report - Aldwych Partners

Transcription

PRICE CAPS FOR AGENCY STAFF:
A RESEARCH REPORT
November 2015
1.
EXECUTIVE SUMMARY
1.
Monitor has proposed that the amount paid to agency staff by NHS trusts be the subject of
a price cap. Aldwych Partners, with the support of ZPB Associates, has undertaken this
research to understand how agency staff are likely to respond to the proposed price cap.
2.
Staff registered with Pulse, Maxxima and Asclepius (all staffing agencies owned by
Independent Clinical Services Limited, the sponsor of this survey) were approached to
participate in an on-line survey in October 2015.
3.
A total of 3,613 responses were received, including 1,960 from nurses, 675 from doctors,
and 978 from allied health professionals.
4.
Key points from the survey are:
•
The Government should not expect the planned price caps to cause agency staff to
return to NHS employment. One reason for this is that nearly half of agency nurses
and locum doctors (45% and 39% respectively) are already NHS employees. Agency
work is being used by NHS employees to top up their income.
•
Over half of the agency staff that are not NHS employees (63% of nurses, 65% of
doctors, 55% of AHPs) say they work through an agency because of the flexibility this
gives to look after children, care for relatives or pursue other interests. Price caps will
not encourage these clinicians to return to the NHS; they will still need the flexible
working arrangements that permanent positions in the NHS have not been able to
provide.
•
More than half of agency nurses (54%) and AHPs (53%), and around three quarters
of locum doctors (74%), say they will work fewer shifts, pursue work outside England,
or otherwise change career, if the proposed price caps are implemented. Very few
agency staff (13% of nurses and 2% of doctors) anticipate working more shifts to
maintain their income.
•
Overall, the survey results imply that the number of shifts that agency staff will work
will decline by half to three quarters if agency staff are paid at the new, lower capped
rates. Further, the NHS will also lose the contribution of permanent staff working
additional shifts through agencies who, as a result of the price caps, choose to
pursue careers outside the NHS in England. This could increase the total number of
shifts lost to the NHS as a result of these proposals by 40% for nurses and 80% for
doctors.
•
The effect of fewer shifts, or fewer placements, being worked by agency staff will be
particularly felt by Trusts in more remote locations. Around 28% of AHPs, and 41% of
those locum doctors that primarily work through placements, lived away from home
for their most recent placement. However, only half this amount (13% of AHPs and
20% of doctors) would be willing to take a placement that involved living away from
home under the proposed price caps, given that travel and accommodation costs
would no longer be covered.
2
Reasons why agency staff work through staffing agencies
5.
Nearly half of agency nurses and locum doctors (45% and 39% respectively) are
permanent NHS employees. Approximately 29% of agency nurses have full-time positions
in the NHS, and a further 17% have part-time positions. Similarly, 33% of locum doctors
have full-time positions in the NHS, and a further 6% have part-time positions. It appears
that agency work is being used by significant numbers of NHS employees to top up their
income.
Are you currently employed (on a permanent basis) by an NHS Trust?
70%
55%
60%
61%
50%
40%
30%
29%
33%
17%
20%
6%
10%
0%
Yes, full-time
Yes, part-time
Nurses
No
Doctors
6.
The large proportion of agency workers that have permanent jobs in the NHS means that
any assessment of the impact of the proposed price caps needs to take account of their
effect on both the supply of agency and permanent NHS staff. This is because capping
agency pay will reduce income for permanent NHS employees who do agency work, and
may result in them making choices that affect both their temporary and permanent
employment.
7.
Around a third of agency staff are registered with an NHS staff bank (35% of nurses and
28% of doctors).
Are you currently registered with a staff bank at one or more NHS trusts?
80%
72%
66%
70%
60%
50%
40%
28%
30%
20%
10%
0%
7%
16%
12%
Yes, more than one
Yes, just one
Nurses
No
Doctors
3
8.
Agency staff with permanent jobs in the NHS mostly work through a staffing agency
because of the higher rates of pay on offer compared with shifts through a staff bank (64%
of nurses and 50% of doctors). Around 20-30% of nurses and doctors with permanent
positions, however, report that their motivation for agency work is to work their extra shifts
at a different location or gain experience in different areas to their permanent job.
What is the main reason you work through a staffing agency?
Nurses with permanent NHS jobs
70%
64%
60%
50%
40%
30%
20%
13%
11%
8%
10%
0%
4%
Agency shifts pay Prefer to work extra To gain experience in
Unable to work
more than extra shifts shifts at a different areas different to my enough extra shifts
location to my
permanent position through my trust’s
through my trust’s
permanent position
staff bank
staff bank
Other
Doctors with permanent NHS jobs
60%
50%
50%
40%
30%
20%
16%
13%
7%
10%
0%
Agency shifts
To gain
Prefer to
pay more experience in work extra
areas
shifts at a
than extra
different
shifts through different to
my
location than
my trust’s
staff bank permanent
my
position
permanent
position
4%
2%
2%
Unable to Flexibility for Additional Transition to
work enough other lifestyle income on retirement,
reasons
top of
supplement
extra shifts
permanent retirement
through my
position
income
trust’s staff
bank
5%
Other
4
9.
Agency staff without permanent jobs in the NHS cite the flexibility of agency work as a key
driver for their decision to work through an agency. This includes around two thirds of
nurses (63%) and doctors (65%) and half of AHPs (55%). For nurses, a significant
proportion of this requirement for flexibility is driven by childcare requirements. Around
20% of nurses say that flexibility for childcare is their main reason for working through an
agency.
Nurses without permanent NHS jobs
50%
45%
44%
40%
35%
30%
23%
25%
19%
20%
15%
11%
10%
5%
0%
1%
Flexibility for
other lifestyle
reasons
Higher pay than
permanent
employment or
working through
a staff bank
Flexibility for
childcare
1%
Unable to secure Unable to work
a permanent
enough shifts
position
through the staff
bank(s) that I am
registered with
Other
Doctors without permanent NHS jobs
60%
54%
50%
40%
27%
30%
20%
11%
10%
0%
2%
Flexibility for
other lifestyle
reasons
Higher pay Flexibility for Transition to
than
childcare
retirement,
permanent
supplement
employment
retirement
income
1%
1%
Unable to
secure a
permanent
position
Previous poor
experience in
permanent
NHS
employment
4%
Other
5
Allied Health Professionals
60%
49%
50%
40%
26%
30%
20%
6%
10%
0%
6%
2%
2%
2%
Flexibility for Higher pay Flexibility for Unable to Experience / Additional
Previous
other
than
childcare
secure a variation of income on
poor
lifestyle
permanent
permanent different top of other experience
reasons employment
position
positions employment
in
permanent
NHS
employment
7%
Other
Response of agency staff to being paid at price cap levels
10.
Agency staff were asked what action they would take if paid at the proposed price cap
levels. Care was taken to put this question to respondents without biasing the results, and
respondents were able to choose between several options as well as being able to specify
other alternatives. 1
11.
The survey shows that a substantial loss in the supply of clinicians to the NHS can be
anticipated if agency staff are paid at the proposed price cap levels.
•
Around 54% of nurses said that they would change career, seek work outside
England, or reduce agency shifts without increasing hours in permanent employment
or bank shifts. This compares to the 13% of nurses that said they would increase the
number of agency shifts that they work (to compensate for the loss of income as a
result of the price cap). The number of nurses that anticipate shifting from agency
employment to permanent positions or increased hours in permanent employment
was less than 10%.
•
The majority of doctors (53%) stated that they would work outside England if the
proposed price cap was introduced. A further 21% of doctors said they were likely to
change career or reduce agency work without increasing bank shifts or permanent
hours. Only 7% said they would keep working the same hours as currently, and 2%
said they would increase the number of agency shifts. The number of doctors that
anticipate shifting from agency employment to permanent positions or increased
hours in permanent employment was around 6%.2
For example, the agency price cap scenario put to respondents was described neutrally, and the order of the options put to
respondents was rotated across the sample.
The effect on doctors also needs to be considered in the light of the current junior doctors dispute, which is also likely to
impact on junior doctors’ willingness to continue working for the NHS in England.
1
2
6
•
More than 50% of AHPs anticipate actions, such as working outside of England,
establishing private practices, retiring, or otherwise reducing time worked in the NHS,
if the proposed price caps are implemented. That said, a much higher proportion of
AHPs (around 23%) compared with nurses or doctors said that they would try to
switch from agency to permanent employment if the proposed price caps are
implemented.
12.
Based on these responses, we estimate that if agency staff are paid at the proposed price
cap levels:
• the number of shifts worked by agency nurses will decline by around half; and
• the number of shifts worked by locum doctors will decline by nearly three quarters.
13.
