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Analysis of Recruitment in the NHS

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CIPD Management Report

Utilising E Recruitment

Executive Summary

This Management report will look at the Recruitment Processes with an NHS Acute Trust and identify if E recruitment can help with the difficulties experienced in the Trust. Alongside a literature review of Recruitment difficulties, Employer Branding, Traditional recruitment and E recruitment, the author has conducted a benchmarking exercise in order to establish best practice in recruitment in local NHS organisations, A Process Mapping exercise to identify current practice and identify any difficulties or hold ups in the current process and a Managers questionnaire to allow the author to identify current perceptions of the recruitment service in the organisation alongside what expectations are.


Satisfaction Survey

Survey results

1.0 Introduction

The Pennine Acute Hospitals NHS Trust was established in April 2002 and manages hospitals in Oldham, Rochdale, Bury and North Manchester. Serving a population of approximately 800,000, the Trust is one of the largest in the country and had an operating expenditure of over £425 million in 2006/07. It runs services across five hospital sites: Fairfield General Hospital, Bury; North Manchester General Hospital; The Royal Oldham Hospital; Rochdale Infirmary and Birch Hill Hospital, Rochdale and employs a staff of approximately 10,000.

The Trust has four divisions identified as Surgery, Medicine, Women and Children's, and Diagnostics and Clinical Support. It also has directorates providing support to clinical services including Human Resources, Facilities, Planning, Finance, Information and Management Technology, Modernisation and Performance, Governance and Research and Development.

The local economy in which the Trust is situated is strong, with a great deal of competition from local organisations for staff. There is little competition within the NHS for staff, as Pennine is ‘the only Trust in town', in each of the 4 areas.

Transport links to the Trust are generally good, although access to some peripheral sites is difficult, and car parking can be a problem, especially at the Royal Oldham site.

The Trust is concerned, as many Trusts in the Greater Manchester area are, that many of its nurses will retire within the next five years and it is trying to develop a programme to get people to stay on after the normal retirement age. It also attempts to recruit as many student nurses as possible, but positions for newly qualified staff have been reduced in the last few years due to reconfiguration of services and redeployment to avoid redundancy.

The Trust has a lower proportion of nursing staff from ethnic backgrounds than the local population, when comparing the 2001 Census with its workforce data; but the percentage of staff as a whole from ethnic backgrounds is higher, due to the numbers of medical staff from ethnic minorities within the Trust.

The Trust works hard to recruit staff from ethnic minorities/deprived backgrounds. It has an Equality and Diversity Team who work to promote diversity within the Trust, supporting proactive recruitment where there is a concentration of individuals from ethnic or disadvantaged backgrounds.

There is a central HR function, with designated HR Managers for each division. Restructuring of this model has taken place in recent years. Recruitment is managed from the North Manchester General Hospital site and provides a central function.

With a workforce of over 10,000 people, the average monthly cost of recruitment at Pennine Acute Hospitals NHS Trust is xxxxxx. Added to this is the length of time it takes to place a new employee in post, which is on average 60 days. This estimate is from measured from the advertised positions closing date to offering that position. Recruitment is currently a major issue in the Trust with days lost in the recruitment process costing money and reducing morale and effectiveness. At present the department is receiving a lot of pressure from the rest of the Trust and the reputation of the department is poor.

This management report is being undertaken to identify recommendations that will allow the recruitment process to become more efficient and identify whether utilisation of e recruitment is a viable proposal in the Trust and whether its implementation will increase efficiency and save resources.

All employers face the challenge of employing the right staff for their organisation and this often falls under a human resource arena. The recruitment and retention of healthcare professionals has been identified as a key challenge facing the NHS (NHS Plan 2002). High on the agenda at local, regional and national levels is the development of strategies and initiatives to attract suitable people to work in the professions, in order to ensure that services are responsive to patient needs.

2.0 Literature Review

Recruitment is an extensive subject with many aspects making up the area. A study by Ullman (1966) cited in Breaugh & Starke (2000) was one of the first to examine recruitment sources. Finding that new employees who were recruited by means of informal sources (i.e., employee referrals, direct applications) had a lower turnover rate than individuals recruited via formal sources (i.e., newspaper advertisements and employment agencies). Barber (1998) has since concluded that past research has not made a strong case for the importance of source differences. The author is interested in research into the prevalence of the sources used in traditional recruitment, which appears to be research that has not been undertaken significantly.

Torrington, Hall and Taylor (2005) identified that employers in the UK recruit over 3 million people each year, in a costly and time consuming exercise to add suitable staff to their organisation. They identify a need to ‘sell' jobs to potential employees in order to ensure they can generate an adequate pool of applicants. Organisations are now facing a greater challenge recruiting rather than selecting. (Ployhart 2005) Other researchers having also identified the difficulties organisations have in attracting candidates, identifying selection will only be effective and financially defensible if a sufficient amount of applicants apply to the organisation. (Taylor and Collins, 2000)

However according to Barber (1998), It is important that employers do not consider the recruitment process to be completed at this point, It continues during the short listing and interviewing stages and is only deemed as complete when an offer is made.

For the purposes of this literature review the author will review thoughts and research on the initial stages of recruitment, that being the attraction of employee's and advertisement of vacancies in order to recruit to the organisation, this will allow the author to include the areas of employer branding and e-recruitment in the review.

2.1 Recruitment Difficulties

The Audit Commission (2002) has identified that the UK labour market is highly competitive at present with the rate of unemployment at a historically low level. Employers are openly competing harder to attract and retain staff. This is made more difficult, with reports across the country, of recruitment and retention problems affecting local public services, the NHS being no exception. There have been serious concerns about shortages in staff numbers, and fewer young people being attracted to work for the public sector, meaning there is a potential ‘demographic time bomb'. It has been identified that 27 per cent of the public sector workforce are now aged 50 or over. (Gulland (2001), Audit Commission (2002))

Recruitment is also expensive, in a recent survey; CIPD (2007) identified the average cost of recruiting a member of staff is £4,333; however this increases significantly to £7750 when organisations are also calculating the associated labour turnover.

