Published: 17/02/2005, Volume II5, No. 5943 Page 35

In the space of just a few years the NHS has become one of the UK's most highly rated employers for parents. Its name has joined the pantheon of familyfriendly bosses such as Microsoft, HSBC and Inland Revenue.

In fact, NHS investment in childcare is unmatched. The£170m price tag attached to the five-year-old NHS childcare strategy is steep, but the initiative is on course to create 7,500 new nursery places and a similar number of out-of-school places.

Two pieces of evidence have been published that claim to show why the strategy works. The studies were carried out by 4Children, a charity that supports childcare development on behalf of South East London and South West London strategic health authorities.

The reviews indicate the strategy has reduced stress and enhanced the image of the NHS as an employer. Crucially, the studies suggest that childcare support is a significant factor in retaining staff.

Based on survey statistics, 4Children estimates that investments in childcare could save the NHS£23.9m per year in south-east London, and more than£300m through reductions in recruitment costs, training and temporary staff. The evidence could not have come at a better time for those trying to secure funding.

Since April 2004, money for the strategy is now included in general funding allocations made to primary care trusts and is no longer ring-fenced.

The effect in some areas has been to reduce severely the amount of money available for childcare co-ordinators. For example, South West London SHA employs eight childcare co-ordinators to cover 12 NHS organisations, but so far they have only confirmed funding for four.

Ann Munday, sector lead for childcare at the SHA, said that trusts need to make a long-term investment in childcare to get results. She estimated that her region had seen a 75 per cent shortfall in childcare funding in the last financial year. She said: 'It is such a shame as we are losing a pool of experts in NHS childcare.' Co-ordinators are typically involved in hands-on advocacy work - for example, helping parents to find a childminder and publicising the childcare service.

South East London SHA strategic childcare co-ordinator Ian Fleming says that the end of ring-fencing has put a financial squeeze on the strategy. 'We would obviously prefer ring-fencing. The money has been absorbed into baseline allocation so It is a case of going to PCTs and saying 'you now have the money we used to have, can we have it please?' 'I know that childcare co-ordinators are worried about their employment.

Some people on fixed-term contracts are not confident about their long-term future. My gut feeling is some people will not have their contracts renewed.' An impact assessment carried out by the NHS in February 2004 found that many co-ordinators felt under-valued at work. Ian predicts that many of those who do survive will have to extend their role to offer advice and support to all staff with caring responsibilities.

Sue Finch, head of consultancy at 4Children, said the NHS was 'by far and away' doing the most of all the major employers about childcare at every level and praised the way the NHS childcare strategy has been embedded into Improving Working Lives.

She hopes the formulas used to calculate savings for SHAs could be used by individual PCTs.

'This information is incredibly useful for PCTs and other trusts to know that investment in childcare can save them an enormous amount of money.'


South East London NHS Childcare Strategy has delivered 350 new childcare places so far.

The 4Children impact assessment received 113 responses from staff who were using the new childcare support, developed with NHS Childcare Strategy funding.

The highest response was from staff working at King's College Hospital trust, which has created an extra 60 places for children of staff at its Mapother House nursery.

As many as 93 per cent of 42 staff using the nursery said it had helped them continue to work for the NHS.

Between 2002-4, King's experienced:

a reduction in vacancy rate from 13.5 per cent to 7.3 per cent.

a 3.2 per cent reduction (to 13.4 per cent) in voluntary turnover.

a 4.3 per cent reduction in voluntary turnover in nursing and midwifery.

a reduction in bank and agency nursing from 61,933 to 52,493 hours.

4Children estimates that a 1 per cent reduction in voluntary turnover can save a trust almost£1.5m every year in recruitment costs. This is calculated based on an average salary of£28,000 and London weighting, and assumes costs associated with staff turnover such as use of temporary staff, recruitment advertising costs, disruption to work and agency fees.

For further information contact Sue Finch at 4Children on 020 7512 2112, or go to www.4children. org. uk.

For a copy of Impact of NHS Childcare Strategy in South West London go to www. swlondon. nhs. uk/childcare