Nicola McQueen, CEO, NHS Professionals, on the value of flexible healthcare workers

In a series examining the challenges and opportunities for healthcare arising from the pandemic, Sally Williams hears from Nicola McQueen, Chief Executive of NHS Professionals (NHSP), which runs the largest staff bank within the NHS of highly skilled flexible workers. This is what she said on 16 July 2020.

We’ve been on a fascinating journey over the previous 15 weeks. I took up post last September with a remit to pivot the business from running staff banks on behalf of 55 NHS trusts – something the organisation has done very successfully for many years – to providing a range of workforce solutions for all NHS trusts. With more than 130,000 workers employed on a flexible contract with us, we wanted to allow all trusts to access our bank and to broaden the workforce support we can offer. Then COVID-19 happened: it fast-tracked our plans in ways I could never have anticipated.

Stand up, Step forward, Save lives

At the beginning of March, I asked Ruth May, the Chief Nursing Officer for England, how we could best help. She responded that we should mobilise as many people as we could to the NHS frontline in the fastest possible time.

First, we launched our COVID-19 Rapid Response to enable qualified nurses, doctors and other healthcare professionals, who were or were not working in the NHS at the time, to move quickly and safely to the frontline. Our new protocol was designed to accelerate the bank registration process from four weeks to 24 hours, to allow qualified health professionals to deliver shifts to the NHS almost immediately.

This led to our national campaign – Stand up, step forward, save lives – to boost and support the wider NHS in attracting more healthcare professionals back into the service, including retirees and those already in the service seeking more shifts. The campaign generated over 60,000 applications. These came mainly from nurses, but also from doctors and a wider spread of healthcare professionals than we would ordinarily attract.

It was a fantastic response. It was also a huge challenge for NHSP’s 850 staff, who adjusted quickly to home-based working. Within a couple of weeks, we had more than 20,000 health workers ready to join the frontline.

Unfortunately demand for flexible staff in the NHS actually declined during the pandemic, which meant only around 9,000 healthcare professionals were deployed to frontline services in response to COVID-19. Trusts had acted swiftly to shut down non-essential services and elective procedures; there just wasn’t the need for additional workers that had been anticipated. It was not the outcome anyone expected, however, it did demonstrate the huge commitment both healthcare workers and the NHSP team were prepared to give in the face of this crisis.

For those who returned to the frontline, they tended to be extremely cautious, as some had not worked in a hospital for a few years and didn’t know what to expect. We were quite careful where we placed those people and did a follow up on day one to check they felt safe. Very few of our flexible workers – less than 1% – went on sick pay because they tested positive for COVID-19 or had to self-isolate.

Stay and save lives

We’ve changed our narrative to ‘stay and save lives’. We are doing everything we can to hold on to those people who bravely stepped forward and were ready for the frontline. It would be devastating for the NHS not to capitalise on this movement, which could help solve some of the longer-term challenges facing the health system. However, at the moment the demand for additional workforce is still low.

We’ve had a lot of conversations with our flexible workers to explain that whilst there is reduced demand now, there will be more demand to come as the NHS begins to ready itself for winter and confronts any secondary COVID-19 peak. We’ve also said that any NHS trust not enrolled with us can utilise the bank and other resources. We had 52 further trusts sign up, which was amazing, and they are now starting to send us demand.

Recently we’ve surveyed 50,000 flexible workers who stepped up during the pandemic. Of the 11,000 responses received so far, approximately 75% have said they want to stay engaged. Some have said they would consider a substantive role in the NHS, which we will pursue with them. Some want a long-term slot on the bank to do regular flexible work. Some want only to provide support in a crisis.

We are striving to keep workers on the bank engaged. We’ve provided access to training, including regular Lockdown Lectures, to keep members motivated and interested. We’ve had a big surge of migration from agencies to NHSP, because healthcare professionals trust us to look after them should they need to isolate or require sick pay. We can also offer the best access to work through our network of NHS trusts.

Virtual frontline

Over the previous four weeks, we’ve supported NHS Test and Trace by recruiting over 10,000 Clinical Contact Caseworkers. This has involved a second campaign, for a different type of home-based work – what we’ve called the Virtual Frontline. Caseworkers undertake interviews with COVID-positive people to help trace other people who may have been in contact with them. They also work with Public Health England on complex cases and to escalate surges, such as in Leicester.

More than 1,000 dentists have joined the programme, in addition to nurses, doctors and other healthcare professionals. It has given an opportunity to some of those professionals who’d stepped forward to our previous campaign to contribute to the COVID response.

The new normal

Now we’re giving attention to what the new normal will be. It’s very difficult to predict what the future will look like. We expect to go into winter pressures, like we always do, and that will create more demand for healthcare staff. Our main focus therefore is on keeping the people we’ve recruited to the bank motivated and ready to be deployed as we move into winter.

Doctors and nurses currently working in the NHS will also want to take leave and everyone has been mounting up holiday since the pandemic started, so there will be a need for flexible staff to provide cover. Flexible staff will also be needed when elective services are switched back on, although we’re not seeing sufficient confidence within NHS trusts at the moment for this to happen.

I expect we’ll have more success in transferring agency workers and flexible workers into substantive posts in the NHS. The trusts that haven’t signed up to us yet will keep us there to provide flexible cover. We are also exploring mobilising healthcare staff into social care and community settings.

I hope that the NHS at large makes use of this incredible power brand that we now have. We represent a large proportion of flexible workers in the health service, who have shown they will step up in a crisis in ways that should support the health service in the long term.

As told to Sally Williams

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