They identified that eighty four percent of organisations have reported difficulties in filling vacancies in 2006, a rise of 2 percent on the previous year. The key challenges faced by organisations in regard to recruitment have been identified from the survey as; attracting and recruiting key staff to the organisation, reducing recruitment costs, enabling the achievement of the organisation's strategic goals and addressing skills shortages.

CIPD strongly believes that:

‘effective recruitment is central and crucial to the successful day-to-day functioning of any organisation'. stating that ‘successful recruitment depends upon finding people with the necessary skills, expertise and qualifications to deliver organisational objectives and the ability to make a positive contribution to the values and aims of the organisation'.

The Audit Commissions report (2002) also identified there are concerns about ‘skill shortages', not only in terms of ‘basic skill levels' in the workforce, but also in key leadership, management and specialist skills that are required. Previous research from the Audit Commission (2001) has showed that, on average, a new employee will perform at only 60 per cent of their productive potential when they are first appointed, only reaching 100 per cent after being in a post for a year. This makes recruitment in these areas and adequate delivery of services even harder to manage.

In their extensive report on public service recruitment, the Audit Commission identifies the way the employers can maximise their recruitment practices. They advised:

  • Informed, quick and professional responses to job advertisement enquiries are essential for maximising applications;
  • routine monitoring of recruitment will ensure that recruitment initiatives are driven by the bigger picture rather than just the latest concern;
  • success in addressing diversity issues are to be achieved through efficient, effective targeted recruitment campaigns based on knowledge of the target community; and
  • any initiative to attract a specific group of staff will benefit from being profession-led and in partnership with HR.

Audit Commission (2002)

Effective recruitment practices and policies are recognised as making a significant contribution to an organisations success, according to Plumbley (1990). He states it is not simply about placing suitable candidates into jobs, but also about building an adept and flexible workforce in order to meet the organisations changing and demanding needs.

The first stage of recruitment and selection is to be able to attract an adequate number of appropriate candidates. Prospective employees do not select the organisation they wish to work for on the foundation of job and organisational characteristics such as location, and organisational structure alone.

2.2 Employee Brand

The increased competitiveness in the recruitment market has led to organisations spending more time, effort and resources on developing their recruitment brand and expanding the range of advertising methods used, to try and attract quality applicants from as broad and diverse a pool possible.

Almost seven in ten organisations describe themselves as having an employer brand according to CIPD (2007), and studies have shown that an organisation's reputation and identity is vital in the fight to attract suitable talented applicants into organisations. (Lievens & Highhouse, 2003; Cable & Turban, 2001). Identifying that in order for the corporate brand to be more successful at attracting suitable candidates there is an importance in promoting and monitoring that brand. (Slaughter, Zickar, Highhouse, & Mohr, 2004)

Fombrun, (1996) agrees with this stating the reputation of an organisation has been acknowledged as one of the key factors that can affect the probability of potential applicants choosing to apply to work for it. In the same way, organisation reputation has been found to be an important influence on applicants' decisions of whether they fit with an organisation and want to join it (Rynes et al., 1991). This researcher has also showed that applicants utilised information on how informative and the ‘recruiter friendliness' as an indicator of how an organisation treated its employees.

Fombrun (1996) expands this argument to identify that reputation is of particular concern to applicants seeking employment in knowledge-based institutions, such as universities and hospitals, because of the intangibility of the services these organisations provide. Whilst Turban et al. (1998) also found that applicants' perceptions of the specific attributes of a post were influenced by their evaluation of the organisation, even if they had been interviewed and were successful.

The importance in private/commercial organisations reputation in relation to the recruitment and retention of staff has been well documented in literature, for example: (Turban, 2001) and Cable and Graham (2000), Gray and Ballmer 1998)), there has however been comparatively little consideration on the impact of reputation for public sector organisations.

Most people in the course of their life have a need to use the services the NHS provide, some more than others and health is an important issue, not only on a personal level, also in the political arena. The NHS is the UK's largest employer, so many of the UK population are at present working in it, with a great number more many having done so at some point in their lives.

In brief, the NHS has a wide range of different stakeholders, who may feel they have a vested interest in the quality; provision of services and ultimately, the reputation. People have varied, and very personal experiences of the NHS and this could mean image and reputation are therefore difficult to manage.

The Audit Commission study (2002) study showed that public sector staff thinks that ‘their image in the eyes of the public would discourage potential recruits from entering the NHS'.

The study analysed a wide sample of the UK's national press to see if the evidence supported this observation. Analysis of the results showed that plenty of stories are told and coverage given to the NHS is extensive. They concur that the picture of public sector work presented to the reading public is often bleak. Of the former public sector workers surveyed, 68 per cent thought that the image of their former profession would discourage people from entering that job. Only 9 per cent thought the opposite and stated that the image would instead encourage people to enter.

The NHS is such a well-known organisation that carries out specific roles in society, that when considering a career in the NHS people often have an idea regarding an occupation they would like to pursue. The GTI (2006) conducted a survey to establish the major determinants that influence applicants in their choice of employer. The results show that for 22% of student nurses and doctors, the reputation of a prospective employer (often influenced by media coverage) is a key factor in determining their aspirations. They identify that ‘word of mouth' can be damaging to an employer's reputation. If employers get things wrong, it can really affect the way they are viewed by potential employees as over half of the survey respondents have shared their bad experiences with their peers.

So for some people the images and reputation of the NHS may be crucial to their decision of whether to work for it.

2.3 Traditional Recruitment Methods

Traditional recruitment methods are the way in the past, that an organisation announced a job opportunity to the marketplace, through a classified advertisement, a job fair, an external recruiter, or other media. Any candidate who happened to see the announcement would submit his or her CV, ring the company for an application form or submit a letter of interest.

