The workforce challenges faced by the health and social care sector during the Covid-19 pandemic have highlighted the need and the benefits of adopting a system-level approach to facilitate the mobility of staff between different employers and care settings. The ability to deploy staff flexibly is a key factor in enabling new models of care, improving service resilience and ensuring continuity of care for patients.

The staffing demands of rolling-out the Covid-19 vaccination programme has required an unprecedented level of cooperation between NHS Trusts, GP practices and other organisations. These temporary frameworks can provide a model for a more permanent system for the sharing of staff within primary care and across the wider health and social care system. We explore what is needed to make this flexible system-wide approach work and the potential risks below.   

Why change?

Mechanisms already exist to enable members of staff to work at another organisation’s premises. Common examples include honorary contracts, joint posts or secondments. However, these arrangements are largely restricted for use between two organisations, making them less suited to the networked nature of modern care. These traditional arrangements can also be slow and bureaucratically onerous to set up and so most suited to longer term arrangements.

Adopting a more flexible, system-wide approach to mobilise staff between organisations will be a key factor in developing more integrated teams which are able to deliver better care and outcomes for patients.

What is needed to make this work?

Adopting a system of workforce sharing requires a robust, shared framework for handling the implications of staff mobility for employers in terms of governance and risk management, without the transactional friction associated with establishing multiple, bilateral honorary contracts or other standalone agreements.

How can you manage the risk?

The following are some of the key issues that need to be addressed in any workforce sharing agreement in order to manage the risks associated with a more mobile workforce:

• Liabilities and indemnities – consideration needs to be given as to how liability for clinical and/or employment claims against individual staff members will be apportioned and appropriate indemnities will need to be put in place. Assurances about adequate indemnity insurance also needs to be sought from all organisations who will be potentially hosting staff.
• Employee checks - participating organisations will want to ensure a consistent standard for employment and other employee checks to provide host organisations with assurance and avoid delay and duplication when mobilising staff.
• Contractual obligations – employment contracts may need to be varied to enable staff to work at a host organisation’s premises.
• Controls on who can participate – employing organisations will retain the risk for their employees and so will need to manage who can be deployed to a host organisation and host organisations will want assurances that staff have the necessary training and qualifications to undertake their role.
• Data and monitoring – information about employees will be shared by employers with host organisations, which will need to be managed in accordance with data protection legislation.
• Reimbursement – employing organisations will continue to be responsible for the payment of salary and benefits and arrangements for reimbursement by the host organisations can be captured in the agreement.

Conclusion

The rapid adoption of a more responsive and flexible approach to the sharing of staff across the health and social care sector over the last 9 months or so, has no doubt helped move a step closer to a system of integrated care.

There is now a growing appetite for this level of cooperation to continue and organisations are looking to explore the options of doing so.

Agreements between organisations to mobilise staff across the health and social care sector can be flexible in terms of duration and scope. They can also complement existing and more traditional arrangements and are not intended to replace long term secondments or service restructures.

How Capsticks can help

Capsticks’ primary care team is comprised of highly experienced primary care legal specialists who genuinely understand the legal and commercial challenges that GP practices and primary care networks (PCNs) face. From advice on employee relations matters, TUPE and pay disputes to claims including large scale litigation in the Employment Tribunal, civil and appellate Courts, our experts have substantial experience in advising on the full range of employment law issues.

If you have any queries around what's discussed in this article, and think that it is something of interest to your organisation, please speak to Alistair Kernohan, or any of your contacts at Capsticks, to find out more about how we can help.