This post may trigger some emotional responses but please persevere and read through to the end! I am not locum bashing by any means, but I do feel at the moment that the good medical recruitment agencies are suffering as a result of a few agencies who have historically used bad tactics to secure bookings or retain candidates. Agencies and locums/temp staff really are in it together!
Not many locum or temporary agency staff fully understand what it takes own and operate a medical recruitment agency in today’s market. Margins are very low; compliance and payroll are more time consuming than ever before. Pre-capping and IR35 “off-contract medical recruitment agencies” (agencies not part of any framework) could previously rally their sales team to call round all the hospitals to ask if there were any needs. If you got the opportunity to fill a few shifts and you did that with one of your best locums or temps you would normally get your “foot in the door” and that locum would often end up self-arranging shifts or at the very least the consultant would get the call on a Monday to fill outstanding shifts for the week and often, into the next week.
A consultant would negotiate a good charge rate that was competitive to win the business but also facilitate the ability to offer of a good pay rate through a limited company for the locum or temp. The agency would have a healthy but fair commission, and everyone was happy. This process was occasionally abused by the odd greedy consultant or agency but overall, the process worked quite well.
If you take theatres for example, the recruitment consultant would often strike up a relationship with the Theatre Manager or Theatre Co-ordinator and work on the shifts directly with no 3rd parties getting involved in the mix. Of course, there was the odd hick up, but generally the communication was clear. You could talk about the lists, the skill requirement, the joint types used for the elective surgery etc, but the landscape is very different now. The agency gets an email about 48 hours before the shift from an automated system asking for a trained nurse for theatres. No mention of the list and sometimes not even a specific skill set requirement. The result is a fastest finger first race to add your temp to the system and wait to see If the locum or temp is accepted. Sounds easy?
You can’t add a non-compliant worker to the system, you need to fill out a long proforma before you even consider it.
Locums and temps often wonder why “all this compliance is needed” before agencies even offer any work. Well the fact of the matter is the managed service and framework audits look at timelines and if you present an uncompliant worker for a shift you are in big trouble. It’s all very chicken and egg and often with no reward. Everybody gets frustrated with this nonsense, but the agency is not trying to be awkward. One of my colleagues made a very interesting comment the other day while we were talking on the phone. “agencies are in a race to the bottom” it rang true, but the reality is lots of good agencies are fighting for survival.
Take a look at one of the pro forma documents needed to supply staff into a Spire hospital and this is before the agency goes about adding a plethora of information to the portal. Spire Pro Forma
To add the problems, often the shifts that appear on the portal have already been filled by other agencies or locums and temps who self-book. The shifts are put out to agency just to follow procedure, often the agency doesn’t know if the shifts are “real” or not.
So why do agencies join frameworks? Why do agencies join managed services?
The fact of the matter is this; if you want to get paid by the trust you don’t have a choice.
It can feel like a catch 22 where unless you are Thornbury, you simply don’t get paid for the shifts. The agency will have paid the worker and Trust will then send you a letter saying person X was not authorised to sign the timesheet or indeed hire the worker so no money for the invoice sorry.
All the relationships built with department heads by recruitment consultants have gone out of the window, there is always the odd exception, but that the general landscape.
Did you know?
- All framework medical recruitment agencies and Trusts are both charged a percentage of turnover that runs through the framework.
- All agencies must submit monthly management information reports to the framework with information on pay, charge, hours worked, payment vehicle, staffing group and dates worked.
- All agencies must submit intermediary reports (RTI reports) to the HMRC (Real Time Information) with very similar information to the above. If you are late you are fined up to £1000 a quarter with interest charged daily. This is where the HMRC will have the ability to hammer down on anyone in the public sector working through a Limited Company and “investigate” those Limited Companies.
- Agencies are contracted to be an REC member who charge a small fortune for providing advice on things like GDPR and other buzz words, even though most agencies already have looked into these matters.
- Agencies must have very expensive insurance policies in place as contractual requirements.
- All Framework agencies are rigorously audited, and rightly so, for compliance. These audits are charged to the agency and are often inconsistent with regards to policy and procedure.
- This adds to the confusion with some agencies operating a different system to another.
- It cost on average £350 per temp to get a file compliant.
Some locums and temps, due to the pressure on the take home pay, are jumping ship for an extra 50p per hour rather than honouring contracts or discussing their rates with the agency who took the time to gather their compliance, liaise with the client or worse, staff bank, to secure the placement and then have a worker accept the work through another agency at the last minute.
It’s the perfect storm for the people in power wanting to squeeze out the agencies. Divide and conquer and cause an internal squabble.
Locums, temps and agencies should try and look at both sides of the coin in my opinion. The locums and temps have had a really bad time of late. Yes, some agencies and consultants let the side down, indeed as do some temps playing games, but remember the agencies are getting battered from all sides too. Some of these who are agencies who generally try and get the best for the locum workforce, are fair and deliberate in their negotiations and have a genuine respect and relationship with their most regular locums.