Lievens and Harris (2003) have stated that in the past, job searching was a more time-consuming activity. They identified

‘A candidate who wished to apply for a job would need to first locate a suitable job opportunity, which often involved searching through a newspaper or contacting acquaintances. After locating potentially suitable openings, the candidate would typically have to prepare a cover letter, produce a copy of his or her resume, and mail the package with the appropriate postage.'

Arboledas, Ferrero and Vidal (2001), presented some examples of recruitment methods that organisations have traditionally used. These were identified as newspaper advertisement, faxed/mailed resumes, recruitment agencies or the use of headhunters. Galanaki (2002) similarly identified all these methods and also defines them as ‘traditional' recruitment methods.

This idea of traditional methods can also be found quoted in numerous HR texts, which have sections dedicated to recruitment and try to identify best recruitment practices. The authors of such texts include Cole (2004), Rayner and Adam - Smith, Armstrong (2007) and Mullins (2005). These texts give a useful overview of the concepts of recruitment but again the best practice and evidence of what is most effective is not present.

An IDS study in 2006 reported that to maximise their chances of appointing the best candidate, many organisations have utilised a combination of online and traditional approaches.

In 2004 Softworld HR and Payroll identified in a study, that 24% of respondents envisaged e-recruitment entirely replacing all traditional methods of advertising in the future, however 76% of the practitioners surveyed, see it as an additional tool to allow the widest possible range of applicants to be accessed.

Traditional methods also identify the use of recruitment agencies in the way of recruiting staff.

According to an IES study (2005), recruitment agencies remain confident that the growth in e-recruitment technology will not eliminate their role in the process, as many organisations lack the time and expertise to carry out these tasks. Many organisations, especially smaller ones may also lack the technology to carry out their own recruitment online. They state with the low unemployment rate that currently exists, the task of finding quality candidates will remain challenging and this may prompt organisations to continue to use agencies, in particular, for specialised, senior or difficult to fill positions

A Demos report (2007) however has identified difficulties in the recruitment business. They point out that the ‘landscape has changed remarkably over the past decade'. And identify the recruitment industry has been growing rapidly, and the talent war has led to an increase in outsourcing and much greater efforts being made to reach candidates through on and offline advertising. They identify that recruiters have had to embrace technology, or be left behind.

In the 2007 CIPD recruitment and retention survey, it was identified for the first time in the UK; corporate websites have broken even with local newspapers advertisements as the most common method of recruiting candidates.

2.4 E-recruitment

E-Recruitment is identified as ‘the use of Internet technology to make the job of recruiting staff more efficient and effective, when used together with traditional recruitment methods; the benefits derived from e-recruitment can be considerable'. (E-recruitment Best Practice Guide 2007)

Internet usage in recent years has seen the recruitment process transformed. Online recruitment, internet recruitment, web-based recruiting and e-recruitment are terms used to describe the use of the internet to recruit potential employees, and mediums to conduct other elements of the recruitment process. We will use the terms interchangeably in this report.

According to Schreyer & McCarter (1998) e-recruitment refers to

“The recruitment process, including placing job advertisements, receiving resumes, and building human resource database with candidates and incumbents''

E-Recruitment is establishing itself as a significant part of the recruitment strategy in a range of organisations across the UK and the world. This is in addition to becoming a progressively more accepted method for job seekers in searching and applying for jobs.

The traditional method of recruitment has been transformed by the appearance of the Internet. In the past few years, the Internet has dramatically changed the face of HR recruitment and the ways organisations think about the recruiting function. There is predicted to be a continued dramatic growth in recruiting and hiring via this medium in future years. (CIPD 2007)

A survey by the public appointment service in Ireland in 2006, relating to e-recruitment in Irish organisations, has also identified a high level of current or intended future use of e recruitment, this being identified as an area forming an important part of the Irish recruitment strategy.

It would seem that e-recruitment has been implemented in many organisations from small companies to large organisations. These organisations are already using e recruitment to advertise jobs and accept CV's on the Internet, and also to communicate with the applicants by e-mail. In the CIPD Recruitment, retention and turnover 2006 survey it was identified that eighty-four percent of respondents have made greater use of e-mail applications in the last three years. Over seven in ten organisations also said they are actively advertising jobs on their corporate websites and using online recruitment applications.

Lievens and Harris (2003) have identified the following methods of using the Internet to attract candidates, acknowledging that approaches are continually changing.

• Company websites - Advertising posts and providing information to candidates through the company website. The facility to apply online is often also provided.

• Job Boards - Commercial general purpose recruitment portals, (e.g. Yahoo!, Monster.com) and specific industry job boards.

• Online Searching - Recruiters searching online sources such as company websites and professional chat sites to identify candidates who may not be actively looking for a position.

• Relationship recruiting - Using the internet to build and maintain long term relationships with passive candidates, through using internet tools to learn more about web visitors interests and experience and to e-mail regular updates about careers and their fields of interest.

Kerrin and Keetley (2005) have suggested that the reasons for many organisations to introduce e - recruitment have been recruitment cost reduction, speedier processes, access to a wider pool of applicants and better employer branding.

In the CIPD Recruitment, retention and turnover survey 2006, it was identified that the key drivers for e-recruitment were; reducing recruitment costs (cited by 71%), broadening the selection pool (60%) and increasing the speed of time to hire (47%). It was also noted that :

‘over a third of respondents believed it brought greater flexibility and ease for candidates, and over a quarter believed it strengthened the employer brand.'

This has been further supported by the IRS Employment review (2007).

Reduction in costs

E-Recruitment has allowed employers to make reductions in advertising costs and remove their dependency on recruitment agencies. Technology in online recruitment is not expensive and the hours saved in the pre-selection process gives HR staff more time. Administration can be significantly reduced in most organisations. This can prove to be extremely important when recruiting involves high numbers of staff or when receiving high numbers of applications. (DTI 2006, Guertal et al 2007). The IRS 2007 study identified 7 out of 10 organisations say administration is easier to perform when utilising online recruitment services and 8 out 10 identified the e- recruitment process as being substantially cheaper.

