Spoiler alert: it’s not a rom-com

In my last blog in September, I bemoaned the market and talked about how difficult it was for the average NHS manager to secure approval to engage interim resource.

Fate was clearly watching and our pipeline promptly exploded into life, giving us a flurry of new requirements over a six week period which resulted in 10 interims starting roles via Melber Flinn in November.

It felt like Christmas had come early – minus the awkward family dinners and garish jumpers.

This was our best month of the year, and well above our average number of monthly placements year to date.

Through this period we found ourselves endlessly speculating whether the market had truly turned, or whether we had just enjoyed a nice blip in an otherwise bleak market.

Drumroll, please… December arrived, and, alas, it seems we were riding a temporary wave of glory. The market went back to being its regular 2023 self – no confetti, no marching bands, and a lot of tumbleweed.

This is perhaps unsurprising given the recent 8th November letter from NHS England, sent out to all NHS organisations and ominously titled:

“Addressing the significant financial challenges created by industrial action in 2023/24, and immediate actions to take.”

Too early for a Christmas card and too long for a short story (spoiler alert: it’s not a rom-com), the letter makes no bones about reiterating the importance of achieving a balanced financial position this year.

It also indirectly deprioritises elective recovery, by removing incentives for trusts to drive elective activity, and giving them elective funding regardless.

I guess the feeling is that the national elective backlog can be kicked that bit further into the long grass and as we come into a winter UEC quite naturally needs to be the focus.

Of course none of this is good news for the interim market, and the letter even asks organisations to include in their plans details of how they will reduce agency staffing.

So the factors that have been suppressing the market all year have effectively been re-affirmed by NHS England, which left us wondering what caused our recent flurry in activity.

Some basic analysis tells us that we have had a good concentration of roles in UEC and CIP, which is entirely consistent with the main messages from the letter, but we have had other roles too, in HR, quality assurance and senior operations.

I asked one of the clients of these requirements what hurdles they had overcome to enable them to come to market for an interim and she explained that building a business case to secure an interim is far easier in October than it is in July.

In the summer you’re only a few months into the financial year, so the pushback is that there is plenty of time to find some internal resource or to solve your problems with another approach. By October, you have much less time in the financial year to solve the same problem or turn performance around, and the back six months also includes winter pressures, during which the maintenance of business as usual is even harder.

Christmas distorts the market as we effectively lose two weeks to Christmas parties, The Pogues and Christmas itself, but we’ll be keen to see whether more clients come to market in January with strong business cases to use interim resource to solve problems and to cover gaps.

In the meantime I’m personally looking forward to a break. When you run your own business and take a mid-year holiday you’re never fully off duty because the world keeps turning even though you’re not in the office. But at Christmas, pretty much everyone else is off too, which means plenty of time to relax.

Finally, just in case fate is still watching, I’d like to finish by stating I absolutely will not win the lottery, and there is no chance whatsoever that I will be going to Glastonbury next year.

I will report back next year as to the accuracy of my predictions – hopefully similarly incorrect as above.

Until then, have a wonderful festive period from all the team at Melber Flinn.