NHS

NHS

The senior management team of 247 Time have an extensive background in the recruitment industry.  It’s through this experience and lack of available quality software in the marketplace that encouraged them to develop their own software, and 247 Time was born

It was way back in 2011 that 247 Time was formed, initially from a desire by an industrial client to manage more effectively their workforce. The directors sold off the recruitment agency side of the business to concentrate on 247 Time.

With over 30 years’ recruitment agency experience, 247 Time quickly added further expertise by bringing into the business additional expertise to manage sales, marketing and systems.

Clients now range from the NHS trusts, Logistics Industry, Care Homes, Facilities management and Councils.  

Based in Enderby, Leicestershire. Our Head office houses our support team, marketing, accounts & sales. It’s 247 Time’s view that the company will always invest into the system will make products increasingly more productive for clients. It’s that philosophy that underpins our 4 key principles.

247 Time are completely neutral. We do not own any recruitment agency or have any affiliation that would be deemed as a conflict of interest.

The public sector operates to different sets of values from the private sector whose primary objective will always be to concentrate on shareholder ‘return on investment’ value. i.e. profit. Indeed, different parts of the public sector have different governance arrangements. Because it is illegal for a council to run a deficit, service deterioration will always occur before financial failure. No councils are in deficit even though 30% of government grants have been lost in recent budgets.

For the NHS, however, financial failure by moving into deficit will always precede service failure. To ensure quality, standards are met as demand increases, the public rightly, will have it no other way. But, that is a tough balancing act for management in our healthcare system to control. The NHS really matters to people’s lives and the relationship between business management, clinical leadership and the healthcare system of providers, commissioners and regulators is more complex than the autonomy enjoyed in areas such as local government. It’ll always be difficult choosing between the public desire for the best health care and the cost of delivering it.

NHS trusts have reported a third quarter year end deficit of £886 million and the government are looking to harness this by seeking the NHS as a body to make savings of £22 billion by 2020. Senior figures at NHS England advise that, they expect the service to fall well short of its target, and that it will therefore need a further £7bn injection from the Treasury, on top of the £8bn already promised, in order to maintain standards of care – £15bn in all. The NHS is bracing for a bruising battle with ministers, who have told them not to expect any more than the £8bn and to urgently start making substantial savings.

“Our current working assumption is that we can make about £15bn of efficiency savings by 2020, maybe £16bn with a fair wind. There’s no way we’ll achieve the £22bn. That’s pie in the sky,”said one senior NHS official. Another said:

“Delivering the £22bn would involve unprecedented productivity gains. The £22bn is overly ambitious and not very realistic.”

It’s with this mind-set that the challenge lies. Clearly, doing nothing is not an option and with some speed, the NHS are now putting in place rigorous processes to monitor the performance of each trust across a number of key pressure points initially.

One area that is registering highly on every trusts radar is the increasing costs of workforce. Many trusts have over the years spent little time and attention to this, instead focussing some say rightly so, on the clinical needs of their patients.

Late 2015 the Trust Development Authority, who provide governance to NHS trusts instigated a new regime of controlling nursing costs, with tight timeframes on compliance, other high spending areas likely to follow quickly behind. The authority’s aims are simple, look at the ways trust procure nursing, what controls they have in place and where can with the application of best practice can savings be achieved? Indeed, one immediate step they encourage trusts to take is to work collectively as a consortium, buying group or partnership to regionalise nursing staff within predefined locations. With most trusts procuring individually, this is a paradigm shift in working practice with the added complication having to gain buy in from workforce not used to seeing the introduction of completely new procedures.

Over time, trusts have built strong relationships with the supply chain particularly, in a people oriented business, with recruitment agencies. It’s customary that, pay rates, agency margins and contract terms will be different, further complicating the buying and administrative processes. In fact it’s true 247 Time does not provide a mechanism for any disguised employed practices. This is all now to levelled across the whole of the NHS.

All this is of course, just the tip of the iceberg!

When a trust uses a recruitment agency to supply for example, a locum to work at the trust, the agency invoices the trust for the doctors pay.  The whole invoice amount is also subject to VAT at the prevailing rate. So, a doctor paid £100 would cost the trust, in effect, £120 because of HMRC VAT rules.