Cappeli (2001) calculated that ‘it costs only about one-twentieth as much to hire someone online as to hire that same person through … other traditional methods.' This can again, be achieved through significantly reducing advertising costs and by reducing recruitment related administration according to Elkington (2005)

An IDS HR Study in April 2006 identified how the Internet now plays a significant role in recruitment activities of employers. The report examined the use of corporate and third party recruitment websites and identified they are being used to reduce advertising costs and tap into a more diverse candidate base. They also identified that technology is streamlining the application process with the encouragement of online applications, linking into sophisticated application tracking systems and allowing organisations to measure the success of attraction methods.

IDS state that over 70% of adults utilise the Internet, and employers are using this medium to attract and recruit much more frequently. They identify significant cost savings for employers and reduced time taken to fill vacancies, but are keen to point out the wariness of employees in missing out on potential candidates and feel that traditional recruitment media is set to retain and important role, particularly when recruiting locally or hard to fill jobs. This supports reservations held by IRS (2007) who identified that e recruitment was considered unsuitable for certain kinds of vacancies.

Grout and Parrin, authors of the book, ‘recruiting excellence' agree with the assessment by IDS. In an article for HR Director (2006), they identify that online recruitment can improve efficiency by the reduction in man hours involved in the process, and help employers reach a wider and larger audience of jobseekers. They also recognise that it can be a valuable part of a recruitment process, in addition to traditional press advertising and the use of agencies (DTI, 2005).

Kerrin and Keetley (2005) however, have stated, that the full cost savings are often only realised if the whole recruitment process is carried out online, a view supported by a number of authors. (Demos 2007, IRS 2007)

Reducing time-to-hire

With e-recruitment the time taken to recruit can be reduced by as much as 75% and allow the recruitment of the most appropriate employees more quickly into the organisation. Time is also saved by spending a reduced amount of time tracking, communicating with and screening the applicants. Online recruitment also allows organisations to the share best practice and improves the consistency of recruitment processes across the organisation.

The Public Appointments Service survey showed that a reduction in administrative workload (cited by 49% of respondents), and reduced timescales for hiring (cited by 40% of respondents), were key drivers in the decision to implementing e recruitment.

Hogg (2000) stresses a shorter recruitment cycle can be gained by the speed at which several steps of the recruitment process are carried out online. Elkington (2005) supports this and has identified that the immediate posting of jobs online and the effortlessness of completing online application forms and e-mailing CVs to an organisation has made these steps much faster.

Moving further into the recruitment process, the short-listing process can be accelerated by routinely aligning applications dependent on prearranged criteria (CIPD 2005). Applications can be progressed within minutes rather than weeks, saving both recruiters and job applicant's time.

Widening Talent Pool

Internet tools that enable employers/recruiters to reach a wider pool of potential applicants and to fill positions faster with less cost to the organisation are obviously advantageous in such a competitive environment.

Online advertising opens up a wider candidate pool, by providing 24/7 access to job seekers, at local, national and international locations, thus providing a better chance of finding the right candidate (CIPD 2005a). As job seekers become increasingly more web literate and the growth of broadband makes web surfing easier and cheaper (IRS 2005), the potential for e-recruitment to attract wider candidate pools is increasing.

Enhancing Employer brand

Increased numbers of candidates are expecting to apply directly online and they routinely make judgements about employers based on their recruitment process. To combat this employers are adopting increasingly dynamic e-recruitment solutions to allow them to distinguish themselves from others and to professionally manage the recruitment process. (Willock, 2005; Paton 2006).

E-Recruitment enables an organisation to raise its profile to potential applicants and promote itself as innovative and forward looking, allow visitors to the website to leave with a positive experience. Kerrin and Kettley (2003) in their report ‘e-recruitment - is it delivering' identified a key factor for organisations in their adoption of e-recruitment, is the desire to increase their profile as an employer of choice amongst potential candidates and to promote their image as a progressive organisation. This is supported by 7 out of 10 organisations also agreeing that the use of online recruitment was more likely to improve reputation (IRS 2007)

E-Recruitment can help to build the image of a brand. Barrow (2005) recommends that organisations build their brand identity very carefully however; warning of a need to ensure substance is beneath the clever name, logo or design, as employees once appointed will see through the facade. This is further supported by Gray and Balmer's (1998) term, ‘routine interactions'. They state that outsiders have a place in shaping image and reputation when they interact with organisations; communications are likely to be received with scepticism when they do not match personal experience.

CIPD (2005) also demonstrated that more detailed information can be provided on the organisations website than in a newspaper advertisements and in recruitment agency literature, reinforcing the employer brand, improving the corporate image and profile whilst also giving an indication of the organisation's culture

The use of the Internet allows organisations to pass far more information in a much more dynamic and consistent fashion to candidates than was the case in the past (Lievens and Harris 2003). Applicants therefore have much more information at their disposal before they even decide to apply for a job than in the past. In addition, candidates can easily and quickly search for independent information about organisations from various sources, such as internet search engines and libraries.

Therefore, unlike in the past, a candidate may have applied for a job based on practically no information; today's candidate may have reviewed a substantial amount of information about the organisation before choosing to apply.

Disadvantages of e-recruitment

The CIPD Recruitment, retention and turnover 2006 survey revealed some concerns that e-recruitment could increase the number of unsuitable applicants and that it could act as a barrier to recruiting older workers.

A factor which seems to be discouraging some employers from making more use of online recruitment systems, is a concern, over the level of internet access and levels of accomplishment with technology, of their target audiences.

While usage of the Internet does vary by social group there is evidence to suggest that recruiting online results in at least as diverse an applicant group as those recruited through traditional methods (McManus M.A., Ferguson M.W. 2003).

Searle (2003) would dispute this however stating that participation in online recruitment is skewed towards ‘white males from higher socio-economic groups.'

