• Michael Allen, Partner |
6 min read

Data published this week suggests that the NHS in England will spend £3.2 billion on agency staff this year.  Much of this is profit to the agencies themselves. At a macro-level there are two reasons for this expenditure:

  1. Organisations aren’t able to attract substantive staff; and
  2. Delays in recruitment and onboarding

Our work suggests that approximately £1.5 billion of the total spend is due to delays in recruitment and onboarding; a process which, on average, takes 75 days or more following an offer being made.  In addition to this, we know that 25 per cent of candidates who accept an offer of employment subsequently withdraw, in part as a consequence of a highly convoluted process.  This withdrawal rate is higher in lower-paid groups, who often cannot afford to wait 2-3 months before they get paid and therefore seek alternative employment in another sector.

In addition to the vast amounts spent on agency staff, the NHS spends over £1 billion a year on people-related services and functions, with 90 per cent of that being transactional and administrative in nature. Over £250m of this amount is spent on recruitment teams who hire and onboard 200,000 people every year. Improving the onboarding process creates significant cost savings as has been seen in health and care systems in other countries and other sectors KPMG has been advising.

Despite the importance of recruitment functions and the costs incurred candidate experience is rarely recorded and used as the basis for improvement.  The data that is available shows that lengthy processes, the need for multiple inputs of data by new hires during onboarding, the need to print off documents for signatures before rescanning and returning forms, inaccurate payroll leading to wrong initial salary payments, all lead to a poor experience and dissatisfaction, with the increased likelihood of new hires leaving.

Nurse recruitment and onboarding

Let’s look at the persona of a nurse coming into an NHS role. If we track every single step of the process, and identify the points of failure, the different IT systems, or delays to get the person onboarded, we see that in every single step of the journey there is frustration with the process for the individual, the recruitment teams and line managers.

The nurse has to navigate through an onboarding process at a period of personal change as new employment can be daunting and stressful, requiring them to understand new working processes, new locations to navigate, and new people to work with. Poor onboarding can lead this nurse to feel on the back foot in a new role, increasing the risk of leaving before joining.

One data point we have been able to identify is the NHS’s own time-to-hire target, which is 36 days. Currently, the average is over 75 days. With three NHS Trusts, we have begun working with, it is more than 80 days, and in some cases as high as 131 days from offer to starting work.

It is also worth noting that over 50 per cent of a recruitment team’s time is spent chasing parts of the onboarding process using multiple IT platforms and alternating between paper and online to do so.

Transformation towards a connected and harmonised system

Getting onboarding of new hires right is critical at a time when there are 133,000 healthcare vacancies, with 1 in 13 posts vacant, yet onboarding times stretching to months instead of weeks makes filling those posts efficiently and effectively very difficult.

The process can be overly complex when dealing with different legacy systems and divisional silos. It can be difficult to know where to start improving the onboarding experience. Focusing on three key perspectives will help:

  1. The first is the employee experience, which is at the heart of the onboarding journey.
  2. Then the perspective of the hiring manager who, whilst continuing to focus on the demands of their day-to-day work, has a number of actions to take to ensure the new joiner is being onboarded properly.
  3. The third is the perspective of the organisation’s HR specialist who may have an overly complex or disconnected onboarding process which inevitably leads to inefficiency and lost time.

To improve the process from a workflow perspective, case managers and HR teams should be looking at what can be done long before the new employee’s first day.

The reimagined employee experience links to simplicity while also feeling the process is personalised and complete, while managers feel it does not take up too much time from other functions and HR managers can see the cost and time efficiencies of a standardised process.

For all three aspects, having a single point to go to for managing the onboarding process ensures greater efficiency and ease.

We have been working with ServiceNow to address the challenges in the onboarding journey in health and care organisations globally and in other sectors such as financial services and have developed a technology-enabled solution which transforms the candidate experience, automates workflows and radically reduces the time to hire. 

ServiceNow gives new hires a streamlined onboarding process through a personalised portal on their smartphone or laptop which gives them a much better sense of control.

By sitting on top of legacy IT systems across an organisation, data from both new hires and HR specialists can be managed through one portal, giving managers and recruitment staff an easily manageable location to follow new staff through the onboarding processes.

With a centralised view of the new hire’s onboarding journey, hiring managers can see where all of their new hires are in the process, with reminders for the activity being generated by the system. This is a system that allows the candidate to be aware of everything they need to do throughout their onboarding journey through one easy step of installing an app.

A case study on Zurich Insurance

Zurich is a company with 50,000 employees globally and we helped the company transform its onboarding process in its Switzerland headquarters. The previous onboarding process consisted of multiple channels with processes being conducted through emails, requiring PDF forms downloaded from SharePoint, and even handwritten notes to ensure information can be transferred across these multiple systems. The process was generic with no actionable personal insights for the new hire, and unclear when HR staff and managers should take over parts of the process.

Using ServiceNow to create an overarching portal for key persons, we helped Zurich achieve a shorter, simplified and personalised onboarding experience that is less stressful and daunting by being accessed in one single portal.

The portal gives access to employment contracts, corporate policies, personal information forms, orientation information, pension forms for them to fill out, opportunity to upload the photo for office access badges, all the way through to the first day and they're settling in period.

The other beneficiaries of the holistic approach in Zurich include other staff. For hiring managers, it initiates setting up a new workplace, ensuring IT; getting passwords sorted, organising the probation period goals

The process is easily tracked, all parties can access, view and input information and has so far been successful in onboarding over 500 new hires in six months since inception in May 2022.

As onboarding extends beyond day one, the portal also covers a settling-in period. So here we would have activities such as initiating any learning and development modules or encourage them to sign up to groups and societies within the company.

What next?

An efficient onboarding solution that is innovative and tailored can give new joiners the experience they deserve and time back to hiring managers. In an event earlier this week 100 per cent of those surveyed said they would make changes to their onboarding system, and 42 per cent shared that it takes applicants 60-90 days to join from offer acceptance. We’re confident that the solution we have developed will transform recruitment in the NHS, get staff to the frontline looking after patients much faster and save the NHS over £1 billion every year.

You can learn more about how you can achieve an efficient and effective onboarding solution by watching our video below.