On top of this, the NHS will lose nurses and doctors that have permanent positions in the
NHS and choose not to work for the NHS anymore as a result of reduced pay for their
agency work. Based on the survey data, this could increase the number of shifts lost to the
NHS by 40% for nurses and 80% for doctors.
If the Government caps agency pay, what are you most likely to do?
Nurses
25%
21%
20%
17%
16%
15%
16%
13%
10%
8%
5%
5%
0%
Change
career
Keep
working the
same hours
Work
outside
England
4%
Reduce
Increase
Reduce
Reduce
agency shifts agency shifts agency shifts agency shifts
without
and increase and obtain
increasing
hours
permanent
bank shifts
worked in nursing job
or hours in
permanent
and/or
permanent
job and/or
increase
job
bank shifts bank shifts
Other
7
Doctors
60%
53%
50%
40%
30%
20%
10%
10%
0%
Work
outside
England
No longer
work
agency or
bank shifts
8%
Change
career
8%
11%
4%
2%
2%
Stop agency Reduce
Keep
Increase
work and
agency
working
agency
obtain
shifts
same hours
shifts
permanent without
job
increasing
bank shifts
or hours in
permanent
job
2%
Reduce
agency
shifts and
increase
bank shifts
or hours in
permanent
job
Other
(please
specify)
Allied Health Professionals
25%
23%
22%
22%
20%
16%
15%
10%
5%
5%
0%
14.
5%
2%
Stop doing Obtain work
agency
outside
work and
England
obtain a
permanent
position
Change
career
Do nothing
differently
2%
Increase Don't know Stop agency
work in
work
private
healthcare
2%
Retire
Other
If agency staff are paid at the proposed price cap levels, this will also impact on their
willingness to travel to more distant NHS trusts for temporary work. This is because the
proposed agency staff price cap will no longer allow the cost of travel or accommodation to
be paid by NHS trusts.
8
15.
Around 28% of AHPs, and 41% of those locum doctors that primarily work through
placements, lived away from home for their most recent placement. However, only half this
amount (13% of AHPs and 20% of doctors) would be willing to take a placement that
involve living away from home under the proposed price caps. This means that Trusts in
more remote locations will be particularly affected by staff shortages to which the proposed
price caps are likely to give rise, increasing inequalities in access to services (which needs
to be taken into account in Monitor’s equalities impact assessment).
9
2.
INTRODUCTION
16.
Monitor has proposed the introduction of price caps for agency staff. The objective for the
research presented in this report is to understand how agency staff are likely to respond to
the proposed price cap, if it is introduced.
17.
Staff registered with three staffing agencies, namely Pulse, Maxxima and Asclepius, each
owned by Independent Clinical Services Limited, the sponsor of this survey, were
approached to participate in an on-line survey in October 2015.
18.
Separate questionnaires were provided to agency nurses, doctors and allied health
professionals.
19.
The survey was administered on behalf of Aldwych Partners by ZPB Associates Limited.
20.
A total of 3,613 responses were received, including 1,960 responses by nurses, 675
responses by doctors, and 978 responses by allied health professionals.
21.
This report is set out as follows:
• Section 2 provides the results of the nurse survey;
• Section 3 provides the results of the doctor survey; and
• Section 4 provides the results of the allied health professional survey.
22.
A copy of each of the questionnaires is at Appendices A-C.
10
3.
NURSES’ SURVEY
23.
This section sets out the results of the survey of agency nurses. Survey results are
presented in the same order as the questionnaire. A copy of the questionnaire is at
Appendix A.
24.
There were 1,960 responses by agency nurses to the questionnaire out of a total of 9,441
agency nurses to whom the questionnaire was sent. This represents a response rate of
approximately 21%.
What is your age?
45.0%
38.8%
40.0%
35.0%
30.0%
27.2%
25.0%
18.6%
20.0%
12.3%
15.0%
10.0%
5.0%
0.0%
25.
2.0%
1.1%
18-24
25-34
35-44
45-54
55-64
65 and over
The largest share of agency nurses responding to the survey live in London (31.3%). Only
a very small number of agency nurses responding to the survey do not live in England.
Which part of the UK do you live in?
London
North West England
South East England
South West England
Yorkshire & Humber
East Midlands
West Midlands
North East England
East of England
Wales
Northern Ireland
Scotland
31.3%
21.9%
17.0%
6.4%
5.8%
4.8%
4.5%
4.1%
3.6%
0.4%
0.1%
0.1%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
11
26.
Most agency nurses are Band 5 (54.5%) or Band 6 (31.5%), with only small numbers of
agency nurses working at other pay bands.
What is your current pay band?
60.0%
54.5%
50.0%
40.0%
31.5%
30.0%
20.0%
10.0%
0.0%
27.
4.5%
Band 2
2.0%
Band 3
6.1%
1.0%
0.2%
Band 4
Band 5
Band 6
0.1%
0.1%
Band 7 Band 8a Band 8b Band 8c
Agency nurses are spread across a variety of practice areas, including mental health
(16.4%), ITU (16.1%), A&E (14.9%), General (12.8%) and Theatres (12.3%).
What is your area of practice?
Mental Health
16.4%
ITU
16.1%
Accident & Emergency
14.9%
General
12.8%
Theatres
12.3%
Paediatrics
10.1%
Other (please specify)
6.9%
Community
3.7%
Midwifery
3.2%
Oncology
3.2%
Health Visitor
0.4%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0%
12
28.
Around 45.5% of agency nurses are also registered with an NHS staff bank, while 65.5%
only work through a staffing agency.
Are you currently registered as part of a staff bank for
one or more NHS Trusts?
65.5%
70.0%
60.0%
50.0%
40.0%
27.7%
30.0%
20.0%
6.8%
10.0%
0.0%
Yes, more than one
Yes, just one
No
How many bank shifts have you worked in the past 12
months?
70.0%
60.0%
57.8%
50.0%
40.0%
30.0%
15.8%
20.0%
10.0%
0.0%
None
Less than
10
8.9%
10-24
5.7%
25-49
3.8%
4.9%
3.1%
50-100 More than Don’t
100
know /
can’t
remember
How much were you paid for your last bank shift?
More than your last agency shift
Don't know / can't remember
The same as your last agency shift
Less than your last agency shift
6%
11%
16%
67%
0% 10% 20% 30% 40% 50% 60% 70% 80%
13
29.
A small majority of nurses are only registered with a single staffing agency, but the
remainder are registered with two, three or more agencies. Around 70% of agency nurses
have started working through an agency in the past 3 years.
How many staffing agencies are you registered with in total?
60.0%
51.0%
50.0%
40.0%
28.8%
30.0%
20.0%
11.9%
8.2%
10.0%
0.0%
One
Two
Three
More than three
How long has it been since you first started working through
a staffing agency?
50.0%
45.0%
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
45.1%
25.2%
11.8%
10.6%
6.6%
0.7%
Less than a
year
1 to 3 years
3 to 5 years 5 to 10 years 10 to 20 years More than 20
years
14
30.
Most agency nurses that responded to the survey are actively participating in agency work,
with their most recent agency shift in the past week. Around a third of agency nurses
(33.0%) are working more than two agency shifts per week (i.e. more than 100 shifts per
year).
In the past 12 months, how many shifts have you worked
through any agency with which you are registered?
25.0%
20.5%
20.0%
17.1%
18.0%
16.6%
16.4%
15.0%
10.1%
10.0%
5.0%
0.0%
1.3%
None
Less than
10 shifts
10 to 24
shifts
24 to 49
shifts
50 to 100 100 to 200 More than
shifts
shifts
200 shifts
How long has it been since your last agency shift?
80.0%
70.0%
69.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
19.6%
8.3%
Less than 1 weekBetween 1 week 1 to 6 months
and 1 month
1.5%
1.5%
6 to 12 months
More than 12
months
15
31.
Two thirds of agency shifts involve travel of up to one hour (67.3%), and two thirds of
agency nurses travel by car to their place of work. Around half of all agency shifts were
daytime shifts.
Thinking about your last agency shift, on average how long
did it take you to get there from home?
47.1%
50.0%
40.0%
30.0%
20.0%
22.4%
20.2%
7.9%
10.0%
0.0%
Less than 30
minutes
30 minutes to 1
hour
1 hour to 1.5
hours
2.4%
1.5 to 2 hours
More than 2
hours
How did you travel to the location of your last agency shift?
80.0%
70.0%
67.1%
60.0%
50.0%
40.0%
30.0%
20.0%
9.6%
10.0%
0.0%
Car
Train
10.9%
5.6%
Underground
Bus
2.7%
4.1%
Walk / Cycle
Other
Was your last shift day, night or Sunday?
60.0%
53.2%
50.0%
39.3%
40.0%
30.0%
20.0%
7.6%
10.0%
0.0%
Day
Night
Sunday
16
32.
