Attracting top interim talent in the NHS

During the last 18 months the NHS interim recruitment market has witnessed several significant changes. Firstly, NHS Improvement applied maximum pay and charge rates for temporary workers for the provider organisations that they oversee. The need for such restriction on interim spend was necessary in some areas, but this ‘one rule fits all’ solution was clearly not fit for purpose in areas where the worker’s core skillset was not NHS specific (e.g. IT, Corporate Services, Change & Transformation) and the new capped rates were not competitive with general market rates.  Secondly, the change to IR35 assessments only within the Public Sector has made it highly likely that, as of 6th April 2017, a contractor working through their own personal service company will now pay significantly higher levels of tax for an assignment within the NHS compared with a like-for-like contract within the private sector. These two factors alone have combined to make interim work within the NHS less attractive for contractors compared to just 18 months ago. 

The NHS must face the reality that the recent change of landscape for contractors within the NHS will result in a significant proportion of the industry’s best and specialist contractors in certain job disciplines seeking interim work elsewhere. With proven and reputable interims leaving the industry for pastures new, this newly created resource gap will need to be replaced with other candidates, in many instances with interims new to working within the NHS.

In order to attract this new talent to the sector effectively, each NHS organisation will need be reassured that they offer best practice within their recruitment processes and candidate propositions. This often doesn’t need to involve a total upheaval of recruitment tools and techniques, but more the guarantee that the basics of recruitment best practice are occurring within their own recruitment function and by working with recruitment partners that focus on a high-quality approach. 

I have listed below five key areas that I believe the NHS needs to focus on in order to improve their chances of securing the necessary quality of interim talent required to deliver their core goals.  These rules can equally apply to both permanent and interim candidate attraction.

Brand Proposition
For years the NHS has been able to rely, rightfully so, on simply working for the NHS being enough to attract candidates. Working for one of the most revered health organisations in the world and one of the biggest and most recognisable brands in Britain was more than enough to entice candidates to the NHS. However, with the current strain on services and staff higher than ever before, combined with the take home pay restrictions for contractors in the sector, this may no longer be the case compared to previous generations. Therefore, what could each individual NHS organisation consider doing differently to attract talent?

• What is unique about your particular NHS organisation’s culture and ways of working that makes working life better for your staff?

• How clearly is your organisation’s individual brand advertised and sold on your company website and on the job specifications you produce?

• What working benefits does your organisation offer in addition to standard NHS benefits? How forward thinking is your Trust with accessibility to flexible working policies that improve your staff’s work/life balance?

• What do you invest in learning & development opportunities for your workers and how clearly defined are the career development opportunities within your organisation?

• Most importantly, in how much detail do the people undertaking recruitment for your organisation, whether that be internal recruitment teams or partner agencies, truly understand the above points and proactively sell your brand and benefits to candidates in the market?

Understanding of the importance of well thought out Job Qualification
Too frequently do NHS vacancies, both permanent and interim, get advertised with either very lengthy formal job specifications, or with just one or two lines of basic top-line information. Neither of these practices provide recruiters with a detailed understanding of the skills, experience and person fit required for the role in question, nor helps attract candidates to apply to NHS vacancies instead of well-advertised roles in other sectors. Therefore, it is important for NHS recruiters to be afforded more time with hiring line managers prior to advertising and resourcing for positions to make sure they are in possession of the following:

• A comprehensive job description, detailing purpose of the role and desired outputs, duties and responsibilities.

• A person specification - competencies, requisite skills and experience (essential and desirable), personal attributes, qualifications.

• Details on the anticipated length of any assignment and plans for knowledge transfer.

• An understanding of the opportunity for the candidate and what the role could mean for their own development.

• A breakdown of the team, culture and environment.

• An open discussion taken place on current market salary/rate expectations and candidate availability. If the required skills and experience exceed the banding assigned to the position, are contingency plans in place to re-evaluate the job and person specifications if required?