A further concern in relation to access is the suitability of online recruitment methods for candidates with disabilities. Research from www.jobsgopublic, 2004, shows that many employers exclude candidates with disabilities by having poorly designed websites and e-recruitment processes, and there is increasing pressure to address this in order to ensure compliance with equal opportunities legislation. Almost 1.3 million disabled people in the UK are excluded by inaccessible and badly designed websites according to latest figures. (IRS 2007)

Developers of Internet technology however, as they become more aware of the requirements of EU policies and legislation on e-inclusion, are producing new products and systems with higher levels of accessibility

Organisations also have limited knowledge of the available options when sourcing and choosing the appropriate technology that will be compatible with their existing HR systems and are reticent at attempting to incorporate this technology into their own systems. IRS 2007 suggested limitations still in the application of online recruitment, identifying that typically it is used to solely advertise and administer the application process. They felt it was underexploited and rather than gathering rich data on usage most employers do not interrogate to identify usage and results in order to improve effectiveness.

2.5 NHS Jobs

NHS Employers has been instrumental in changing the emphasis of recruitment in the NHS from paper based to internet based. This change they feel demonstrates the commitment of NHS Employers in supporting NHS organisations to promote the NHS as a leading employer that is achieving the delivery of cost-effective workforce strategies and raising the profile of the NHS and its associated brand. NHS Employers want to reverse the damage demonstrated in the words of Tony Blair

‘There was a time when we could assume that the brightest and best of each generation would want to join the public sector. But that is an assumption that we can no longer make, particularly when the financial rewards at the top of the private sector are so great, and too often public sector workers are weighed down by bureaucracy and silly rules.'' Tony Blair, 1999

It is suggested in surveys by CIPD (2005b) and Kerrin and Keetley (2003) that the posting of job vacancies on the Internet is standard practice when organisations have corporate websites. This would support the theory of research conducted by CIPD (2005a), suggesting that the public sector exceeds the private in terms of the use of e - recruitment. The public sector has utilised their own websites for many years and all public organisations have these sites, unlike other private organisations

An IRS employment review in 2005 found that many employers believe that:

‘industry-specific sites/job boards are a better resource than general job boards, as they enable employers to identify more suitable candidates because specialist boards tap into a self-defining market'.

This would support the views of the NHS who have developed their own sector specific online recruitment site.

NHS Jobs is the main NHS Internet option for online recruitment. The recruitment website was launched in 2003 with claims that savings for the health service could be 24 million in advertising costs every year according to then Health Minister John Hutton (BMJ 2003). An initial pilot was carried on 46 NHS organisations. The site is now available to all NHS organisations and more than 80% use it as their primary source for candidates. The reputation of the site increases daily as trusts attain significant benefits from using it.

‘E-recruitment Projects in the Public Sector' (2007) identified that 1/3 of organisations utilising NHS Jobs showed half-yearly savings of £6.8 million, a saving of an estimated £5.7 million in recruitment advertising, savings of more than £0.5 million on recruitment administration supporting the theory that online recruitment reduces paper handling and administrative costs, and a reduction of over £0.5 million on temporary staffing, indication that the utilisation of NHS Jobs reduces both the time and cost of filling vacancies. This would support the researcher's findings earlier in this report.

With an estimated 50,000 visitors attracted to NHS Jobs website daily. It was identified that 80% of the 575 registered organisations use NHS Jobs regularly and 92% of users reported to be exceedingly satisfied with the service.

It has been approximated that less than 5% of applications now arrive on paper, reducing the need to mail application packs. The improved efficiency of the recruitment processes and savings on advertising expenditure thus reduce outgoings and direct money back into patient care, this identified as supporting the ethos behind the NHS's Gershon review. The report states that the cost per hire using NHS Jobs is approximately £2,000 whereas they state the national average is in the region of £5,000.

The report identifies organisations are undertaking a ‘more local approach' to the recruitment process, as enquiries are routed directly to trusts. NHS Jobs allows individual NHS organisations to connect vacancies with their own websites; this allows trusts to promote their individual employer brand, whether it is to local candidates or to the wider audience, nationally and internationally, when recruiting to difficult to fill or more specialist posts.

The report supports the developments that NHS employers have put in place to state:

‘NHS Jobs enables NHS organisations to present themselves as modern employers through embracing new technologies, delivering savings on recruitment processes and enabling paperless and seamless recruitment processes.'

The NHS Jobs website has been highlighted as an answer to issues for NHS trusts across the country to deal with all their recruitment problems, however a research report entitled ‘Scoping Study on NHS Trusts' Coping Strategies for Local Recruitment Retention Problems' undertook studies of NHS organisations across the country and identified one Trust that said :

‘Its move to e-recruitment via the NHS Jobs website, may have also caused some problems in recruiting to some posts, because people looking for non-medical jobs such as administrative jobs, would not normally look at this website, because they tended to browse for jobs of a particular type rather than look for jobs in the NHS.'

This is further supported by research quoted earlier from IDS (2006) and the IRS report (2007).

3.0 Methodology

3.1 Literature Review

The literature review aimed to provide an initial overview of recruitment, including an assessment of the complexity of traditional recruitment methods and e recruitment. It explores the initiatives made to overcome these problems.

The method of undertaking the literature review was a desk-based analysis of research and evaluation literature. Academic articles were sought through online searches using relevant databases (Cinahl, Cochrane, ERIC, and CIPD). Keyword searches were carried out using a combination of terms including ‘recruitment', ‘employee branding', ‘e-recruitment', ‘NHS recruitment' and ‘online recruitment'.

Journals yielding the highest relevant search results, such as ‘Personnel Today' and ‘People Management' were further searched by hand. Searches were initially limited to papers written in English published after 1998, when Barber had undertaken a substantial review of the literature, and ended our search at the end of 2007. These restrictions were identified to provide access to the studies most directly relevant to the report, it was identified that some key studies were found before this date, so were included also.

The literature review included all studies that were found that met specific criteria, and selections were made on the basis of the criteria, these being relevance and quality. Relevance was identified if the study provided insight into issues surrounding recruitment or not, and whether these studies were about attracting candidates rather than the fuller recruitment processes. Quality was assessed by identification of the source of the article, whether it had been peer reviewed and its inclusion in other studies.

