Leaders: Grim prognosis for NHS reliant on agency staff

Agency nurses are vital to the running of the NHS. Picture: Ian Georgeson

There can be no doubt that the daily expenditure on agency staff to help fill the gaps across Scotland’s health service is an eyewatering figure. At £64,000, the outlay is the more than three times what is spent in a year on the starting salaries of three nurses on the NHS’s band five grade.

At a time of dire warnings over shortfalls in the funding of health and social care, it is little wonder that such an expense has attracted criticism.

Scottish Labour’s Anas Sarwar, for example, has accused the Scottish Government of overseeing an “utterly botched” workforce planning system. As a result, he says, hospitals have to turn to expensive agency staff to deliver the care patients need.

There is the kernel of an reasoned argument in Mr Sarwar’s submission, and the scale of the challenge facing the NHS is an undoubted concern. But certain factors at play mean any opprobrium being directed the government’s way does not necessarily belong at its door.

The issues of recruitment and retention are problems not exclusive to Scotland. They exist across the NHS in England and Wales. The shifting demographic pattern has led to a retirement timebomb. Defusing it is no easy task and time is on not on the government’s side – the number of midwives in their fifties and sixties in Scotland soared by a third between June 2011 and June 2015.

The first step must be to acknowledge that although NHS staffing levels have reached a record high, other statistics tell other stories; such as the one showing there were more than 2,200 nursing and midwifery vacancies in March, a figure which has doubled since 2012 according to official NHS data.

What is crucial to this issue is the way in which health boards are taking on employees. The increasing reliance on agency staff is a problem that costs £23 million a year. Yet the expense is not only the only concern.

The use of outside agencies, now par for the course, has long-standing repercussions for the continuity of care patients receive. Even if targets are met and boxes ticked thanks to a full complement of temporary cover, the entire service is being gradually yet inexorably diminished.

This in itself has worrying knock-on effects. As morale plunges, NHS staff who are already hard-pressed feel they have to work even harder to hold it all together. If they do not feel they have sufficient time or resources to do their job properly, then everyone suffers.

Ministers have invested £450,000 over the next three years to encourage qualified nurses to return to work, and a dedicated team was set up in December to address spending on temporary staff. Yet one wonders if these steps go far enough. Theresa Fyffe, director of the Royal College of Nursing Scotland, believes nothing short of “transformational change” is required.

The NHS, like so many employers in Scotland, finds itself adapting to a period of transition where the make-up of its workforce is changing, but the need for it to continue to provide its unique service requires a speedy solution.

Talk is good, especially for young

The proliferation of social media channels and video calling apps means there are now more ways for us to communicate with friends and family than ever before. This new media landscape is open to everyone, but it is the young who have seized upon it with the greatest enthusiasm. Consequently, they chat far more than their forebears ever did.

While this is undoubtedly welcome, the technological revolution can act as a hindrance to honing communication skills which, though traditional, remain crucial. Nearly all of us have at some point misconstrued the tone of an e-mail or text message. Such misunderstandings are less common when the conversation takes place face to face, where intonation, emotion and emphasis come to the fore.

Nowhere are these nuances more important than in key events of our lives, such as job interviews. The human touch is an invaluable tool for impressing prospective employers and may even count for as much as an impressive CV.

That is why the launch of a pilot course at a Scottish school to help pupils develop one-on-one conversation skills is a cheering development. Young people have always benefited from guidance when it comes to taking their first steps in the jobs market, but in an age when so much of our dialogue takes place electronically, such an initiative is especially welcome.

The firm behind the course, at Kinross High, claims many youngsters have “lost the art of dealing with people face to face”. That may be overstating the problem, but ensuring our young people have the right interpersonal skills is no LOLing matter.