Now is the opportunity to ensure this is the best time to join the NHS

Aspirational recruitment advertising cannot mask cold reality

Published: 12 May 2020 Government & NHS

The Society welcomes the campaign to recruit people to work as AHPs in the NHS: it is long overdue. But, the positive message is spoilt by the false claim at the end of the video that "There has never been a better time to join us."

Repeatedly making this assertion on prime-time television during the pandemic is insulting to frontline NHS workers who have been worried about the lack of appropriate PPE and the ongoing shortage of Covid-19 testing, adding to staff shortages and increasing stress and anxiety.

Even without the added pressures of Coronavirus, the statement is a lie and undermines the trust of NHS workers in employers and the government. They should be "Making sure there really has never been a better time to join the NHS.”

The recruitment campaign comes on the back of the £5000 annual maintenance grant for students starting pre-registration courses from this September. But we can't take this payment in isolation.

In 2015, George Osborne exposed trainee radiographers and other health professionals to £27,000 of university tuition fees. Teresa May’s government abolished the bursary and access to other grants and loans two years later. Students now are significantly worse off than any previous generation.

The current cohort of third year students, who are delaying graduation by joining the temporary register on the Covid-19 frontline, have borne the brunt of these changes and enter the workplace with no grants, only debt.

This is one example of the Public Value Gap (PVG). Over the past four decades, health professionals have seen their pay, support package and status devalue relative to the growth in pay, rewards and status of the employers. The Public Value Gap has grown and it needs to be closed.

The pandemic has exposed the PVG even more. NHS AHPs know there have definitely been better times to join the NHS.

Trainees and newly qualified health professionals would historically have had access to NHS housing support. In 2017, the government failed to support an NHS Confederation proposal to turn unused NHS land into homes for key health workers.

The NHS has relied on EU and other overseas nationals to fill the gaps for decades. Brexit has seen a significant reduction in applications from EU nationals and an increase in the number leaving the NHS to return home. The Home Office's 'hostile environment' policy has successfully discouraged people from outside Europe coming to the UK to work in the NHS.

Measures such as the discriminatory Immigration Healthcare Surcharge which people applying to work in the UK are required to pay to access the very service they are providing, does not encourage health and medical professionals to apply. This charge will increase to £624 per person a year from October. So a health professional with a partner and two children will pay £2496, as well as visa costs of up to £928 each. Welcome to the UK!

The NHS has relied on overseas staff because of recruitment and retention challenges that have built up over decades. In 2019, many parts of the UK saw more professionals leaving the NHS than recruits. These shortages lead to a self-defeating cycle by fuelling excessive hours and pressures, leading to burnout, and both high absenteeism and presenteeism.

What needs to happen now?

Current NHS staff

  1. Significant pay increases for all NHS staff this year alongside other key workers. This must be backed-up by a full, cross-party parliamentary review with input from unions and professional associations to establish public sector pay levels which permanently close the PVG over the following five years.
  2. Support by government for targeted recruitment and retention to close the gap between Public Value rewards and support and Money Valued bonuses and perks. These could include, for example:

For trainees and students

  • Writing off student loans if someone stays in the profession for a minimum time 
  • Removing the fees burden
  • Incentivising training for key workers with paid study

To fill places in harder to reach communities

  • Targeted payment of pension contributions on a geographic basis

For all NHS and other key workers

  • Support the building of NHS worker homes in perpetuity
  • Support local authorities wanting to extend this to other key workers, especially on brownfield sites and town centres
  • Tax breaks for transport costs
  • Removing discriminatory barriers and disincentives for staff from overseas, especially following Brexit.

The SoR and other allied health profession unions stand ready to engage and work with government and NHS Employers to close the Public Value Gap. Now isn’t the best time to join the NHS. Together, we can make sure it is.