Around three quarters of agency shifts are in the usual area of practice for a nurse. For the
quarter of agency nurses that said that their most recent agency shift was in a different
practice area (441 responses), the most common alternative area of practice was general
nursing (26.5%). Around one third of agency nurses had less than 24 hours’ notice of their
most recent agency shift.
Was your last agency shift in your usual area of
practice?
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
77.2%
22.8%
Yes
No
If no, please specify the area in which you carried
out your last placement:
Midwifery
Mental Health
Theatres
Paediatrics
ITU
Health Visitor
Community
Oncology
General
5.4%
15.2%
7.3%
9.1%
16.1%
11.6%
0.0%
0.0%
6.8%
2.0%
26.5%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
For your last shift, how much notice did you get?
80.0%
68.4%
70.0%
60.0%
50.0%
40.0%
30.0%
17.5%
20.0%
10.0%
0.0%
3.4%
6.2%
4.4%
Less than one 1 to 3 hours 3 to 5 hours 5 to 24 hours More than 24
hour
hours
17
33.
Nearly one quarter of agency nurses (23.7%) report having registered with a new agency
in return for higher pay in the past 12 months.
Have you ever registered with a new agency in return for
higher pay?
70.0%
62.9%
60.0%
50.0%
40.0%
30.0%
23.7%
20.0%
8.9%
10.0%
0.0%
34.
Yes, in the past 12
months
4.4%
Yes, in the past 12
months to 3 years
Yes, longer than 3
years ago
No
Nearly half of agency nurses (45%) are permanent NHS employees. Approximately 29% of
agency nurses have full-time positions in the NHS, and a further 17% have part-time
positions.
Are you currently employed (on a permanent basis) by an
NHS Trust?
60.0%
54.6%
50.0%
40.0%
30.0%
28.9%
16.5%
20.0%
10.0%
0.0%
Yes, full-time
Yes, part-time
No
18
35.
Agency nurses were asked their main reason for working through a staffing agency.
•
Agency nurses with permanent NHS jobs said that they mostly work through a
staffing agency because of the higher rates of pay on offer compared with shifts
through a staff bank (64% out of 857 responses). A further 20% of these nurses said
that their main motivation for agency work is to work extra shifts at a different location
or gain experience in different areas to their permanent job.
•
Around two thirds of agency nurses (63% out of 1,034 responses) without permanent
NHS jobs cite the flexibility of agency work as a key driver for their decision to work
through an agency. A significant proportion of this requirement for flexibility by
agency nurses is driven by childcare requirements. Around 20% of nurses say that
flexibility for childcare is their main reason for working through an agency.
What is your main reason for working through a staffing
agency? (Nurses with permanent NHS jobs)
70%
64%
60%
50%
40%
30%
20%
13%
11%
10%
0%
8%
4%
Agency shifts pay Prefer to work To gain experience Unable to work
more than extra extra shifts at a in areas different
enough extra
shifts through my different location to my permanent shifts through my
position
trust’s staff bank to my permanent
trust’s staff bank
position
Other
What is your main reason for working through a staffing agency?
(Nurses without permanent NHS jobs)
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
44%
23%
19%
11%
Flexibility for Higher pay than Flexibility for
other lifestyle
permanent
childcare
reasons
employment or
working through
a staff bank
1%
1%
Unable to
secure a
permanent
position
Unable to work
enough shifts
through the
staff bank(s)
that I am
registered with
Other
19
36.
Agency nurses were asked what action they would take if paid at the proposed price cap
levels.
•
More than half of agency nurses (54%) said that they would change career (21%),
seek work outside England (16%), or reduce agency shifts without increasing hours
in permanent employment or bank shifts (16%).
•
This compares to the 13% of nurses that said they would increase the number of
agency shifts that they work (to compensate for the loss of income as a result of the
price cap).
•
The number of nurses that anticipate shifting from agency employment to permanent
positions or increased hours in permanent employment was less than 10%.
If the Government caps agency rates, which of the following are you
most likely to do?
25%
21%
20%
17%
15%
16%
16%
13%
10%
8%
5%
5%
0%
Change
career
Keep working Work outside Reduce
Increase
the same
England agency shifts agency shifts
hours
without
increasing
bank shifts or
hours in
permanent
job
4%
Reduce
Reduce
agency shifts agency shifts
and increase and obtain
hours worked permanent
in permanent nursing job
job and/or
and/or
bank shifts increase bank
shifts
Other
20
37.
Of those agency nurses that said they would increase the number of agency shifts that
they would work (13% of total, or 248 respondents), around one third said that they would
work one additional shift per week, and another third said they would work two additional
shifts per week.
38.
Of those agency nurses that said they would decrease the number of agency shifts that
they work (21% of total, or 466 respondents), most said that they would work one fewer
agency shift per week, and around one third said they would work two fewer agency shifts
per week.
How many additional agency shifts per week would you
work? (If would work more)
40.0%
35.0%
35.3%
34.5%
30.0%
25.0%
17.7%
20.0%
12.4%
15.0%
10.0%
5.0%
0.0%
One
Two
Three
More than three
How many fewer agency shifts per week would you work? (If
would work less)
50.0%
45.0%
45.2%
40.0%
35.0%
28.9%
30.0%
25.0%
20.0%
16.5%
15.0%
9.4%
10.0%
5.0%
0.0%
One
Two
Three
More than three
21
39.
Nearly two thirds of agency nurses stated that under the price caps they would not be
willing to travel as far as they do currently for agency shifts. More than 90% said they
would only be willing to travel a maximum of one hour, compared with nearly 60% who are
currently willing to travel more than one hour for an agency shift.
If the Government caps payments for agency work,
how would this affect how far you are willing to travel
for agency shifts?
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
66.3%
22.0%
11.7%
Would be willing to
travel further to work at
more distant locations
No change
Would only be willing to
work at closer locations
What is the maximum time that you would currently
travel for an agency shift?
32.6%
35.0%
33.1%
30.0%
25.0%
17.4%
20.0%
15.0%
10.0%
8.6%
8.3%
5.0%
0.0%
Less than 30 30 minutes to 1 hour to 1.5 1.5 to 2 hours More than 2
minutes
1 hour
hours
hours
What is the maximum time that you would travel for
an agency shift if the Government caps agency pay?
60.0%
52.1%
50.0%
40.0%
38.8%
30.0%
20.0%
10.0%
0.0%
7.0%
1.6%
0.5%
Less than 30 30 minutes to 1 hour to 1.5 1.5 to 2 hours More than 2
minutes
1 hour
hours
hours
22
40.
Nearly 40% of agency nurses stated that they would be willing to work more of their shifts
in unsocial hours under the proposed price caps. (This would presumably be to mitigate
the effect of a lower price per hour.)
If the Government caps agency pay, which of the following are you
most likely to do?
42.3%
45.0%
39.2%
40.0%
35.0%
30.0%
25.0%
20.0%
18.6%
15.0%
10.0%
5.0%
0.0%
Work more of my shifts in
normal hours
No change to my shift patterns
unsocial hours
What is your ethnic group?
Other ethnic group: r. Any other ethnic group
4%
Other ethnic group: q. Arab
0%
Black/African/Caribbean/Black British: p. Any…
4%
Black/African/Caribbean/Black British: o.…
4%
Black/African/Caribbean/Black British: n. African,
22%
Asian, Asian British: m. Any other Asian…
8%
Asian, Asian British: l. Chinese
1%
Asian, Asian British: k. Bangladeshi
1%
Asian, Asian British: j. Pakistani
1%
Asian, Asian British: i. Indian
4%
Mixed or Multiple ethnic groups: h. Any other…
1%
Mixed or Multiple ethnic groups: g. White and…
1%
Mixed or Multiple ethnic groups: f. White and…
2%
Mixed or Multiple ethnic groups: e. White and…
2%
White: d. Any other White background
8%
White: c. Gypsy/Traveller
1%
White: b. Irish
3%
White: a. English/Welsh/Scottish/Northern…
43%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
23
4.
DOCTORS’ SURVEY
41.
This section sets out the results of the survey of locum doctors. Survey results are
presented in the same order as the questionnaire. A copy of the questionnaire is at
Appendix B.
42.
There were 675 responses to the locum doctors questionnaire out of a total of 2,944 to
whom the questionnaire was sent. This represents a response rate of approximately 23%.
What is your age?
45.0%
38.7%
40.0%
35.0%
30.0%
25.8%
25.0%
20.0%
20.0%
15.0%
10.5%
10.0%
5.0%
0.0%
43.
4.9%
0.1%
18-24
25-34
35-44
45-54
55-64
65 and over
The largest share of locum doctors responding to the survey live in London (25.5%). Only
a very small number of locum doctors responding to the survey do not live in England.
London
West Midlands
North West England
Yorkshire & Humber
South East England
South West England
East Midlands
East of England
North East England
Wales
Scotland
Northern Ireland
25.5%
15.9%
15.1%
10.8%
8.7%
6.4%
6.1%
4.7%
3.1%
1.9%
1.5%
0.3%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
24
44.