Candidate Attraction – Active and Passive
Gone may be the days where fruitful recruitment would be near-guaranteed by advertising a permanent role solely on NHS jobs, or by an agency recruiter speaking with their typical core network of NHS career contractors. As more talent leaves the NHS for different sectors, it is more important than ever to look further and wider for potentially suitable candidates. Therefore, every NHS recruiter, both internal and agency, should consider the following:

• How well developed are your candidate networks outside of the core NHS candidate market? Are your recruitment partners successful in other sectors and are they capable of introducing candidates from outside the NHS with transferable skills?

• On what media do your advertisements go out on? If just on NHS Jobs, how frequently do candidates from outside the NHS visit this site? Is it more important than ever that your adverts reach a wider audience by being placed on a greater number of the industry’s core and niche job boards?

• How well trained are the people who write your adverts in selling the benefits and opportunity of the vacancy in question and making the advert more attractive than similar roles advertised across different sectors?

• Does your recruitment function actively approach the passive job market and headhunt where necessary? Have you invested in access to the required tools and media necessary to search for and reach out to suitable candidates who may not be proactively looking for a career change?

Interviewing Techniques
As it is likely that some of the ‘tried and tested’ industry top talent may explore work opportunities elsewhere, it is important that potentially less proven and experienced candidates go through a stringent and rigorous interview process to ascertain that they possess the required skills and experience that their role in the NHS requires. It is therefore important that people recruiting for the NHS guarantee that candidates go through the following interview vetting as a minimum:

• Structured face-to-face interviews, including a thorough review of skills, qualifications, experience and abilities and incorporated role-specific questions.

• Technical Tests and Psychometric Tests where appropriate.

• A full referencing process, including both verbal and written references to guarantee the accuracy of the candidate’s work history and to assess their fit for your role and organisation.

Post-Offer and Induction Process
For any new starter joining the NHS, it is imperative that they receive effective communication between contract offer and start and are provided with a standardised and informative induction process. A lot of hard work goes into filling a vacancy, so it is worth working just as hard to make sure that the new recruit feels welcome, ready to contribute fully and wants to stay. Therefore, given the recruitment challenges the NHS now faces to recruit effectively, it is paramount that each induction process helps retain successful recruits. An effective induction plan should include:

• Prior planning before the new starter’s start date that guarantees that they have all the information they require prior to their start date and have access to all the tools and technology they need to do their job from day one.

• A detailed plan for their first day to make sure that the new starter is introduced to and welcomed by their new colleagues

• Coverage of all necessary company and legislative policies, but try not to overburden with too much paperwork and induction on the first day.

• Provision of clear development and training plans, whilst also clarification of the manager’s expectations and targets for the early stages of the new starter’s role.

• Regular reviews booked in between new starter and manager to update on performance progress and give the new starter the opportunity to voice any concerns.

For the reasons outlined in this article, the NHS faces significant challenges in both attracting and retaining the industry’s top talent. This is particularly the case within the NHS interim and contract market due to the unprecedented earning restrictions recently placed on contractors by HMRC and NHS Improvement; their higher level of pay previously being the trade-off for both their greater level of expertise and their lack of job security and employment benefits. The contractor market is responding in numbers by moving into alternative employment sectors, leaving the NHS short on the interim talent it has previously heavily utilised and somewhat relied upon.

Whilst these market trends and restrictions cannot be reversed, it is believed that a significant proportion of the talent gap created can be closed by improving the organisational recruitment capability of the NHS – both within each Trust’s recruitment processes and the thoroughness and rigor offered by their framework recruitment partners. Within the current NHS recruitment landscape there appears to be few other areas to make gains in talent attraction, we cannot simply buy our way out of this situation or compete with the disproportionate advantage of the private sector, so the talent gap must be closed in this way.

I would welcome your thoughts and views on recruitment best practice within the NHS and whether improving the recruitment basics within the NHS will be enough to tackle the recent changes and challenges that the NHS interim market has experienced.
By Stephen Wooldridge, Manager


Recruitment , Public Sector , NHS , Local Government
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