The review was not restricted to those research activities of an academic nature, but the majority of searches looked to peer-reviewed journals as sources of the publications. In choosing to study non-peer-reviewed publications the author ensured they were of high enough quality and relevance to justify inclusion. The range of sources included; systematic and non-systematic reviews, other published research, grey literature, white papers and policy documents, reports, evaluations, cost-effectiveness studies, literature reviews and bibliographies.

Newspaper and magazine articles were also included, especially in looking at e recruitment, as the development of this new technology has not seen a great many empirical studies undertaken on the subject to date. The Internet also offered a plethora of downloadable publications, some of which contained valuable research findings, but limited resources did not permit a full search for these types of items, so there is minimal inclusion within the review.

The data base searches and other sources returned more than 2,000 items. Approximately 1000 were on subjects not relevant to this report; over 900 were relating to the wider recruitment processes, only available as abstracts, or from dubious sources. This left 90 items in our final review.

The author feels the methodology used carries with it some limitations. Due to the broad nature of the topic being searched; locating all the relevant articles through systematic database searching was difficult. With the large number of studies contained in multiple literature databases and the inaccurate functioning of keywords as search tools, it may be that useful studies that contained information pertaining to the subject, but not explicitly described, were overlooked.

The findings listed in the review, as in most literature reviews, may also be subject to “publication bias” and only studies that were providing positive effects were offered for publication.

3.2 Benchmarking

Benchmarking can provide facts to answer questions. It can provide data to show what can be achieved. Perhaps more important, benchmarking can tell how to achieve the same type of results! Benchmarking gives the external references and the best practices on which to base evaluations and to design work processes.

There three types of benchmarking that can be conducted, these are: strategic, data based, and process-based benchmarking. There are differences depending on the type of information that is being gathered. Strategic Benchmarking looks at the strategies organisations use in order to compete. Data based and Process-based Benchmarking focus on making improvements in business processes and are usually aimed at identifying how well other organisations perform in comparison, and how these performance results can be achieved.

When it is known how others are doing, data is utilised in order to understand how the organisation can improve. The most straightforward way is assessing where there are gaps between the organisations performance and that of the benchmarking partners. These assessments can be used to identify the best practices for the organisation to adopt.

A benchmarking exercise was undertaken to look at the way other NHS organisation locally manage their recruitment process and to gain some benchmark data to identify how long the process takes and their utilisation of E recruitment via the NHS jobs website. 15 local organisations were contacted by telephone and questions that were asked included their time to recruit, frequency of advertisement on NHS Jobs and when references were sought.

The benchmarking was undertaken utilising telephone surveys. Telephone surveys provide a means of gathering a snapshot of the views of a large number of people. The results can be summarised in the form of statistics allowing the measurement of such things as current performance, possible future performance/expectation, attitudes and opinions. A mix of qualitative and quantitative data can be collected depending on the questions asked, for this exercise quantitative data was gathered.

The advantages of this method is that, it is a cheap option, has a higher response rate than some methods, is easy to manage and can be carried out in the short time frame I had available. Disadvantages were difficulty in contacting people, and people as seeing the phone calls as intrusive. It was also identified when developing the questions they need to be short and concise.

3.3 Managers Questionnaire

A set of questions was developed in order to establish people's opinions on the individual topics relating to recruitment. Effectiveness depends on asking the correct questions and having the correct response choices. Responses are normally chosen from a suggested range. Questionnaires are often self-completed, in the case of postal surveys, which are posted directly to chosen participants or dispensed interactively with an individual asking the questions and recording the answers.

For this report the questionnaires were self completed, but distributed and collected by hand to ensure the response rate was good. They provided a means of gaining an understanding of the views, of a large number of people in the organisation, in relation to recruitment. The results were analysed and summarised in the form of percentages of respondents, which allowed responses to be expressed as quantified measures. Predominantly quantitative questions were asked, where respondent can choose from a range of responses, although some open-ended questions also generated limited qualitative data.

This method was utilised as I was looking for a broad understanding of current performance with regards to, current satisfaction, people's perceptions of issues, and identifying priorities for future service delivery.

The advantages of using this method was, results are easy to assimilate and communicate, results can be presented in different formats and can incorporate several issues in one survey.

The disadvantages are often poor response rates; particularly in postal surveys where respondents often need incentives or a reminder; sample bias; if the sample is too small or unrepresentative, and often poor design can produce misleading results .

The questionnaire was piloted before distribution around the offices by utilising a small group of staff available, in order to identify any issues with the questions. Some investigative work had also been conducted through a focus group in the development of the questionnaire, and a mixture of closed questions, where people choose an answer, and open questions, where people can provide reasons were developed.

To ensure a good response rate was achieved the questionnaires were kept relatively short and simple and it was made easier to reply by the questionnaires being collected once completed. Assuring people of confidentiality and data protection was important at this point.

The sample group was drawn up to include representatives of the four Divisions of the Trust and of the 4 sites, to ensure recruitment services were examined across the Trust. A group of 30 representatives were identified to represent the senior managers in the organisation. (8a and above)

Whilst the spread of respondents was carefully chosen to avoid sampling errors, it could be argued that some degree of bias was deemed inevitable due to the non-probability sampling method used. However, the research attempted to minimize response bias through seeking the trust of the respondents in ensuring confidentiality was assured. It is also possible for researchers to deliberately or inadvertently write survey questions that bias people to respond the way they want them to. (Salant and Dillman (1994), Frankfort-Nachmias and Nachmias (1996))

The use of face-to-face interviewing would have enabled the author to ensure that questionnaires were correctly complete. This method also affords the flexibility required when conducting research on concepts or when using various stimuli. However, the time restraints of the author and managers in the organisation did not allow this method to be utilised.

