overseas workers. You can read up on the different roles available, and there is lots of information available on looking for a job, identifying transferable skills, developing careers and applying / interviewing. We at QualifiedPhysio offer similar services to physiotherapists looking for work or career progression but we encourage everyone to use all the resources available to you.
So there you have it – there are some good incentives, there is a lot of information to go through, but long story short – the NHS needs staff, they are prepared to give financial support through University and help you change careers and become a member of the work force. Whether they are offering enough, or the career prospects are attractive enough is up to you.
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