A leading tax consultancy for contracting professionals has said that the NHS is compounding an already-critical staffing crisis by implementing IR35 indiscriminately.
Qdos Contractor cites statistics from the Nuffield Trust which reveal the following:
- More nurses are leaving the NHS than entering, resulting in a shortfall of 40,000 nurses
- The vacancy rate for paramedics in England stands at a stubborn 10%
- 10% of mental health posts remain vacancy in England
- GPs are leaving the NHS at a faster rate than they can be replaced
- 84% of physicians report staff shortfalls in their teams
Like any organisation urgently needing to fill vacancies, the NHS depends upon thousands of highly qualified contracting professionals. Yet with budgets constricting and staff shortages worsening, the NHS needs to be exceptionally savvy about how and where it spends its money. And as the need for contracting professionals strengthens, it has become crucial for the organisation to attract and retain them.
Yet this does not appear to be a discernible feature of NHS staffing policy. On the contrary, Qdos Contractor has heard that the organisation is continuing to make blanket IR35 decisions which dragoon large swathes of independent professionals into an “inside IR35” designation, regardless of their individual working arrangements.
This is likely to have potentially disastrous, patient-endangering consequences. A new study by the Independent Healthcare Professionals Association (IHPA) found that 98% of contracting healthcare professionals were already contemplating working outside the NHS as a direct consequence of these indiscriminate determinations.
Assumptions that, as public sector servants, these skilled contractors would eschew private healthcare careers are misplaced: with morale collapsing due to the NHS’s handling of IR35, 70% are quite prepared to move to the private sector, including working outside the EU if placed inside IR35 (half the respondents) or in another European country (32%).
Expressing deep concern that the NHS was forging ahead with a seriously unfair implementation of IR35 which results in locums being falsely categorised as “caught” by the rules and losing up to half their income, Ben Itsuokor (consultant geriatrician and President of the IHPA) said:
“Clearly, there is the real and present danger that patient safety and care will be put at risk. Continuing to contract under false employment in this manner increases costs for (NHS) Trusts and will lead to much bigger problems down the line.”
Qdos Contactor concludes that “something has to give.” As Qdos blog contributor Benedict Smith puts it, “The NHS has the opportunity to set an example to other public bodies, and prove that last year’s reform – albeit disruptive – can in fact be managed.”