Around half of locum doctors are citizens of a country other than, or in addition to, the UK.
Are you a citizen of a country other than, or in addition to,
the UK?
UK Only
Other
Nigeria
Pakistan
India
Poland
Republic of Ireland
South Africa
Sri Lanka
Greece
Egypt
Italy
Hungary
Spain
Romania
Iraq
Sudan
3%
3%
2%
1%
1%
1%
1%
1%
1%
1%
1%
1%
0%
45.
52%
10%
8%
7%
6%
10%
20%
30%
40%
50%
60%
Most locum doctors who responded to the survey are consultant grade (41.2%), with a
further 27.0% at specialty doctor level.
What is your current grade?
45.0%
41.2%
40.0%
35.0%
30.0%
27.0%
25.0%
20.0%
15.1%
15.0%
5.0%
0.0%
8.4%
8.1%
10.0%
0.1%
FH01
(formerly
FY1/PrHO)
FH02
(formerly
FY2/SHO)
Specialty
STR Higher
Doctor
(formerly
(formerly
ST3/SpR)
Staff Grade /
Associate
Specialist)
STR Lower
(formerly
ST1/ST2)
Consultant
25
46.
The most common specialty reported by locum doctors who responded to the survey was
psychiatry (26.8%) followed by emergency medicine (24.1%), and general medicine
(16.3%).
What is your specialty?
Psychiatry
26.8%
Emergency Medicine
24.1%
General Medicine
16.3%
Pathology
11.0%
Women’s & Children
6.7%
Surgery and Specialist Surgery
5.3%
General Practitioner
Anaesthetics
Radiology
0.0%
47.
3.7%
3.0%
2.2%
0.9%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Slightly more than a quarter of locum doctors (26.8%) are registered with one or more NHS
staff banks.
Are you currently registered as part of a staff bank for one or
more NHS trusts?
80.0%
72.1%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
11.7%
16.1%
10.0%
0.0%
Yes, more than one
Yes, just one
No
26
48.
Of those doctors registered with a staff bank (26.8%, 187 responses), around a third
(36.3%) reported doing less than ten bank shifts in the past 12 months. However, some
locum doctors are also doing many bank shifts, with 21.4% reporting that they have carried
out more than 100 bank shifts in the past 12 months (i.e. around two per week).
49.
The pay differential between bank and agency shifts for doctors is less pronounced for
locum doctors compared with agency nurses. Nearly half of locum doctors (44.9%)
reported that their last bank shift paid the same as their last agency shift, compared with
16% of nurses.
How many bank shifts have you worked in the past 12
months? (if you are part of a bank)
30.0%
25.1%
25.0%
21.4%
20.0%
15.0%
17.6%
15.5%
11.2%
9.1%
10.0%
5.0%
0.0%
None
Less than 10
10 to 24
25 to 49
50 to 100
More than
100
How much were you paid for your last bank shift? (if you are
part of a bank)
50.0%
44.9%
45.0%
40.6%
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
14.4%
10.0%
5.0%
0.0%
More than your last agency
shift
The same as your last
agency shift
Less than your last agency
shift
27
50.
More than two thirds of locum doctors (69.7%) are registered with more than one staffing
agency (compared with around half of agency nurses), and more than half of locum
doctors (59.2%) first started working with a staffing agency in the past three years
(compared with 70% of agency nurses).
35.0%
30.0%
28.0%
29.5%
25.0%
21.2%
19.0%
20.0%
15.0%
10.0%
5.0%
0.0%
2.3%
One
Two
Three
More than three
Don’t
know/can’t
remember
How long has it been since you first started working through
a staffing agency?
45.0%
38.7%
40.0%
35.0%
30.0%
25.0%
20.0%
20.5%
17.6%
17.5%
15.0%
10.0%
5.1%
5.0%
0.0%
0.6%
Less than a
year
1 to 3 years
3 to 5 years 5 to 10 years 10 to 20 years More than 20
years
28
51.
Nearly 40% of locum doctors have permanent jobs with an NHS Trust, with most of these
being full-time jobs.
Are you currently employed by an NHS Trust?
70.0%
60.7%
60.0%
50.0%
40.0%
33.0%
30.0%
20.0%
10.0%
6.3%
0.0%
52.
Yes, full-time
Yes, part-time
No
Around half of locum doctors with permanent NHS jobs reported that their main reason for
working through a staffing agency was that it paid more than extra shifts through a staff
bank, while around 29% reported that their main reason for agency working was to gain
experience in different areas or to work in a different location during their extra shifts.
What is your main reason for working through a staffing agency? (Doctors
with permanent NHS jobs)
60%
50%
50%
40%
30%
20%
10%
0%
16%
13%
7%
4%
2%
2%
Agency shifts To gain
Prefer to
Unable to Flexibility for Additional Transition to
pay more experience work extra work enough
other
income on retirement,
in areas
shifts at a extra shifts
lifestyle
top of
supplement
than extra
different to different through my reasons
shifts
permanent retirement
my
location than trust’s staff
position
through my
income
trust’s staff permanent
my
bank
position permanent
bank
position
5%
Other
29
53.
Nearly two thirds of locum doctors without permanent NHS jobs cited the need for flexibility
as their main reason for working through a staffing agency. Less than one third (27%) said
that they worked through an agency in return for higher pay than a permanent position.
What is your main reason for working through a staffing agency?
(Doctors without permanent NHS jobs)
60%
54%
50%
40%
27%
30%
20%
11%
10%
0%
54.
2%
Flexibility for Higher pay Flexibility for
other lifestyle
than
childcare
reasons
permanent
employment
1%
4%
1%
Transition to Unable to Previous poor
retirement,
secure a experience in
supplement permanent permanent
retirement
position
NHS
income
employment
Other
Slightly more than one third of locum doctors (35.8%) said that they had at some point
registered with a new staffing agency in return for higher pay. This is around the same
proportion as for agency nurses (37.0%).
Have you ever registered with a new agency in return for higher
pay?
70.0%
64.2%
60.0%
50.0%
40.0%
30.0%
20.0%
19.4%
10.9%
10.0%
0.0%
5.5%
Yes, in the past 12
months
Yes, in the past 12
months to 3 years
Yes, longer than 3 years
ago
No
30
55.
Around 40% of locum doctors take agency work in the form of individual shifts, while
around 60% work through longer term placements.
Does your agency work usually take the form of single
shifts or longer-term placements?
70.0%
60.0%
60.0%
50.0%
40.0%
40.0%
30.0%
20.0%
10.0%
0.0%
56.
Single shifts
Longer-term placements
For locum doctors that take agency work in the form of individual shifts, the number of
agency shifts that were worked in the past 12 months varied significantly. However, nearly
half (45.3%) reported working 24 or less shifts in the past 12 months (i.e. two or less shifts
per month). Nearly half (48.0%), however, reported working an agency shift in the past
week.
In the past 12 months, how many shifts have you
worked through any agency with which you are
registered?
28.0%
30.0%
25.0%
20.0%
18.9%
15.7%
15.0%
19.3%
12.2%
10.0%
5.0%
0.0%
4.3%
1.6%
None
Less than 10 to 24
10
25 to 49 50 to 100 100 to 200More than
200
How long has it been since your last agency shift?
60.0%
50.0%
48.0%
40.0%
24.8%
30.0%
22.4%
20.0%
10.0%
0.0%
2.8%
Less than 1
week
1 week to 1
month
2.0%
1 to 6 months 6 to 12 months More than 12
months
31
57.
Most locum doctors travelled (58.3%) less than an hour to their most recent agency shift,
and around three quarters (76.0%) travelled by car to their place of work.
For your last agency shift, on average how long did it take
you to get there from home?
45.0%
38.6%
40.0%
35.0%
30.0%
25.0%
20.0%
20.9%
19.7%
15.0%
11.4%
10.0%
9.4%
5.0%
0.0%
Less than 30 min 30 min to 1.5
hours
1 hour to 1.5
hours
1.5 to 2 hours
More than 2
hours
How did you travel to the location of your last agency shift?
(Doctors who work shifts)
80.0%
76.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Car
8.3%
7.5%
Train
Underground
2.0%
2.4%
3.9%
Bus
Walk / Cycle
Other
32
58.
There was a fairly even distribution of shifts across days, nights and weekends for locum
doctors, with around one fifth of locum doctors getting less than one day’s notice of their
shift.
Was your last shift day, night or weekend?
50.0%
45.3%
45.0%
40.0%
35.0%
29.1%
30.0%
25.6%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
Day
Night
Weekend
For your last shift, how much notice did you get?
90.0%
83.9%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
10.6%
0.8%
2.8%
2.0%
Less than one
hour
1 to 3 hours
3 to 5 hours
5 to 24 hours
More than 24
hours
33
59.
