The NHS White Paper: What does it mean for recruiters?

With nothing mentioned in pre-election manifestos about the proposed changes to the NHS, the industry has had very little time to prepare, and the extent of the shake-up is still in some senses an unknown. Several Timothy James consultants went to the NHS Confederation in June where various views and speculations about the proposed plans were doing the rounds there. The expected shake-up in the service, however – the biggest changes for a decade and even, some say, in NHS history – was still in its early stages and there were very few details available.

Now Andrew Lansley has published his White Paper (entitled Equity and Excellence: Liberating the NHS) we will have to think about what it means for the recruitment industry. Are NHS employees, and candidates seeking work with them, going to have to change the way they do business? And how are we going to change our business in order to keep up with the fast pace of restructuring and cutbacks?

The Revision to the Operating of the NHS Framework written by the Department of Health states that, “The overall ceiling for Management Costs in PCTs and SHAs will now be set at two thirds of the 2008/9 Management Costs... the expectation is that most of the reductions need to be realised in 2010/11 and 2011/12.” These tighter managerial budgets mean that we will have to search harder to find the best jobs as well as the most versatile candidates capable of dealing with such big changes within an industry they may have worked in for years. These changes do not just affect the NHS directly but also a whole spectrum of related industries and we must respond as quickly as possible so that we are not left behind.

Secretary of State for Health, Andrew Lansley, has recently described the reasoning behind his new plans. “In order to truly improve health outcomes and the service the NHS gives to patients,” he says, “it must be free from the shackles of central control. All NHS trusts will become foundation trusts and they will have greater freedom so that they can concentrate on being more responsive to patients.” Lansley is basing his plans on a need, he says, to remove ‘bureaucracy’ and so is putting managerial responsibilities, and finances, in the hands of GPs.

A restructuring on this level and at this pace is also quite a risky strategy for the Department of Health to follow. Perhaps, therefore, the NHS will begin to rely, particularly in the early stages, on interim staff and contractors in order to test the lay of the land before managers become committed to new structures, staff, and practices in the long-term. This could lead to productivity benefits for the service as individuals, particularly in senior appointments, can be matched very specifically to particular jobs and projects that will need doing quickly. Using contractors is also more economically viable than employing permanent staff, and so has a further benefit in the form of helping with the financial cutbacks.

With the advent of the new coalition government and its programme of change, the turbulence of the past couple of years in the private sector is now going to hit the public sector as well. In order to keep on top of budget cuts and structural changes, recruiters will have to adapt their own business even faster than the NHS adapts theirs. This will enable them to respond early to what may be coming, protecting their market share whilst delivering successful results.