Winter is coming: time to embrace the gig economy in health?
22 November 2018
We are all now used to the headlines every year about ‘winter pressures’ and the associated strains on an under-resourced NHS. Fast forward to the Spring and those headlines will inevitably be about how much the NHS has over spent on agency staff during its busiest period.
This isn’t new. There is unlikely to be a single trust in the country that doesn’t have some form of agency spend. There are over 200 different trusts and health boards across the UK, all with their own budgets and patient demands, and agency spend has been averaging – on face value – an eye-watering £2.8 billion a year since 2012/13. Hardly surprising that with the inflammatory news headlines we see nearly every year, the public asks a collective: ‘Why are we spending on agency workers when we should be hiring people?
Let us compare this to the private sector. There is equal noise in the press about new start-up companies, often on a tech platform, engaging with workers on a flexible basis. It’s called the gig economy, which is defined as ‘a labour market characterised by the prevalence of short-term contracts or freelance work, as opposed to permanent jobs’.
Put simply, the gig economy is about people changing how they work. People are working when they want to, in a pattern that suits their own lifestyle and availability and in response to business demand. And it is happening all over the world, not just the UK. This way of working is increasingly gaining popularity as businesses aim to support this change in culture. Classic examples are companies like Uber, Deliveroo or Amazon.
I for one am extremely proud of the NHS, and in awe that it can upscale almost instantly to cover immediate needs by utilising such a vast network of flexible workers, from locums to nurses, even admin and clerical and IT contractors, who are willing to sign on at the last minute and support where they can. Access to this network no doubt brings the extra and very much deserved support to those permanent employees who face the full time day to day challenges. I am further in awe of the fact that, despite the constant and very public challenges around how the NHS utilises temporary staff, it carries on regardless - putting patient safety first. Wouldn’t we all take comfort in knowing, if we ever find ourselves in need of A&E for example, that neither cost nor the threat of a negative headline will have any influence on how and when we will be seen, even if that does mean calling on a medical locum to step in last minute due to demand?
I think it is fair to say that no trust can forecast when there is going to be an epidemic, it will never know, winter-pressure-wise, what’s going to happen, so it will always be reliant to a degree on these agile workers. For this reason, the NHS is arguably the original gig economy. There will always be a different need at a different trust at a different time at a different location and so we need flexible workers to be able to meet demand all over the country.
So instead of being so quick to criticise the NHS over its use of temporary, transient staff, we should perhaps be looking to it as a shining example of how flexibility can work for both employer and employee when it is structured and managed in the right way.
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