Published: 03/11/2005 Volume 115 No. 5980 Page 32

Many trusts are still recruiting despite uncertainty and financial issues - but as Alexis Nolan reports, they are getting smarter

If you believed the doom-mongers, you would think the NHS is in a state of atrophy. With an imminent primary care trust reorganisation expressly designed to cut£250m of costs, widespread financial hardship means that many organisations are cutting back their spending plans.

If you believed them, you would think there were blanket recruitment freezes, and that it is better to keep your head down and hope to ride out the storm.

While some organisations are reacting in this way, there are still many that are actively recruiting. At Central Manchester/ Manchester Children's University Hospitals trust, recruitment and employment manager John Harwood says the imperative is for organisations not to lose sight of their real purpose amid the turmoil.

'We have a service to deliver, ' says John.

'The way the NHS is moving in terms of the way individual organisations are to be funded in the future all depends on payment by results, and that means if we do not deliver the right level of service we will not be funded to the same levels we are used to.

'But there is always a balance because, like many others, we are in the middle of a recovery plan at the moment - and It is working. But we need to recruit to areas that will allow us to continue to offer the service we currently offer. That will give us funding to put into the trust to develop others.' John says It is a Catch 22 situation. If you do not recruit, service quality will decline, funding will fall and you will not be able to develop services in the future. But in the current financial climate it is not always easy to find the resources to continue to recruit.

'We have strict internal measures and central procedures in place that say where to advertise and where to fill posts, but we very rarely hold back on posts critical to service delivery, ' says John.

Instead, the focus is on developing a 'slicker and quicker' recruitment process to make sure the trust is more effective at bringing high-quality recruits into the organisation in a cost-effective way.

He says it is also important for trusts to prepare themselves for competition from independent sector providers as patient choice gathers speed. 'You have to recognise and rise to the challenge and make sure that your core workforce is high calibre and in the right numbers, ' he adds. 'Our organisation is not expanding, we are having to recruit to stand still in terms of head count.' Newham University Hospital trust recruitment strategy manager Jason Rosenblatt says that while trusts cannot ignore their financial positions, 'the main message that needs to be highlighted is that recruitment freezes would compromise patient care and quality'.

'Although It is very important for trusts to balance the books, because you can't be reckless in spending public money we have a duty of care to the patient as well.

You have got to look at cuts elsewhere rather than on frontline staff. Otherwise they can compromise patient care.

'We do not have any recruitment freezes here and our chief executive and director of finance have said we can still do recruitment, but let's be smart and not be careless.' Jason believes part of that smarter thinking is the development of robust workforce and progression planning. 'We are able to predict and plan what we need in posts and money for the forthcoming 12-24 months.' He says ensuring there are the right numbers and calibre of good managers is essential to improving planning of service requirements. 'When they do that it reduces the level of agency spend which is, at the end of the day, one of the main reasons trusts are overspent.' John is similarly trying to target reductions in bank, agency and temporary staff. He says that there is often a 'false economy' in short-term use of these staff, when the long-term need is for full-time recruits.

Visit www. hsj. co. uk to see the jobs currently on offer.