Nearly all locum doctors work through a limited company or similar arrangement for their
agency work.
For your last agency shift, did you work PAYE or through a
limited company / umbrella company / other arrangement?
100%
89%
90%
80%
70%
60%
50%
40%
30%
20%
11%
10%
0%
60.
PAYE
Limited company / Umbrella company /
other arrangement
For locum doctors that work through longer term placements (as opposed to individual
agency shifts), which was around 60% of respondents, most have worked at least one
placement in the past 12 months.
In the past 12 months, how many placements have you had,
including those organised through a staffing agency and
those that have been arranged outside a staffing agency?
35.0%
30.7%
30.0%
25.5%
25.0%
17.8%
20.0%
15.0%
10.0%
5.0%
0.0%
11.6%
9.0%
3.1%
None
2.3%
One
Two
Three
Four
Five
More than
five
34
How long has it been since your last placement?
45.0%
40.0%
35.0%
39.7%
34.0%
30.0%
25.0%
20.0%
13.1%
13.1%
6 to 12 months
More than 12
months
15.0%
10.0%
5.0%
0.0%
61.
Less than 1 month
1 to 6 months
Around 60% of locum doctors working through placements required accommodation for
their most recent placement, with nearly 20% travelling more than three hours to this
placement.
For your last placement, how far did you travel from home?
40.0%
36.6%
35.0%
31.2%
30.0%
25.0%
20.0%
13.9%
15.0%
13.1%
10.0%
5.2%
5.0%
0.0%
Less than 1 hour
1 to 2 hours
2 to 3 hours
3 to 4 hours
More than 4
hours
How did you travel to the location of your last placement?
80.0%
73.2%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
8.2%
10.0%
0.0%
Car
Train
9.8%
3.9%
2.8%
2.1%
Underground
Bus
Walk / cycle
Other
35
Was accommodation required for your last placement?
70%
59%
60%
50%
40%
41%
30%
20%
10%
0%
62.
Yes
No
Nearly all doctors working through placements report that they work through a limited
company or similar arrangement for their agency work.
For your last placement, did you work PAYE or through a
limited company / umbrella company / other arrangement?
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
94%
6%
PAYE
other arrangement
36
63.
The majority of doctors (53%) said that they would work outside England if the proposed
price cap was introduced. A further 21% said they were likely to change career or reduce
agency work without increasing bank shifts or permanent hours. Only 7% said they would
keep working the same hours as currently, and 2% said they would increase the number of
agency shifts. The proportion of locum doctors that anticipate shifting from agency
employment to permanent positions or increased hours in permanent employment was
around 2%.
60%
53%
50%
40%
30%
20%
10%
10%
0%
Work
outside
England
No longer
work agency
or bank
shifts
8%
Change
career
8%
11%
4%
2%
Stop agency Reduce
Keep
work and
agency
working
obtain
shifts
same hours
permanent without
job
increasing
bank shifts
or hours in
permanent
job
2%
2%
Increase
agency
shifts
Reduce
agency
shifts and
increase
bank shifts
or hours in
permanent
job
Other
(please
specify)
37
64.
Those locum doctors working through individual shifts were asked how the agency price
caps would affect the number of shifts that they work. Around half of those that said they
would increase the number of shifts worked (2% of total) said they would work three or
more additional shifts per week. Similarly, around half of those that said they would reduce
the number of shifts worked (4% of total) said they would work three or more less shifts per
week.
How many additional agency shifts per week would you work? (If
would work more)
60.0%
54.5%
50.0%
40.0%
27.3%
30.0%
20.0%
10.0%
0.0%
9.1%
9.1%
One
Two
Three
More than three
How many less agency shifts per week would you work? (If would
work less)
60.0%
48.6%
50.0%
40.0%
30.0%
21.6%
27.0%
20.0%
10.0%
0.0%
2.7%
One
Two
Three
More than three
If the Government adopts these plans, which of the following are
you most likely to do?
46.4%
50.0%
40.0%
34.5%
30.0%
19.0%
20.0%
10.0%
0.0%
normal hours
No change to my shift
patterns
unsocial hours
38
65.
Nearly 60% of locum doctors that work through individual shifts said that they would only
be willing to work at closer locations following the introduction of agency pay caps, and the
maximum distance that these doctors would be willing to travel drops significantly.
If the Government caps pay for agency work, how would this
affect how far you are willing to travel for agency shifts?
70.0%
58.7%
60.0%
50.0%
40.0%
27.2%
30.0%
20.0%
14.2%
10.0%
0.0%
Would be willing to travel
further to work at more
distant locations
No change
Would only be willing to work
at closer locations
What is the maximum distance that you would currently travel
for an agency shift?
30.0%
25.5%
25.0%
22.8%
22.8%
22.1%
1 hour to 1.5
hours
1.5 to 2 hours
More than 2
hours
20.0%
15.0%
10.0%
6.7%
5.0%
0.0%
Less than 30 min 30 min to 1 hour
What is the max. distance you would be willing to travel for an
agency shift if the Government caps agency pay?
60.0%
57.0%
50.0%
40.0%
28.9%
30.0%
20.0%
9.4%
10.0%
0.0%
Less than 30
minutes
30 min to 1 hour
1 hour to 1.5
hours
2.7%
2.0%
1.5 to 2 hours
More than 2
hours
39
66.
Around two thirds (67.8%) of locum doctors that work through longer term placements said
that they would only be willing to travel shorter distances following the introduction of
agency pay caps. Only a fifth of these doctors would be willing to take placements that
required accommodation. A significant impact can also be seen on the distance that locum
doctors would be willing to travel for a work placement.
If the Government caps agency pay, would you be willing to
travel the same distances for placements as now?
80.0%
67.8%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
20.4%
11.9%
10.0%
0.0%
greater distances
No change
travel shorter distances
Would you still be willing to take placements that require
accommodation?
90.0%
79.7%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
20.3%
10.0%
0.0%
Yes
No
40
What is the maximum distance that you would currently
travel for a placement?
35.0%
31.4%
30.0%
23.4%
25.0%
20.7%
20.0%
15.0%
13.8%
10.7%
10.0%
5.0%
0.0%
Less than 30 min 30 min to 1 hour 1 hour to 1 and 1 and a half to 2
a half hours
hours
More than 2
hours
What is the maximum distance you would be willing to travel
for a placement if the Government caps agency pay?
50.0%
45.0%
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
45.2%
36.0%
8.4%
7.7%
2.3%
0.4%
Less than 30 30 min to 1 1 hour to 1.5 1.5 to 2 hours More than 2
min
hour
hours
hours
N/a
41
4.4%
5.9%
Black/African/Caribbean/Black British: p. Any other…
0.8%
Black/African/Caribbean/Black British: o. Caribbean
0.5%
13.6%
Asian, Asian British: m. Any other Asian background
4.8%
0.6%
1.9%
13.9%
16.6%
Mixed or Multiple ethnic groups: h. Any other Mixed…
0.6%
Mixed or Multiple ethnic groups: g. White and Asian
0.8%
Mixed or Multiple ethnic groups: f. White and Black…
1.4%
Mixed or Multiple ethnic groups: e. White and Black…
0.6%
13.2%
0.2%
White: b. Irish
0.8%
White: a. English/Welsh/Scottish/Northern Irish/British
0.0%
19.3%
5.0%
10.0%
15.0%
20.0%
25.0%
42
5.
ALLIED HEALTH PROFESSIONALS’ SURVEY
67.
This section sets out the results of the survey of locum allied health professionals (AHPs).
Survey results are presented in the same order as the questionnaire. A copy of the
questionnaire is at Appendix C.
68.
There were 978 responses by locum AHPs out of a total of 5,486 to whom the
questionnaire was sent. This represents a response rate of approximately 19%.
What is your age?
40.0%
34.8%
35.0%
30.0%
25.9%
25.0%
20.4%
20.0%
13.1%
15.0%
10.0%
5.0%
0.0%
69.
3.5%
2.4%
18-24
25-34
35-44
45-54
55-64
65 and over
The largest share of AHPs responding to the survey live in London, with only a very small
number of respondents from outside England.
London
North West England
South East England
Yorkshire & Humber
West Midlands
South West England
East Midlands
East of England
Wales
North East England
Scotland
Northern Ireland
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
43
70.
Most locum AHPs are UK citizens only, but around 30% have citizenship of other
countries.
Are you a citizen of a country other than, or in addition to,
the UK?
UK only
69%
Other
7%
Australia
7%
Republic of Ireland
3%
Portugal
3%
South Africa
2%
New Zealand
2%
Nigeria
2%
India
1%
Poland
1%
United States
1%
Ghana
1%
Zimbabwe
1%
Italy
1%
Canada
1%
0%
71.
