NHS ICB

As NHS leaders juggle meeting the needs of the community with the challenges of finding and recruiting qualified people, low staffing levels and high workloads, it’s inevitable that bottlenecks occur.

With the pressures facing every corner of the NHS, our Continuing Healthcare (CHC) recruitment team is consistently busy.

In this case study, we spoke one of our NHS clients, the Head of Continuing Healthcare Services for an NHS Integrated Care Board (ICB), about using interims to alleviate backlogs in CHC assessments.

Rising case load

When people are newly admitted into a care home, it’s essential that an assessment is done to assess them for NHS funding they may be entitled to and to ensure their needs are being appropriately met. These assessments are conducted by registered NHS CHC nurses who go to the care home, visit the patient, liaise with the family and talk to staff as part of the process.

At this NHS ICB, due to a steady influx of people moving into homes, a backlog of some 350 cases had accrued, with more coming in every day. It was clear that, even with the dedicated CHC team working at maximum capacity, they needed additional support to get back on an even keel.

We felt like we weren’t getting anywhere. Even though the health needs assessments are not as detailed as full CHC assessments, the staff could only expect to get through 3 or 4 of these in a week.

Using CHC nurse interims

Of course, the situation was being monitored, and steps taken to hire internally for substantive, full-time CHC nurses.

But, our client was finding it difficult to recruit and retain nurses in the current climate. And, if they did, new staff took time to get up to speed with the already-stretched team having to resource training.

The benefits of hiring permanent CHC nurses are there long term, but they are not immediate.
Interims are familiar with what’s needed, can produce work at pace and hit the ground running. It felt like the right thing to do, to bring in interim support via agencies and clear the backlog.

She made the decision to hire four interims, initially from April to September, to tackle the issue.

Finding the right recruitment agency

Once our client had decided to work with a specialist agency, she approached three, all on the Crown Commercial Supplier (CCS) framework, to pitch for the project, including Boston Hale.

After discounting the first recruitment agency, who were ‘pushy, tried to get me to retain them rather than talk to other agencies and bombarded me with CVs and emails’, our client was left with a choice of two.

For me, it came down to the personality fit with Simon at Boston Hale. He had a very personal approach and a good understanding of the CHC market. I felt he was reliable, that I could work with him and trust him to put the right people forward.

Of the 8 or 9 CVs Boston Hale’s CHC recruitment team put forward, all but 1 were interviewed. Once again, the final decision was based on who our client felt would fit best into the existing team.

Ongoing support

The objective of using interims was to bring in qualified, experienced staff who would quickly be able to turn the work around and reduce the backlog. These are very specific roles; CHC nurses need to produce clear, accurate documentation. Their decisions have financial implications, and it can be stressful and difficult working with families, which adds to the pressure.

Things don’t always work out and early on, it was clear one of the CHC interim nurses was not able to deliver to the standards required.

The nature of the assessment work is document-heavy and requires accuracy as funding decisions are based on it. We hire interims as experienced people who can do the work without training, and we expect a good result.

Our client quickly reported these issues to Simon who, working with the ICB management team, held meetings with the CHC interim nurse. Plans were put in place to try to improve the output.

Simon gave us a lot of advice and support, and to the nurse concerned. He was very fair, listened and helped us deal with that situation.

Positive outcomes

After a short three week process from pitch to signed contracts, the project started in April. By the beginning of September, the interims had helped achieve the goal of clearing the backlog of 350 cases.

This had immediate benefits for the care homes, which are funded according to patient needs. Whilst they are waiting for assessments to be done, they do not receive money to cover those needs. This has a negative impact on their cash-flow in already challenging times and affects the care homes’ ability to provide the right care for their residents.

And, of course, there are huge benefits for patients and their families too. The assessment looks in detail at their specific needs. Are they in the right place? Are the staff meeting their needs? Are care plans up to date? Are they getting the right diet?

Before the assessment is complete, there is a level of risk. Quality assurance and confidence in the care provision comes once it’s done. The work also feeds into the bigger picture and helps the NHS plan for the future.

What next?

Yes, this project was a success. The NHS ICB cleared the backlog using interims, a sensible and effective use of budget which produced real benefits for the community, case homes and the internal team.
But, people were still coming into nursing homes, more cases had been accruing elsewhere in the NHS system – leading to a build-up of 250 new cases. Our interims are being re-deployed, and the cases are steadily being tackled.

And, would our client work with us again?

Overall, it was a very positive experience. We caught up frequently at the beginning of the project, and now reach out when the need arises rather than have meetings for meetings’ sake.
Simon has been very responsive, got back to me quickly and addressed concerns effectively.
I would recommend Simon and Boston Hale and he will be my first port of call for interims going forward.

If you would like to talk about hiring or contracts in Continuing Healthcare, talk to Simon.

‹ Back