3.5 Process Mapping Exercise

Process has been defined as; a series of connected steps or actions to achieve an outcome. The most commonly used methods for designing and analysing processes are process maps and flow charts. They are the most widely used of the entire problem solving toolkit. In order to promote a greater and shared understanding of 'how the work is done' it is often easier to graphically represent the logical steps. This can lead to process improvements as it presents opportunities for identification of problems.

The process mapping exercise with the recruitment department was undertaken in a half-day session with the whole of the recruitment team from the Trust. It has been identified that the whole team should be present to allow the process to be mapped effectively and changes made to be ‘owned' ( xxxx )

The Process mapping exercise was undertaken as a continuation from the ‘lean game' and assessment (xxxxx) that had been carried out to allow the team to be made more aware of processes and team working.

The author facilitated the session, directing the team to identify the steps involved in the recruitment process. Once the mapping stage was completed the team were supported to identify the areas that were hold ups to the process, areas of good practice and identify solutions to identified problems in the process.

The team were hesitant initially as to what the process mapping would reveal, but the outcomes were identified as positive and enabled the team to get an insight of others responsibilities and the overall processes the recruitment department followed. The process is facilitated to allow the participants to feel safe and able to contribute.

4.0 Findings

4.1 literature Review

The report clearly shows that online recruitment has established itself as a significant part of the recruitment strategy and practice of a wide range of organisations.

The Internet is currently being used to greatest effect for advertising and facilitating the application process. Use of internet-based systems to track and manage candidate applications are becoming increasingly popular, particularly amongst larger organisations and are providing significant benefits in terms of efficiency, cost and capability to monitor and report on recruitment activities.

Recruitment is a costly business and it seems that the review has identified that e - recruitment is a way of saving money by reducing the time to recruit and cut the administration processes involved in recruitment. Researchers have identified the need to enhance and develop employer branding to allow more applicants to be attracted to the organisation and actively apply for vacancies, whether that be by traditional or by e recruitment methods.

4.2 Process Mapping

Process Mapping was successful in identifying areas where there were potential problems. Once the process map was in place it was identified which areas of the process presented the problems.

Hold ups were identified at the short listing and pre interview stages. References and CRB check stages and in posting the jobs for advertisement. Advertisement of positions was undertaken on a two weekly basis with a bulletin being published on the Trust website and local job centres being sent a hard copy. Hard to recruit jobs were also listed in local press and relevant journals. The NHS Jobs website was used, but jobs are posted on the site every 2 weeks when the bulletin is published or often with only a few days before the closing date is reached. From the results of the process mapping, a bench marking exercise was planned to get further information on the areas of hold ups and difficulties within the process.

4.3 Benchmarking

A benchmarking exercise was conducted with local Trusts in the area to identify best practice and identify targets for the Trust to aim for. A telephone survey was undertaken with questions being asked of Recruitment Mangers to assess the practice across the area. 15 trusts were chosen (Appendix A), the demographics of these Trusts do not match Pennine Acute Trust, and only one CMMC came close to the numbers of staff and multiple site complexities, but the other Trusts gave an n indication of practice and the expectations that could be achieved.

Of the 15 trust surveyed, the average time to appoint to a post from advertising the post to a start date being arranged was xxxxxx. The least time being xxxx the greatest being xxxxxx.

This cut of point was chosen as with the introduction of agenda for change notice periods vary dependent on grade from 1 month to 3 months and this would not give an accurate indication of recruitment processes.

It was identified that all of the Trusts surveyed utilised NHS Jobs to advertise there vacancies, but only our own Trust did not put on the post as soon as it was cleared for advertising. 7 put of the 15 Trusts identified an interview date on the advert and the same 7 identified using the short-listing tool with the NHS Jobs to short list candidates. These 7 Trusts also proved to be the Trust with the shortest recruitment times.

4.4 Managers Questionnaire

To get some feedback from the users of the recruitment service internally a questionnaire was developed and circulated to a sample of senior manager's with a responsibility for recruiting staff in the Trust. Questions were asked about the service and the difficulties experienced and feedback requested to identify what would make the process more effective for managers.

The questionnaire identified the following results

  • How often do you utilise the recruitment Department in the Trust?

One hundred percent of the respondents utilised the department at least yearly, with 50 percent utilising at least 6 monthly.

  • Are you happy with the service you receive?

Eighty percent of respondents identified they were not happy with the service they received.

  • What are your main complaints about the service? Slow process, time it takes to get the documents, timing of advertising,
  • Would you prefer to receive electronic applications or paper?

80 per cent of the respondents identified they would prefer electronic applications, stating they were easier to access, cut down the waiting time for them to be sent to another site, the 25 percent who preferred paper copies felt the y were easier to look at and looking at applications on the computer could be difficult. Some were not happy with their computer skills to allow this to occur

  • If available, would you be happy to short list candidates online?

80 percent of respondents were happy to shortlist candidates on line, the 20 percent that were not corresponded with the previous question and it can be assumed similar reasons may be behind the

  • Would you be able to identify an interview date when advertising a post?
  • Do you check all candidates' references after the interview?
  • Could you wait until the successful candidate was identified and then request references?
  • How long do you feel the recruitment process should take advertisement to confirmation of a start date? Xxxx thought the process should take 4-6 weeks, xxxx 6-8, xxxxx 8-10, xxxx 10-12 weeks
  • How long does it usually take? The average time that the respondents felt it took was 10-12 weeks
  • If you were looking for another job where would you look first? 80 percent said they would look on NHS Employers website or Trust website, xxxx would look in the Health Service and Nursing journals and at the Trust Weekly bulletin
  • Would the reputation of an organisation have an influence on your decision to apply? 100 percent agreed that reputation of an organisation would have an influence on their decision to apply for a position with that organisation.
  • How would you rate the NHS brand? Of respondents thought the NHS brand was good, XX thought it was average and xxx thought the NHS brand was poor.
  • How would you rate Pennine Acute Hospitals brand? Of respondents thought the NHS brand was good, XX thought it was average and xxx thought the NHS brand was poor.