With Direct Engagement, the trust is paying the doctor the £100 direct and the agency is invoicing the trust for their margin or finder’s fee (in effect, commission) separately.   VAT is payable on the finders fee element only, as  VAT is not applicable to the doctors pay, only the invoice provided by the agency. So, for example, If an agencies fee is £10, then the VAT on this is then only £2 which is reclaimable. Therefore, there is no 20% added to the supply.

With agency spending likely to hit over £3 billion in 2017, the VAT element on this could be as high as £700 million. With the balance between giving the highest levels of care and the increasing cost of paying for it, it’s no wonder that many savvy trusts are looking at ways in which every pound is used as wisely as can be.

247 Time automates this process by generating self-billing within the system so that doctors are paid directly by the trust, The same self-billing process generates each agencies finder’s fee in order that the trust can pay these separately.

Through 247 Time, there is a simple process that allows a trust to pay the worker directly. The agency then receives a finder’s fee for supplying the worker. As the pay is made direct, this means that no VAT is charged. If the agency invoiced directly for the pay and their commission, then VAT would be levied at 20% on the whole invoice.

It’s an easy mechanism for direct engagement. When the trust agrees to use the worker, the agency adds the the required information in to the 247 Time system. This includes any documents required by the trust and could include, for example, right to work, certificates, pension and new starter forms. In addition, the agency would add the candidates bank account information. This allows the trust to payroll the workers’ wages into their own bank account.

The Agency then assigns the candidate to the relevant job role so they appear on that departments timesheet. Once a week the approver goes and approves the hours that the agency has added along with a copy of the approved physical timesheet. This triggers payments to the candidate and the agency along with management information.

247 Time works with all staffings groups and accomodates AHP's. nursing and clerical.  

Staffing a payroll department for temporary workers can be  expensive, especially when factoring in the time and effort it takes to setup a worker who maybe working for only a short period. It therefore, makes sense for trusts to operate a one step process, where they can not only manage a worker,  processes,  approve and pay all in one portal.

This is where the 247 Time payroll service can make a  difference. By using worker’s information already approved for use by the trust, the payroll  service can pay candidates weekly via the traditional PAYE mechanism or as a limited company (with  deductions for tax and other liabilities taken at source). This means that the trust will remain within scope for IR35 regulations.

It is still the trust who will approve each worker’s hours on a weekly basis. Payroll files are available securely within the reports section of 247 Time. These are show the nett amounts due to the candidate, the HMRC and any pension provision for NEST or NHS pensions. The candidates nett pay is remitted to the 247 Time escrow account for release to the candidate same day.

There are a number of frameworks in the marketplace including, The NHS Collaborative Procurement Partnership (CPP), Health Trust Europe (HTE) & Crown Commercial Service (CCS) amongst others. Each of these will have their own set rates for job roles and margins that the supplying agency can charge, everytime they supply a worker to a trust.

In addition, those supplying agencies will certify to the framework that any worker they supply will meet the employment check standards that the NHS require and that as these change will be maintained. This will also include the revalidation of workers where required and that they also adhere to the rules that govern the recruitment industry.

247 Time can work with all frameworks currently available. You can procure 247 Time from the Governments Crown Commercial Service (G-Cloud) via the Digital Marketplace, or the HTE.

The emphasis is increasingly on using approved agencies, that is those who are shown as authorised collectively by the NHS and the Government frameworks. Such frameworks are HTE, LPP and the CCS amongst others. As a matter of urgency the Trust Development Authority are placing stronger controls to ensure that every trust uses frameworks and only approved agencies moving forward.
Non Framework agencies are those suppliers who either are in the process of gaining framework approval or choose as a matter of choice to supply outside of these agreements. Trusts will have used non framework agencies as a case of last resort when all other channels to procure workers have been exhausted. The obvious consequence of this has resulted in higher costs. It’s also become apparent to 247 Time that some recruitment agencies will have both framework agencies and non framework agencies within the same business and play off each other vacancies

Running a busy department in any trust can be challenging, even with the most experienced managers in place.

Take for example, any day, at any trust, where patient numbers may increase, a ward unexpectedly needs to be closed and then add in, workforce not being available or reduced for any number of reasons. Valuable time can be taken away from the front line as managers are forced to spend time calling in resources from either the bank staff or at additional cost, external agencies to maintain clinical service levels, to the required standards.

It’s with that, that many trusts have recognised that there is a need to manage workforce more effectively, through the 247 Time system. The sensible view is that, it’ll create immediately, an environment that will ease a number of pressure points that build up as a result of these needs and bring in a number of other additional benefits as a result.

