Agency worker experience in the NHS: Supporting healthcare providers to improve the employee experience

During time of increased demand, bank and agency healthcare workers are increasingly relied upon to ensure critical services remain safely staffed. Just like their permanent colleagues, these professionals are on the front line. Their insights are hugely valuable in understanding issues facing everyone who works within the NHS.

When captured at scale, these insights allow us as a global healthcare delivery partner, to identify opportunities to impact positive change. Working in partnership with the providers we serve, we’re seeking new and innovative ways to address these challenges.?

Seeing through the eyes of our workers

As the leader of five specialist healthcare staffing businesses, understanding the wants and needs of the workforce is core to our offering. Engaging with the workers on a personal level has always been a key strategy but this is hard to scale and offers little basis for comparison. For example, how does candidate A feel about working for a health care provider in the South West compared to candidate B who does the same role in a similar organisation in the North East?

I introduced the Viewpoint programme and its role in supporting our customers in my last article, sharing some of the high-level insights across 11 Acacium Group businesses. This has allowed us to compare agency worker experiences in Trusts right across the UK.

Top 3 challenges

Over the past 12 months we have collected c37k unique responses from agency staff operating in NHS organisations in England, Scotland, and Wales. Despite the geographical differences, there were several common themes in the sentiments we collected.

Challenge: Inability to access patient records

Access to patient’s electronic records is one of the biggest frustrations for candidates working in the NHS. Not only is it an annoyance for workers but it means highly qualified nurses are being paid to do a job they can’t do.

This is a waste of money for health care providers. It fails to alleviate the pressure on substantive staff and leaves agency workers frustrated they have to ask for help to conduct simple tasks they're more than willing and able to do.

• ?“I have had problems several times accessing electronic records and have never really been shown how to use the system. I have sometimes been made to feel inadequate when I have asked for advice.”

• “I was unable to login to the Trust computer, which means I can't look up information such as blood results or complete discharges. I feel bad having to rely on Trust staff members and take up their time.”

• “We as agency do not have access to all services online. I’m not able to order equipment for a patient for example. The electric system crashed easily and this is so frustrating.”

While there are existing forums for Trusts to collaborate, these often operate a top down rather than bottom-up approach. Agency and bank staff, who are not tied to a specific hospital or Trust, can also identify opportunities for improvement having experienced what other providers do well.?

This ability to compare and share their experiences allows us to highlight best practice across the board.

• “Agency workers have no access to electronic systems. One hospital that excels at this is X hospital. All agency workers are given an access card to use the system at the start of the shift. This is available at the site manager’s office.”

Acacium Group solutions

Forward-thinking Trusts and Integrated Care Boards (ICB’s) are already engaging with our vast workforce data and seeing the positive impacts this can have.?Acacium Group's proprietary data gives our clients the insights necessary to improve digital access.?We can see areas where a Trust is performing exceptionally well through the eyes of their workforce, whilst neighbours have friction in their processes and task management causing greater frustrations to their employees – agency and substantive.??

Challenge: Poor or non-existing inductions and training

Every healthcare worker knows that no two days are the same – and the same goes for individual hospitals and Trusts. While an agency nurse or doctor may be hugely qualified and experienced, they do not know the specific processes of that hospital, clinical or otherwise.

From the people who specifically mentioned training and inductions in their feedback, 62% of our candidates told us they were not satisfied with the level of support they received, if they received any at all.

A lack of induction means staff aren’t familiar with the organisations systems and processes. It also means they’re not made to feel welcome which can often reflect the low morale and disengagement of the permanent workforce.

• “No induction and some of their staff are not friendly.”

• ?“The induction process could do with some improvement.”

• “There needs to be a stronger induction culture and better team work - not pile all of the work to the agency nurse.”

We all know the value of seeing things with fresh eyes, and agency workers can often offer a valuable external perspective. We see sentiments like this in a lot of the feedback we receive from our candidates.

• “They need to work towards increase of staff on the wards to be able to facilitate patients leave safely. I think it would help to improve staff training regarding communication/active listening with patients to update care plans.”

Acacium Group solutions

There is quite rightly a big focus on attracting new starters to the NHS but there is a significant opportunity to stem the alarming number of leavers.?Ultimately, this requires addressing the employee experience – the root cause of employee turnover in any organisation, public or private.

Listening to the employee experiences of both temporary and permanent staff on a more frequent basis empowers healthcare providers to address challenges as they happen. By addressing issues in real time, the NHS will be able to support workers to stay in careers they love and upskill new recruits to join them, rather than replace them.?

Rather than the traditionally laborious annual surveys when many of the issues have been forgotten, brushed under the carpet, or worse, the worker has left, Viewpoint is constantly collecting fresh insights. These ‘always on’ listening posts allow us to act immediately where necessary but also collect, collate and publish our findings on a quarterly basis to understand workforce patterns and trends.

Think thumbs up, thumbs down, smiley face, sad face. This is how we’ve become accustomed to responding to experiences elsewhere – why should the employee experience in healthcare be any different.?

Challenge: Frustration around pay

With all that’s going on at the moment, pay is a topic that many would assume would be a key priority for healthcare workers – locum or otherwise. However, our data shows that how much you get paid is less of an issue than the systems and processes causing issues around pay.

We see lots of direct engagement mechanisms where Trusts use various portals to manage staff pay. This causes friction around the frequency and consistency of pay, as well as issues when pay is not administered accurately. This can mean people often don't get paid for as long as three weeks when they first start an assignment.

The comments below give a real flavour of the negative sentiments we see around pay in our candidate feedback.

? “Signing of our timesheet is always a struggle.”

? “I had lot of problems with them to releasing my timesheet on-time and my pay was delayed when I was in need over Christmas.”

? “Delay and processing timesheet.”

? “The way they pay locums through XXX is truly terrible. I am still waiting to resolve pay issues after 27 weeks!”

Acacium Group solutions:?

It’s apparent from talking to Trusts and the correlation between candidate satisfaction that the use of these direct engagement platforms can have vastly different outcomes. Some proselytise about improved efficiencies and cost savings, and others result in frustrations like those described above.?

The difference is there are some Trusts up and down the country haven't invested, or more likely haven’t been able to invest, in the level of administrative resource and clerical support that's needed to administer the portals their end.

Those with a very lean back office, or times where there’s staff holidays or a surge in administrative volume, Trusts can't keep pace. This means that workers pay suffers and people must wait weeks to be paid, which just isn’t viable when so many people are living hand to mouth.?

Going forward

Collecting these insights has been a fascinating experience and despite being so early in our journey, Viewpoint has already transformed many of our internal processes to put the candidate experience at the heart of what we do. I’m buoyed by the fact that so many of our NHS clients are embracing this data and feedback to implement best practice in their own organisations.?

I will continue to share what we learn in the hope we can empower more healthcare providers to see the potential in this big data . By protecting the health and wellbeing of our healthcare professionals, we can secure better patient outcomes for the people they care for.

If you’d like to know more about Viewpoint and how Acacium Group can help you increase your capabilities and capacity, please drop me a message.??