5.0 Conclusions

This report set out to provide a comprehensive overview of how recruitment including e-recruitment is being used, and provide an insight of the benefits and challenges of using e-recruitment technologies.

From results of the benchmarking exercise it would appear that recruitment times are slower within Pennine Acute than within other Trusts, and process mapping identified hold ups to the recruitment process in areas of short listing and interviewing due to the time taken to transport the documents across sites that are 7-10 miles apart.


Pennine acute Trust are currently not utilising the NHS e recruitment website effectively and the opportunity to shortlist online would not only save the time as identified in the literature search evidence, but has been identified in the efficient Trusts through benchmarking exercise and would be welcomed by the Senior Managers utilising the Service.

Process Mapping identified that references are being requested for all candidates, wether they are successful or not. This was time consuming for recruitment staff and was costly in terms of postage. The facility on NHS jobs to utilise references from candidates who had applied for jobs within the previous 3 months was not been utilised.

The e-recruitment initiative aims to reduce both those figures; saving time and money, which can then be spent on patient care.

6.0 Recommendations

Recommendations for the organisation from the results of the literature review, process mapping, benchmarking exercise and Senior Managers questionnaire are

  • E-recruitment to be fully introduced alongside existing recruitment methods for all posts, with an aim to reduce recruitment costs by 5% per year, which in an average year will mean savings of more than £100,000
  • Utilise the short listing functions of NHS jobs
  • Request references for successful candidates only, and check availability on NHS Jobs site to avoid duplication.
  • Managers to Identify an interview date on the advertisement

These interventions if applied to the recruitment process and implemented in the department should allow

  • The reduction from 12 weeks to 6 weeks for the length of time it takes to make an appointment. With 450 positions advertised every year (2006) this would mean an extra 2700 weeks during which new employees in the Trust are working for our patients instead of waiting for the red tape before they can start work.
  • Requesting references after interviews for successful candidates only
  • All applicants have a positive experience of the recruitment process and, wherever possible, are considered for the full range of opportunities available with Pennine Acute, reputation of the organisation is positive on first contact, word of mouth from staff within the NHS improving employee brand.
  • Resourcing is conducted both internally and externally in an open, fair and transparent manner and reviewed regularly so that supply is sustainable and inclusive of all available talent.
  • More traffic is driven through our local website, which is linked to the national NHS job website, and improvement in the quality of information available to potential candidates.
  • We will also be able to assess the impact of e-recruitment in hiring a workforce that is reflective of our local community.

7.0 References

Arboledas, J. R., Ferrero, M.L. and Vidal-Ribas, I. S. (2001). ‘Internet recruiting power: opportunities and effectiveness', University of Navarra, Spain.

Audit Commission, Change Here! Managing Change to Improve Local Services, Audit Commission, July 2001.

Audit Commission (2002). Recruitment and Retention: A Public Service Workforce for the 21st Century. London.

Armstrong, M. (2007). A Handbook of Human Resource Management Practice. Kogan Page Ltd. London

Barrow, S., Moseley. R. (2005). The Employer Brand - bringing the best of brand to people at work. Wiley. London.

Berry, M. (2005). Top companies lead online recruitment revolution.


BMJ. (2003). NHS launches recruitment website. BMJ 2003; 327:1367(13th December)

Breaugh, J., & Starke, M. (2000). Research on employee recruitment: So many studies, so many remaining questions. Journal of Management, 26, 405-434.

Cable, D.M., & Turban, D.B. (2001). Establishing the dimensions, sources and value of job seekers' employer knowledge during recruitment. In G.R. Ferris (Ed.), Research in personnel and human resource management, p.115-163. New York: Elsevier Science.

Cappeli P. (2001). ‘Making the Most of Online Recruiting', Harvard Business Review, Vol. 70(3).

CIPD (2001), Labour Turnover Survey Report, Chartered Institute of Personnel and Development. Available at http://www.cipd.co.uk/ onlineinfodocuments/factsheets.htm [Accessed 14 April 2008].

CIPD. (2005). Online Recruitment. Factsheet. London: Chartered Institute of Personnel and Development. Available at http://www.cipd.co.uk/ onlineinfodocuments/factsheets.htm [Accessed 14 April 2008].

CIPD. (2005) Employee turnover and retention. Factsheet. London: Chartered Institute of Personnel and Development. Available at http://www.cipd.co.uk/ onlineinfodocuments/factsheets.htm [Accessed 14 April 2008].

CIPD. (2006) Employee turnover and retention. Factsheet. London: Chartered Institute of Personnel and Development. Available at http://www.cipd.co.uk/ onlineinfodocuments/factsheets.htm [Accessed 14 April 2008].

CIPD. (2007) Employee turnover and retention. Factsheet. London: Chartered Institute of Personnel and Development. Available at http://www.cipd.co.uk/ onlineinfodocuments/factsheets.htm [Accessed 14 April 2008].

Department of Health, Delivering the NHS Plan: Next Steps on Investment, Next Steps on Reform, Department of Health, 2002.

DTI Survey. (2006).E-recruitment best practice in the private sector: a research project - phase 1: emerging issues to inform best practice across the public sector". Department of Trade and Industry. London

Elkington, T. (2005). Bright future for online recruitment. Personnel Today, 1/18/05, p.9.

Fombrun, C. J. (1996). Reputation: realising value from the corporate image. Harvard Business School Press, Boston.

Galanaki, E. (2002). ‘The decision to recruit online: a descriptive study'. Career Development International, vol. 7, no.4, p. 243-251

Gallagher, N. O'Leary. D. (2007). Recruitment 2020. How recruitment is changing and why it matters. DEMOS. London.

Graduate recruitment rising, survey finds. www.educationguardian.co.uk October 13, 2005.

GTI. (2006). NHS Trusts: Recruiting for the long term. GTI Specialist Publishers. Oxon.

Frankfort-Nachmias, C., and Nachmias, D. (1996). Research Methods in the Social Sciences, 5th ed. London: Edward Arnold

Gray, E.R., Balmer. J. M .T. (1998

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