Looking closely at how rosters are managed and personnel are booked is one way that brings direct benefits into the whole process of personnel management.

 

So what should I expect from a booking system?

The booking process begins with understanding that there is need to fill a vacancy. Ideally, good practice dictates that any vacancy should be foreseen and there is adequate time for the booking team to send out requests and fill them with the right personnel.

Equally, any good booking system should be capable of sending job requests out, electronically to all, in one simple process. Even with last minute bookings, any booking system should be able easily to accommodate this urgency. So, once a vacancy is established, where does the booking team sent the request to? Any credible system should enable the booking request to be sent in a series of established tiers to the right people, according to strict timetable.

An example we use at 247 Time is that, any vacancy should be sent initially to the trusts own bank staff. This keeps costs down and maximises the use of the valuable resource that the trust will have spent some time developing. If the bank are unable to fill the vacancy, the second tier, typically framework agencies are sent the request to fill. These agencies will work within defined rates, margins and will have passed the frameworks requirements in terms of supplying workers. If failing these steps, the vacancy is still not filled, then the option remains to send a request to all other suppliers.

Key here in the booking process is, managing who is working at the trust, at what price, who is supplying the worker and managing the process, all in a managed timeframe.

 

What will a booking system deliver?

Any booking system should deliver not only a structure to manage vacancies, but also a number of other advantages to the trust. Many of these will vary in importance to each trust, but all help build a comprehensive management approach that NHS governance are now seeking from each trust. The adage that ‘if you can’t measure it, you can’t manage it’ is reason alone that many savvy trusts are looking to add the booking system into the other products 247 Time offers as, having one portal to manage the whole process in a simple, intuitive system will give the trust:

  • Control over the whole booking process.
  • Realtime information on filled, unfilled, suggested candidates & bookings to complete.
  • Information on roles that are near to start of shift.
  • Comprehensive Management Information.
  • The booking system works seamlessly with the 247 Time direct engagement model that is used by many NHS trusts throughout the UK

 

Having made the decision to procure 247 Time and use it within your business, you can choose which route to take:

  1. Order Directly from 247 Time.

Easily the quickest way in which to implement 247 Time. There is no difference in the product offering and our service, support and training is still maintained at the highest level.

  1. The Government Marketplace.

The ‘G-cloud’ is the digital marketplace set up by government with the aim of simplifying the procurement process for public sector bodies. 247 Time are on the Cloud Software framework. The product pricing is set and buy procuring 247 Time through the G -Cloud process you can be assured that we have met the strict requirements laid down.

  1. Health Trust Europe

A recent addition to the 247 Time procurement process. Similar to the Governments             G- Cloud, Health Trust Europe (HTE) offer a procurement process at defined prices along with pre-determined product offerings that have met their criteria for supply.

To find out how 247Time™ can help your business call us on
0333 1014 247 or email info@247time.co.uk

Working with Recruitment Agencies

Recruitment agencies play an important role within the care industry and in particular help the NHS to maintain the standards of care that they have to adhere to. It’s through an agencies invaluable bank of workers that a trust can plug into, on demand, to maintain the  required staffing levels. In a people related industry such as recruitment it’s important that any relationship that has been developed over time is able to continue. The flexibility within 247 Time, allows any trust to work with any type of agency, framework or non-framework.

This of course comes at a price and it’s with that, the trusts will opt in the first instance, to procure workforce from framework approved agencies and then only use non framework agencies as a last resort. Those first choice agencies will be governed by the framework agreement. However, using non framework agencies will invariably increase costs as these operate outside of any framework guidelines.

247 Time works with practically all medical recruitment agencies in the UK and as the footprint of 247 Time’s usage grows throughout the UK, any new agency can be added to the supplier bank easily.

Typically, agencies will operate under two payment types. A framework agency working under direct engagement will receive their finder’s fee (commission) as a direct payment is made to the candidate receiving his/her pay directly regardless of their employment status.

Non Framework agencies will receive the whole payment, including finder’s fee and doctor’s pay directly, in turn they are responsible in paying the candidate.

247 Time manages this whole process, easily.

Case Studies

247Time - Heart of England NHS Foundation Trust Heart of England NHS Foundation Trust Download [#BUTTONS(DownloadIcon)#]

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