10%
20%
30%
40%
50%
60%
70%
80%
Most locum AHPs are Band 6 (39.1%) or Band 7 (32.1%) with a further 13.3% at Band 5.
This contrasts with agency nurses where most are Band 5 (54.5%) or Band 6 (31.5%).
What is your current pay band?
45.0%
39.1%
40.0%
35.0%
32.1%
30.0%
25.0%
20.0%
13.3%
15.0%
10.0%
5.0%
0.0%
6.4%
1.4%
1.4%
2.4%
Band 2
Band 3
Band 4
2.9%
Band 5
Band 6
1.0%
Band 7 Band 8a Band 8b Band 8c
44
72.
Locum AHPs that responded to the survey are spread across a wide variety of professional
groups, including Biomedical Scientists (14%), Clinical Physiologists (12%) and
Physiotherapists (11%).
What is your professional group?
Biomedical Scientist
Clinical Physiologist
Physiotherapist
Pharmacy
Counsellors & Psychotherapists
Psychological Therapists/PWP
Diagnostic Radiography
Psychologist
Occupational Therapist
Podiatrist
Dietician
Speech and Language Therapist
Audiologist
Anatomical Pathology
Other
14%
12%
11%
8%
8%
7%
7%
7%
6%
6%
6%
4%
2%
2%
14%
0%
73.
2%
4%
6%
8%
10%
12%
14%
16%
Around two thirds of locum AHPs (67.5%) are registered with more than one staffing
agency.
35.0%
32.5%
31.1%
30.0%
23.4%
25.0%
20.0%
15.0%
13.0%
10.0%
5.0%
0.0%
One
Two
Three
More than three
45
74.
Around two thirds of locum AHPs (65.6%) have started working through a staffing agency
in the past three years. This compares with around 70% of agency nurses and 59% of
locum doctors. More than 80% of locum AHPs that responded to the survey have
undertaken a placement in the past 12 months.
How long has it been since you first started working through a
staffing agency?
45.0%
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
38.3%
27.3%
14.6%
12.9%
6.3%
0.5%
Less than a
year
1 to 3 years
3 to 5 years
5 to 10 years 10 to 20 years More than 20
years
In the past 12 months, how many placements have you had,
including those organised through a staffing agency and those
arranged outside a staffing agency?
35.0%
29.0%
30.0%
32.0%
25.0%
19.0%
20.0%
15.0%
10.0%
5.0%
0.0%
7.2%
5.2%
None
5.0%
2.6%
One
Two
Three
Four
Five
More than
five
How long has it been since you started your most recent
placement?
50.0%
45.2%
40.0%
30.0%
20.0%
19.5%
19.2%
16.2%
10.0%
0.0%
Less than 1 month
1 to 6 months
6 to 12 months
More than 12 months
46
75.
Locum AHPs reported travelling significant distances to their most recent placement, with
nearly 30% travelling more than 1.5 hours. Nearly three quarters reported that
accommodation was required for their most recent placement.
For your most recent placement, on average how long did it
take you to get there from home?
35.0%
29.5%
30.0%
25.6%
25.0%
20.0%
15.0%
15.4%
15.6%
14.0%
10.0%
5.0%
0.0%
Less than 30
minutes
30 min to 1 hour
1 hour to 1.5
hours
1.5 hours to 2
hours
More than 2
hours
How did you travel to the location of your most recent
placement?
70.0%
60.0%
60.0%
50.0%
40.0%
30.0%
20.0%
15.4%
8.6%
10.0%
0.0%
Car
Train
Underground
3.4%
Bus
5.8%
6.8%
Walk / Cycle
Other
Was accommodation required for your most recent placement?
80%
72%
70%
60%
50%
40%
30%
28%
20%
10%
0%
Yes
No
47
76.
A large proportion of locum AHPS (88%) work through limited companies or similar
arrangements. This is a similar proportion as for locum doctors.
For your most recent placement, did you work PAYE or through
a limited company / umbrella company / other arrangement?
100%
88%
80%
60%
40%
12%
20%
0%
77.
PAYE
other arrangement
Flexibility is the most common reason why locum AHPs work through an agency (54.3%).
Around one quarter (25.1%) report that it is for higher pay compared with a permanent
position. Only a quarter of locum AHPs (23.7%) report registering with a new staffing
agency in return for higher pay.
60.0%
48.3%
50.0%
40.0%
30.0%
25.1%
20.0%
10.0%
0.0%
20.6%
6.0%
Flexibility for
childcare
Flexibility for other
lifestyle reasons
Higher pay than
permanent
employment
Other
48
Have you ever registered with a new agency in return for higher
pay?
90.0%
76.3%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
78.
11.2%
8.7%
Yes, in the past 12
months
Yes, in the past 12
months to 3 years
3.8%
Yes, longer than 3
years ago
No
More than 50% of AHPs anticipate actions, such as working outside England, establishing
private practices, retiring, or otherwise reducing time worked in the NHS, if the proposed
price caps are implemented. That said, a much higher proportion of AHPs (around 23%)
compared with nurses or doctors said that they would try to switch from agency to
permanent employment if the proposed price caps are implemented.
25%
23%
22%
22%
20%
16%
15%
10%
5%
5%
5%
2%
0%
Stop doing
agency
work and
obtain a
permanent
position
Obtain
work
outside
England
Change
career
2%
Do nothing Increase Don't know Stop agency
differently work in
work
private
healthcare
2%
Retire
Other
49
79.
Three quarters of locum AHPs (75.6%) said they would only be willing to travel shorter
distances under agency price caps. Nearly 90% said that they would no longer be willing to
take placements that require accommodation, and the maximum travel time for more than
90% of respondents was less than hour compared with less than 30% currently.
If the Government caps agency payments, how would this
affect how far you are willing to travel for a placement?
75.6%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
19.6%
20.0%
10.0%
0.0%
4.8%
greater distances
No change
travel shorter distances
What is the maximum time that you would currently travel
for a placement?
35.0%
29.9%
30.0%
25.0%
22.6%
22.3%
19.9%
20.0%
15.0%
10.0%
5.0%
0.0%
5.2%
Less than 30
minutes
30 min to 1 hour 1 hour to 1.5
hours
1.5 hours to 2
hours
More than 2
hours
50
What is the maximum time you would be willing to travel for
a placement if the Government caps payments for agency
placements?
60.0%
50.0%
48.0%
44.5%
40.0%
30.0%
20.0%
10.0%
5.9%
1.6%
0.0%
Less than 30 min 30 minutes to 1
hour
1 hour to 1.5
hours
0.0%
1.5 hours to 2
hours
More than 2
hours
Would you be willing to take placements that require
accommodation if the Government caps payments for agency
placements?
100.0%
87.1%
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
12.9%
10.0%
0.0%
Yes
No
51
2.4%
Black/African/Caribbean/Black British: p. Any other…
1.2%
0.6%
1.4%
6.9%
2.6%
1.3%
1.7%
2.4%
6.8%
Mixed or Multiple ethnic groups: h. Any other Mixed…
1.1%
1.1%
Mixed or Multiple ethnic groups: f. White and Black…
1.2%
Mixed or Multiple ethnic groups: e. White and Black…
1.3%
14.8%
0.5%
White: b. Irish
2.8%
0.0%
55.8%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
52
Appendix A - Nursing Survey Questions
Nurse Survey - Survey of Clinical Staff
Introduction to the Survey
ZPB Associates has been commissioned to gather information on how agency nurses are likely to respond if
the government implements its proposal to cap the amount that can be paid to temporary workers by NHS
trusts.
Just to reassure you, everything you tell us is confidential. In line with the Market Research Society’s Code of
Conduct, ZPB Associates will anonymise all responses so that noone will be able to identify you from your
answers. Completing the survey should only take 510 minutes. Please answer all the questions as truthfully
as possible. This survey will close at 9pm Sunday 1st November.
Summary of Comments on Nurse Survey PDF.pdf
This page contains no comments
*1. What is your age?
1824
2534
3544
4554
5564
65 and over
*2. Which part of the UK do you live in?
*3. What is your current pay band?
*4. What is your area of practice?
*5. Are you currently registered as part of a staff bank for one or more NHS Trusts?
Yes, more than one
Yes, just one
No
*6. How many bank shifts have you worked in the past 12 months?
*7. How much were you paid for your last bank shift?
Don't know / can't remember
N/a
*8. How many staffing agencies are you registered with in total?
One
Two
Three
More than three
*9. How long has it been since you first started working through a staffing agency?
