‘The majority of nurses that we recruit already have a post within the NHS’
Former NHS nurse Adrian Hearne is one of the founding directors of Richmond Nursing, an agency formed in Llanelli in 1998 which now has more than 500 nurses on its books. The agency is one of the approved suppliers to the Welsh NHS under the All Wales Age
Q
Tell me a bit more about the history of your agency, how many nurses you have on your books and what health boards you cover
Richmond Nursing Agency was established in 1998.
The three owners/directors of the company were qualified nurses who had worked locally for many years within the NHS and, to begin with, were the only staff that the agency had registered on its books.
We have always prided ourselves on our unique “pitch” to our clients (local health boards) in that we were – and continue to be – able to offer a nurse-led approach and are “in tune” with local culture, knowledge and practices.
This has always been one of the attractions for staff to choose to work with us in what has always been an extremely competitive market.
Because of our insight and experience, we were able to offer our nurses a knowledgeable and professional experience when joining the agency. This continues today and we now have more than 500 nurses registered with the company. This is made up of qualified registered general nurses, qualified registered mental health nurses and healthcare support workers – all working on a regular basis.
These days we cover every health board in Wales, including many specialist areas within hospitals and the community, and additionally all nursing homes throughout Wales.
Q
Why is working for an agency an attractive career option for nurses?
There are some nurses who choose to work solely for agencies. However, the majority of nurses who are registered with nursing agencies also hold positions in substantive nursing roles within the NHS. Most do not work exclusively for agencies.
This is mainly due to the fact that nursing agencies are rarely able to offer any guarantee of continuous work (shifts) and the location and nature of the work available might not always be suitable for the individual’s preferences and skills.
To a degree, nurses who work for Richmond during their free time (days off from their usual job, while on annual leave, etc) are able to select where and when they work for the agency.
This process can now be dealt with via our nurse portal or by
telephone, which allows the individual the ability to peruse the shifts that we have available at that time which are suitable for them to work.
Conversely, to some, this flexibility is a big part of the attraction of working for an agency.
Another attraction is that we offer a comprehensive educational package to every nurse who joins us. These packages consist of both mandatory and non-mandatory training elements which the nurse can undertake and then apply to their practice within their work. Staff are then able to utilise this acquired knowledge and skills under any employer.
This means that the nurse can apply their knowledge to their usual place of work. This also plays a significant part in contributing towards their NMC revalidation, which is a mandatory NMC (Nursing and Midwifery Council) requirement for nurses registration and allows them to practice.
We pay our nurses on a weekly, rather than monthly, basis. Some nurses also find this more convenient and it is one attraction of working for an agency.
We’re constantly listening to our staff and they’ve always told us that they feel valued by us and (more importantly) by the patients and health boards that they work for.
Q
The Welsh NHS is desperately short of nurses – aren’t agencies hindering their recruitment?
No. In fact, arguably the opposite is true. As previously mentioned, the majority of nurses that we recruit already have a post within the NHS.
Agency work can sometimes be a way for some individuals to work outside of their usual work settings (during their time off, etc) and experience work in other NHS areas.
This sometimes acts as an “introduction” for the nurse to another NHS workplace and, as such, there are many occasions where nurses have subsequently moved their permanent jobs from one NHS employer to another.
While this might mean that we ultimately lose that particular member of staff, it can be a reality of the nature of agency work and we accept it as such.
I think that it is only fair to also acknowledge that if there were no demand then there would be no requirement for supply and that, like most businesses, we have experienced both good and some not so good times over the last 23 years.
Q
According to an FOI, the Welsh NHS is spending (on occasion) three times as much on agency nurses as they are on paying NHS nurses. Do you believe that’s right?
I think that the key words here are “on occasion”.
Richmond Nursing Agency is part of what is referred to as the All Wales Agency Framework. Briefly, this means that we had to tender (or apply) for a place within this framework which would then mean that Richmond Nursing Agency is regarded by health boards in Wales as an “on-contract” or framework agency.
This was only made possible after we were able to robustly demonstrate that Richmond met – and continues to meet – all of the strict requirements that the terms of this contract dictate.
The majority of these terms involve items relating to the compliance of our nurses and our business as a whole. Another aspect of the contract is that it sets out a strict and non-negotiable hourly charge rate which we are permitted to invoice the client for our supply of nursing services.
Because this charge rate is fixed, it directly influences the amount of money that we are then able to offer the nurse as an hourly rate of pay.
The reason for mentioning the above is that some agencies that supply nurses to Wales are not part of the All Wales Framework and are able to charge the client at their own chosen rate of pay.
This is almost certainly a rate that will be above the All Wales Framework rate – sometimes substantially more. This then means that these companies are then able to remunerate their nurses at a far higher level than an agency that is part of the framework.
As a framework agency, this is (and has always been) a constant battle for us as, if the demand for work dictates, nurses will sometimes have the option to accept work from these other agencies at a significantly higher rate of pay.
With the above in mind, as a framework agency we have always felt that it is extremely important for us to work as closely as possible with all the health boards to try and understand their long-term staffing requirements in order to avoid any shortfalls in supply.
It is therefore arguable that a significant proportion of this expenditure is attributable to some health boards sometimes being “forced” to seek staffing support from nonframework agencies.
While this might not be for the majority of the time, clearly even smaller amounts of coverage by these other agencies will result in higher expenditure, like for like.
Q
Last year the Welsh NHS spent £69m on agency nurses – the highest amount on record. Do you believe this spending is sustainable?
I am unable to comment as I am not part of the NHS and an not involved in their planning, etc.
Q
What sort of percentage/cut in pay does the agency typically receive?
As previously mentioned, Richmond has experienced some challenging times over the last 20-plus years of trading.
Suffice to say that our margins are certainly not what we sometimes hear that the general public think they are.
As a framework agency, the costs incurred through maintaining items such as nurse compliance (training), employment of office staff (over the last three years the compliance team alone has grown from two to eight full-time employees), insurances, office accommodation, etc all mean that we have to continuously work very hard at ensuring that Richmond is always the nurse’s first choice if they decide to join an agency.