With the NHS under siege and a desperate shortage of GPs, it’s unsurprising that practice managers and GP partners struggle to find doctors and have to turn to recruitment agencies for help bringing in both locums or permanent candidates, writes recruitment expert Ash Higgs, who is also MD at MCG Healthcare.
Sometimes practices in the same area are forced to compete for locums. And when locums are in high demand, costs soar, affecting already overstretched budgets.
At the same time, although job boards provide a way of finding emergency placements, hiring a GP at any price is not good practice nor cost-effective as it drives up market rates. That’s why working in partnership with a trusted recruitment agency can be so beneficial for practices. Working with people who understand and know your needs enables a practice to get a good return on its investment. In short, it lowers recruitment costs.
So, how do practices get the most out of working with a recruitment agency? Here are answers to some of the most frequently asked questions.
How do you choose an agency?
A good starting point is to ensure the agency is accredited by the Recruitment and Employment Confederation (REC). The REC represents 3,300 UK recruitment businesses that live by the same values of professionalism and high-quality service. So, REC accreditation is a kitemark to seek out in an agency.
Check if the the agency is also a ‘framework supplier.’ NHS staffing frameworks are in place to ensure staff pay is kept in line, as well as to ensure you get the best value service by monitoring agencies’ profit margins. Usually these frameworks have very stringent compliance, so where an agency is on an approved framework you know it will take these responsibilities seriously even if you are not engaging them as part of the framework.
Check the agency’s website. This will give you a sense of whether or not the agency is professional. The website will also mention any awards they might have won in recognition of their service.
Read the testimonials on Google and Facebook reviews, but don’t leave it at that. Ask the agency for contact details of other surgeries they currently work with, ideally in your area or PCN.
A good agency seeks to work in partnership with a practice, PCN or ICS and will want to meet with you (possibly virtually). That way, the team can understand more about the practice and its needs, which helps them find the right GP for you. It also enables the agency to sell the benefits of the surgery as opposed to attempting to lure candidates with high pay rates. And they can ensure their clinicians are well-prepared before they undertake the role.
The sign of a good agency is knowledge of its clinicians. It will work with those who are focused on good patient care and have the surgery’s best interest at heart. It won’t work with those who are solely about money. It’s another positive if the agency sends a compliance pack.
A useful tip is for a practice to speak with the clinician directly after they are booked in for locum work or before the booking has been confirmed. And, of course, agree on charges and pay rates in advance.
Keep an eye out for any red flags that might suggest bad practice. For example, the agency may have set the rates too high or sent you CVs that were not requested. This is called ‘hopeful recruitment’, and you should give those agencies a wide berth.
Another indication of poor practice is booking a clinician for locum work and cancelling or changing them at the last minute. This can be a sign that the agency did not have a clinician booked and used a different name to secure the job.
How can a practice encourage the agency to work hard for them to achieve the best results?
Like any relationship, both parties play a role in making it work. The key advantage of investing time and effort into an agency is that it can mean practices find the right person for the role, rather than choosing a potentially cheaper option who doesn’t go the distance. No practice wants to suffer high turnover and having to continually fork out for recruitment costs.
If you want a positive working relationship with an agency, there are a few dos and don’ts to consider.
Honesty is the best policy. Making an agency aware of everything happening within the practice is essential. The practice may be short-staffed because of illness or holidays, which is straightforward. You tell them how many clinicians you need and for how long.
But if there are other issues, let them know about that too. Tell them about your practice’s culture, especially when recruiting a permanent or long-term locum. It’s vitally important that agencies know how you work so they can find the right person for you. A good agency will match its candidates to your practice, often finding GPs willing to work in more challenging environments, where necessary.
Should you have an ongoing need for locums, then share that too. Strategic long-term planning will save you money and time, and you can do this in partnership with the agency.
Be transparent about existing workforce arrangements. If you already have locums working directly for you, tell the agency. Otherwise, you could create problems. For example, your locum may also be on the agency’s books. And issues arise if your locum is working for you at a lower rate than the one advertised by the agency. You may have to pay more or lose the clinician. It may also affect how the clinician feels about working for the practice in the future.
Don’t leave things until the eleventh hour. Let an agency know you need support with as much advance notice as possible. Otherwise, you may pay a premium for a last-minute booking or miss out altogether. Emergency placements are sometimes unavoidable, but agencies cannot guarantee you will secure a clinician due to the current demand and shortages.
Finally, avoid working with lots of different agencies because that’s a sure-fire way of pushing up pay rates at your practice. Agencies can potentially have the same locums on their books, and while trying to secure your GP, they end up in a bidding war – not a good outcome for the practice.
How do you gauge success with an agency?
If you’re unsure whether you’re with the right agency, you may be keen to measure success. But with what barometer? Should you be counting the number of CVs they send, the interviews conducted, or whether or not the post is filled?
For a permanent role, it should be the quality rather than quantity of CVs. That’s because it’s the agency’s job to filter applications. By understanding the surgery’s needs and culture, the agency matches the candidates to your specific requirements. That should be apparent in the CVs you receive.
In a temporary role, the measurement of success is more straightforward. It’s the speed of filling the position with the best available candidate for the agreed rate.
For any role, there are a couple of ways to assess whether your agency is right. One measurement is the transparency of the process.
You should know how much the clinician is being paid and how much the agency is making. There should never be any surprises. Always ensure that you pre-agree the charge rate with the agency to ensure that’s the case.
Likewise, you should expect the agency to charge VAT for their services (excluding the concession for nurses) if the business exceeds the VAT threshold of £85,000 per annum turnover. There have been repercussions from HMRC where VAT hasn’t been charged.
How can practices feel confident in the pricing structure?
Pricing will be based on several factors, such as a practice’s location and locum availability. So, the practice’s geography and the area’s demand will have an impact. Another factor is how far the locum has to travel or, in some cases, relocate. The reputation of your surgery may also have an effect.
If you are not being charged VAT there is the possibility that you will have to pay VAT later if there is a VAT inspection – the agency is supplying you with a recruitment service, not a medical service and therefore you should be paying VAT, assuming the business is above the VAT threshold.
The key is transparency from both the agency and the practice. Don’t be scared to ask questions. So, if it is unclear what the final cost will be when the rates are hourly, it is ok to ask. A good agency will be happy to clarify.
Is partnership working the best way forward?
An agency partnership results in them looking after all of a practice’s recruitment requirements, both temporary and permanent. That is true, whatever the size of the practice.
It also includes clinicians who directly approach the practice. These candidates can be passed to the practice’s agency to check compliance and get them work-ready.
You will always get more loyalty and commitment from the agency if you partner with them. It will save you time, money and headaches.
What does good communication look like between agency and practice?
Bigger practices should have weekly calls and quarterly usage documents from their recruitment agency. This will show how many locums and how many days they are using each quarter.
Good communication should always be a priority, no matter what size practice you are or which stage of the process you are at. For a good relationship, both practice and agency should be transparent and honest.
And agreeing on everything at the outset is always advisable. There should be no surprises.
Ash Higgs is MD at MCG Healthcare