Page: 2
Author: Date: 17/11/2015 21:10:03
London
North West England
North East England
Yorkshire & Humber
South West England
South East England
West Midlands
East Midlands
East of England
Scotland
Wales
Northern Ireland
Author: Date: 17/11/2015 21:10:15
Band 2
Band 3
Band 4
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Author: Date: 17/11/2015 21:10:23
General
Oncology
Community
Health Visitor
ITU
Paediatrics
Theatres
Mental Health
Midwifery
Author: Date: 17/11/2015 21:10:32
None
Less than 10
10 to 24
25-49
50-100
More than 100
Don’t know / Can’t remember
Author: Date: 17/11/2015 21:10:44
Less than 1 year
1 to 3 years
3 to 5 years
5 to 10 years
10 to 20 years
More than 20 years
*10. In the past 12 months, how many shifts have you worked through any agency with
which you are registered?
Page: 3
Author: Date: 17/11/2015 21:10:53
None
Less than 10
10 to 24
25-49
50-100
More than 100
My Last Agency Shift
*11. How long has it been since your last agency shift?
Less than 1 week
Between 1 week and 1 month
1 to 6 months
6 to 12 months
More than 12 months
*12. Thinking about your last agency shift, on average how long did it take you to get
there from home?
Less than 30 minutes
30 minutes to 1 hour
1 hour to 1.5 hours
1.5 to 2 hours
More than 2 hours
*13. How did you travel to the location of your last agency shift?
Car
Train
Underground
Bus
Walk / Cycle
*14. Was your last shift day, night or Sunday?
Day
Night
Sunday
*15. Was your last agency shift in your usual area of practice?
Yes
No
*16. If no, please specify the area in which you carried out your last placement:
General
Oncology
Community
Health Visitor
ITU
Paediatrics
Theatres
Mental Health
Midwifery
*17. For your last shift, how much notice did you get?
Less than one hour
1 to 3 hours
3 to 5 hours
5 to 24 hours
More than 24 hours
*18. For your last agency shift, did you work PAYE or through a limited company /
umbrella company / other arrangement?
PAYE
Limited company / Umbrella company / other arrangement
*19. For your last shift, how much were you paid per hour?
*20. Have you ever registered with a new agency in return for higher pay?
Yes, in the past 12 months
Yes, in the past 12 months to 3 years
Yes, longer than 3 years ago
No
Page: 5
Author: Date: 17/11/2015 21:11:00
Less than £15
£15 to £19.99
£20 to £24.99
£25 to £29.99
£30 to £34.99
£35 to £39.99
£40 to £45
More than £45
*21. Are you currently employed (on a permanent basis) by an NHS Trust?
Yes, fulltime
Yes, parttime
No
Page: 6
Author: Date: 17/11/2015 21:11:08
LOGIC
Yes - continue to (22)
No - skip to (24)
*22. What is the main reason you work through a staffing agency?
Unable to work enough extra shifts through my trust’s staff bank
Agency shifts pay more than extra shifts through my trust’s staff bank
Prefer to work extra shifts at a different location to my permanent position
To gain experience in areas different to my permanent position
*23. The Government is consulting on whether to cap the amount paid by the NHS for
agency and bank roles. If this goes ahead, the amount paid for each agency and bank
role will be the equivalent of that paid to a permanent employee in the same role.
(Agency staff, however, would get a higher cash amount than a permanent employee as
they do not receive the same holiday, sick pay and pension payments as permanent
staff).
If the Government adopts these plans, which of the following are you most likely to do?
Increase the number of agency shifts you work
Keep working the same hours
Reduce the number of agency shifts you work without increasing bank shifts or hours in permanent nursing employment
Work outside England
Change career
Reduce the number of agency shifts you work and increase the number of hours worked in your permanent job and/or the number of bank
shifts
Page: 7
Author: Date: 17/11/2015 21:11:15
Increase - skip to (26)
Reduce - skip to (27)
All others - skip to (28)
Flexibility for childcare
Unable to work enough shifts through the staff bank(s) that I am registered with
Higher pay than permanent employment or working through a staff bank
Flexibility for other lifestyle reasons
Unable to secure a permanent position
agency and bank roles. If this goes ahead, the amount paid for each agency and bank
role will be the equivalent of that paid to a permanent employee in the same role.
(Agency staff, however, would get a higher cash amount than a permanent employee as
they do not receive the same holiday, sick pay and pension payments as permanent
staff).
Change career
Reduce the number of agency shifts you work without increasing bank shifts or hours in permanent nursing employment
Reduce the number of agency shifts you work and obtain a permanent nursing position and/or increase the number bank shifts
Page: 8
Author: Date: 17/11/2015 21:11:23
LOGIC
Increase - skip to (26)
Reduce (either answer) - skip to (27)
All others - skip to (28)
*26. How many additional agency shifts per week would you work?
One
Two
Three
More than three
Page: 9
Author: Date: 17/11/2015 21:11:37
LOGIC
All - skip to (28)
*27. How many less agency shifts per week would you work?
One
Two
Three
More than three
*28. If the Government adopts these plans to cap payments for agency and bank work,
how would this affect how far you are willing to travel for agency shifts?
Would be willing to travel further to work at more distant locations
No change
Would only be willing to work at closer locations
Page: 11
Author: Date: 17/11/2015 21:11:46
LOGIC
Further or No change - skip to (31)
*29. What is the maximum time you would be willing to travel for an agency shift if the
Government caps payments for agency placements?
1 hour to 1.5 hours
1.5 to 2 hours
More than 2 hours
*30. What is the maximum time that you would currently travel for an agency shift?
1 hour to 1.5 hours
1.5 to 2 hours
More than 2 hours
which of the following are you most likely to do?
Work more of my shifts in normal hours
Work more of my shifts in unsocial hours
32. Do you have any other comments about the proposals to cap agency pay rates?
*33. What is your ethnic group?
White: b. Irish
Mixed or Multiple ethnic groups: e. White and Black Caribbean
Mixed or Multiple ethnic groups: f. White and Black African
Mixed or Multiple ethnic groups: h. Any other Mixed or Multiple ethnic backgrounds
Black/African/Caribbean/Black British: p. Any other Black/African/Caribbean background
Appendix B - Doctors Survey Questions
Doctors - Survey of Clinical Staff
ZPB Associates has been commissioned to gather information on how agency doctors are likely to respond if
the government implements its proposal to cap the amount that can be paid to temporary workers by NHS
trusts.
Summary of Comments on Doctors Survey PDF.pdf
1824
2534
3544
4554
Page: 2
Author: Date: 17/11/2015 21:04:44
London
North West England
North East England
Yorkshire & Humber
South West England
South East England
West Midlands
East Midlands
East of England
Scotland
Wales
Northern Ireland
5564
Author: Date: 17/11/2015 21:04:51
List of all countries
65 and over
Author: Date: 17/11/2015 21:04:58
FH01 (formerly FY1/PrHO)
FH02 (formerly FY2/SHO)
Specialty Doctor (formerly Staff Grade / Associate Specialist)
STR Higher (formerly ST3/SpR)
STR Lower (formerly ST1/ST2)
Consultant
*3. Are you a citizen of a country other than, or in addition to, the UK?
*4. What is your current grade?
*5. What is your specialty?
*6. Are you currently registered as part of a staff bank for one or more NHS trusts?
Yes, more than one
Yes, just one
No
Author: Date: 17/11/2015 21:05:07
All the sub-specialities listed of the following specialities:
Pathology
Emergency Medicine
General Medicine
Surgery
Specialist Surgery
Anaesthetics
Women’s & Children
Radiology
General Practitioner
Psychiatry
Other
Author: Date: 17/11/2015 21:05:18
LOGIC
No - skip to (9)
*7. How many bank shifts have you worked in the past 12 months?
None
Less than 10 shifts
10 to 24 shifts
25 to 49 shifts
50 to 100 shifts
More than 100 shifts
*8. How much were you paid for your last bank shift?
One
Two
Three
More than three
Don’t know/can’t remember
*11. Are you currently employed by an NHS Trust?
Yes, fulltime
Yes, parttime
No
Page: 4
Author: Date: 17/11/2015 21:05:28
Less than 1 year
1 to 3 years
3 to 5 years
5 to 10 years
10 to 20 years
More than 20 years
Author: Date: 17/11/2015 21:05:37
LOGIC
No - skip to (13)
Unable to work enough extra shifts through my trust’s staff bank
Prefer to work extra shifts at a different location than my permanent position
To gain experience in areas different to my permanent position
Agency shifts pay more than extra shifts through my trust’s staff bank
Page: 5
Author: Date: 17/11/2015 21:05:44
LOGIC
All answers - Skip to (14)
Higher pay than permanent employment
No
*15. Does your agency work usually take the form of single shifts or longerterm
placements?
Single shifts
Longerterm placements
Page: 7
Author: Date: 17/11/2015 21:05:54
LOGIC
Single Shifts - continue to (16)
Longer-term placements - skip to (31)
My Last Agency Shift
*16. In the past 12 months, how many shifts have you worked through any agency with
which you are registered?
*17. How long has it been since your last agency shift?
Less than 1 week
Between 1 week and 1 month
1 to 6 months
6 to 12 months
More than 12 months
*18. For your last agency shift, on average how long did it take you to get there from
home?
