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Dr Michelle Horridge discusses how junior doctors like her are so often seen as temporary members of staff as they rotate between teams and are employed at different trusts on a regular basis, despite being permanent members of the NHS workforce.

Temporary staff have been called on throughout the pandemic. Having worked across different trusts, in temporary roles despite being a permanent member of NHS staff as a junior doctor, I know how tiring and transitory it can feel. This often manifests itself in the absence of simple basics that facilitate working life, such as knowing in advance where you are going to be working or having access to trust or hospital policies. Even getting a locker or a parking space can be an exhausting and demoralising administrative challenge.

Trusts vary on how well they manage rotational colleagues and the provisions they have in place. Inevitably requests for support are met with an almost default position of “that is not how it is done here.” In part, this is a result of many colleagues being under an enormous amount of pressure, with a heavy administrative burden, and a general lack of support to make autonomous decisions. This can lead to colleagues feeling a lack of empowerment and often, giving a blanket “no” to requests is easier and less disruptive to the status quo.

The challenge for the NHS is that this goes beyond the day-to-day issues facing junior doctors. Having taken part in the Health Education England Future Leaders programme, I am aware of the time and effort that goes into developing an organisation’s values and mission statement. My experience has been that these organisational values are not always cascaded down effectively, and frequently there is a disconnect between what senior leadership believe is happening in an organisation and the way this is delivered “on the ground.” In my experience, this affects temporary staff greatest, who often do not feel the organisation’s values have permeated to their experience.

This mismatch between the organisational values and the actual experience perpetuates the sense of not feeling a sense of belonging, which many temporary staff experience, chipping away at their motivation to pursue a rewarding and satisfying career in the NHS.

This is not just the purview of junior doctors. Temporary staff, across all areas of health care, played and continue to play a significant role within the COVID-19 pandemic, with a huge recruitment drive to cope with increased demand.

There will always be a role for temporary staff. And for some, being a temporary member of staff is a personal choice. The NHS needs the flexibility to cope with fluctuating demand and ongoing staffing challenges. Organisations must recognise the need for temporary staff, demonstrating the same treatment to their temporary staff as offered to permanent staff, not just in mission statements but in actions.

A good practice example is in an emergency department in a hospital I worked in. Every six months, there was a team meeting for discussion of shifts, leave and for medical staff to self-roster. These inclusive sessions give all staff, temporary, rotational, or permanent, a sense of autonomy in planning their work around their other commitments.

It’s time to acknowledge that temporary staff are a key and permanent part of the NHS workforce. It is the people and the policies behind the systems that make the difference in how this group of colleagues are treated. Temporary staff have much to offer, not least the breadth of experience gained in other settings. We need to treat our temporary staff better and value the experiences they bring if the NHS is to make the most of this valuable workforce.


Back to Basics – On-Demand HPMA Session

As outlined by Dr Michelle Horridge, getting some of the basics right can make a tremendous impact on those working on a temporary or rotational basis.

In our webinar – ‘Time to Rewrite the Narrative on Workforce Policy’, at the 2021 HPMA Conference we hear first-hand about the challenges faced around workforce policy, and discuss some of the positive initiatives that are in place to help the workforce.

Watch the On-Demand session here or complete the below form to find out how you can be a change agent on workforce policy in your organisation.

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