1 hour to 1 and a half hours
1 and a half to 2 hours
More than 2 hours
*19. How did you travel to the location of your last agency shift?
Car
Train
Underground
Bus
Walk / Cycle
*20. Was your last shift day, night or weekend?
Day
Night
Weekend
Page: 8
Author: Date: 17/11/2015 21:06:03
None
Less than 10
10 to 24
25-49
50-100
More than 100
*21. For your last shift, how much notice did you get?
Less than one hour
1 to 3 hours
3 to 5 hours
5 to 24 hours
More than 24 hours
*22. For your last agency shift, did you work PAYE or through a limited company /
PAYE
*23. For your last agency shift, how much were you paid per hour?
agency and bank roles.
If this goes ahead, the amount paid for each agency and bank role will be the equivalent
of that paid to a permanent employee in the same role. (Agency staff, however, would
get a higher cash amount than a permanent employee as they do not receive the same
holiday, sick pay and pension payments as permanent staff).
Change career
Reduce the number of agency shifts you work without increasing bank shifts or hours worked in permanent employment
For doctors without a permanent position: Reduce the number of agency shifts you work and obtain a permanent position and/or
increase the number of bank shifts you work
For doctors with a permanent parttime position: Reduce the number of agency shifts you work and increase the number of hours you
work in your permanent job and/or the number of bank shifts
No longer work any agency or bank shifts
Page: 10
Author: Date: 17/11/2015 21:06:14
Less than £15
£15 to £19.99
£20 to £24.99
£25 to £29.99
£30 to £34.99
£35 to £39.99
£40 to £44.99
£45 to £49.99
£50 to £54.99
£55 to £59.99
£60 to £64.99
£65 to £69.99
£70 to £74.99
£85 to £89.99
£90 to £94.99
£95 to £99.99
£100 to £104.99
£105 to £109.99
£110 to £114.99
£115 to £119.99
£120 and over
Author: Date: 17/11/2015 21:06:28
LOGIC
Increase the number of shifts - (25)
Reduce the number of shifts (any of 3 answers) - skip to (26)
All other answers - skip to (27)
*25. How many additional agency shifts per week would you work?
One
Two
Three
More than three
Page: 11
Author: Date: 17/11/2015 21:06:36
LOGIC
All answers - skip to (27)
*26. How many less agency shifts per week would you work?
One
Two
Three
More than three
how would this affect how far you are willing to travel for agency shifts?
Would be willing to travel further to work at more distant locations
No change
Would only be willing to work at closer locations
Page: 13
Author: Date: 17/11/2015 21:06:45
LOGIC
Further or no change - skip to (30)
Close locations - continue to (28)
*28. What is the maximum distance you would be willing to travel for an agency shift if
the Government caps payments for agency placements?
1 hour to 1.5 hours
1.5 to 2 hours
More than 2 hours
*29. What is the maximum distance that you would currently travel for an agency
shift?
More than 2 hours
*30. If the Government adopts these plans, which of the following are you most likely to
do?
Work more of my shifts in normal hours
Work more of my shifts in unsocial hours
Page: 15
Author: Date: 17/11/2015 21:06:53
LOGIC
All answers - skip to (43)
My Last Longer Term Placement
*31. In the past 12 months, how many placements have you had, including those
organised through a staffing agency and those that have been arranged outside a
staffing agency?
*32. How long has it been since your last placement?
Less than 1 month
1 to 6 months
6 to 12 months
More than 12 months
*33. For your last placement, how far did you travel from home?
Less than 1 hour
1 to 2 hours
2 to 3 hours
3 to 4 hours
More than 4 hours
*34. How did you travel to the location of your last placement?
Car
Train
Underground
Bus
Walk / cycle
*35. Was accommodation required for your last placement?
Yes
No
*36. For your last placement, did you work PAYE or through a limited company /
PAYE
*37. For your last longterm placement, how much were you paid per hour?
Page: 16
Author: Date: 17/11/2015 21:07:02
None
One
Two
Three
Four
Five
More than five
Author: Date: 17/11/2015 21:07:10
Less than £15
£15 to £19.99
£20 to £24.99
£25 to £29.99
£30 to £34.99
£35 to £39.99
£40 to £44.99
£45 to £49.99
£50 to £54.99
£55 to £59.99
£60 to £64.99
£65 to £69.99
£70 to £74.99
£85 to £89.99
£90 to £94.99
£95 to £99.99
£100 to £104.99
£105 to £109.99
£110 to £114.99
£115 to £119.99
£120 and over
Do nothing differently
Stop doing agency work and obtain a permanent position
Obtain work outside England
Change career
*39. If the Government adopts these plans, would you be willing to travel the same
distances for placements as you currently do?
Would be willing to travel greater distances
No change
Would only be willing to travel shorter distances
Page: 17
Author: Date: 17/11/2015 21:07:26
LOGIC
Greater and No change - skip to (43)
*40. Would you still be willing to take placements that require accommodation?
Yes
No
*41. What is the maximum distance you would be willing to travel for a placement if
the Government caps payments for agency placements?
1 hour to 1.5 hours
1.5 to 2 hours
More than 2 hours
N/a
*42. What is the maximum distance that you would currently travel for a placement?
More than 2 hours
White: b. Irish
Appendix C - Allied Health Professionals Survey Questions
Allied health professionals and health science services staff - survey of
ZPB Associates has been commissioned to gather information on how allied health professionals and health
science services staff are likely to respond if the government implements its proposal to cap the amount that
can be paid to temporary workers by NHS trusts.
Summary of Comments on AHP Survey
PDF.pdf
Page: 2
Author:
1824
2534
3544
4554
5564
65 and over
*5. What is your professional group?
One
Two
Three
More than three
staffing agency?
Date: 17/11/2015 20:59:41
London
North West England
North East England
Yorkshire & Humber
South West England
South East England
West Midlands
East Midlands
East of England
Scotland
Wales
Northern Ireland
Author:
Date: 17/11/2015 20:56:10
List of all countries
Author:
Band 2
Band 3
Band 4
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Date: 17/11/2015 20:58:54
Author:
Date: 17/11/2015 20:59:22
Ambulance Staff
Anatomical Pathology
Arts Therapist
Audiologist
Biomedical Scientist
Chaplaincy
Clinical Physiologist
Clinical Science
Counsellors & Psychotherapists
Cytology
Dental Services
Diagnostic Radiography
Dietician
Genetic Counselling
Health Promotion
Medical Photography
Occupational Therapist
Optometrist
Orthopaedic / Plaster Technician
Orthoptist
Pharmacy
Comments from page 2 continued on next page
1824
2534
3544
4554
5564
65 and over
*5. What is your professional group?
One
Two
Three
More than three
staffing agency?
Phlebotomist
Physiotherapist
Play Specialist
Podiatrist
Prosthetists & Orthotists
Psychological Therapists/PWP
Psychologist
Sexual Health
Speech and Language Therapist
Therapeutic Radiograpy
Other
Author:
Date: 17/11/2015 20:59:51
Less than 1 year
1 to 3 years
3 to 5 years
5 to 10 years
10 to 20 years
More than 20 years
Author:
Date: 17/11/2015 20:59:58
None
One
Two
Three
Four
Five
More than five
My Most Recent Placement
*9. How long has it been since you started your most recent placement? (If you are
currently working in a placement, please treat this as your most recent placement.)
Less than 1 month
1 to 6 months
6 to 12 months
More than 12 months
*10. For your most recent placement, on average how long did it take you to get there
from home?
1 hour to 1.5 hours
1.5 hours to 2 hours
More than 2 hours
*11. How did you travel to the location of your most recent placement?
Car
Train
Underground
Bus
Walk / Cycle
*12. Was accommodation required for your most recent placement?
Yes
No
*13. For your most recent placement, did you work PAYE or through a limited company
/ umbrella company / other arrangement?
PAYE
*14. For your most recent placement, how much were you paid per hour?
Page: 3
Author:
Date: 17/11/2015 21:00:10
Less than £15
£15 to £19.99
£20 to £24.99
£25 to £29.99
£30 to £34.99
£35 to £39.99
£40 to £45
More than £45
Higher pay than permanent employment
No
Do nothing differently
Stop doing agency work and obtain a permanent position
Unable to obtain a permanent position
Obtain work outside England
Change career
how would this affect how far you are willing to travel for a placement?
Would be willing to travel greater distances
No change
Would only be willing to travel shorter distances
*19. What is the maximum time you would be willing to travel for a placement if the
1 hour to 1.5 hours
More than 2 hours
*20. What is the maximum time that you would currently travel for a placement?
1 hour to 1.5 hours
More than 2 hours
*21. Would you be willing to take placements that require accommodation if the
Yes
No
White: b. Irish

report - Aldwych Partners

Transcription

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