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The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions, attitudes and behaviour of permanent staff with particular reference to their implications for patient safety and service quality in hospital accident and emergency departments. The analysis is set in the context of the job demands-resources theory.

The research was undertaken using a case study approach with semi-structured interviews in two London hospitals. Participants included staff from the HR director level, clinical managers and permanent staff who all had an influence in the hiring and management of temporary staff in some way. Transcripts were analysed thematically using an adopted framework approach.

The results indicate that the effect of temporary staff on permanent staff depended on the quality of the “resource”. There was a “hierarchy of preference” for temporary staff based on their familiarity with the context. Those unfamiliar with the department served as a distraction to permanent staff due to the need to “manage” them in various ways. While this was rarely perceived to affect patient safety, it could have an impact on service quality by causing delays and interruptions. In line with previous research, the use of temporary staff also affected perceptions of fairness and the commitment of some permanent staff.

A model developing an approach for improved practice when managing temporary staff was developed to minimise the risks to patient safety and service quality, and improve permanent staff morale.

The review highlights the difficulties that a limited amount of temporary staff integration can have on permanent staff and patient care, indicating that consideration must be placed on how temporary staff are inducted and clarifying expectations of roles for both temporary and permanent staff.

This paper studies the under-researched impact of temporary staff, and, distinctively, staff employed on a single shift, on the behaviour and attitudes of permanent staff. It highlights the need to consider carefully the qualitative nature of “resources” in the job demands-resources theory.

The purpose of this paper is to provide an up-to-date, comprehensive, independent and credible assessment of relevant academic and other literature since 2007, on the effectiveness and value for money of performance-related-pay (PRP) in the public sector.

PRP was studied using both economics-based literature and literature from the organisational and management field (including human resources, management sociology and psychology). An initial search of databases identified 7,401 documents regarding PRP in the public sector, which was reduced to 57 final papers included in the study (27 in the health sector, 16 in the education sector and 16 in the civil service) after abstract and full paper screening.

The review found some evidence that PRP schemes can be effective across the three domains of the public sector for which there was evidence available (health, education and the civil service), but findings within and between the sectors are mixed, with scheme effectiveness often dependent on scheme design and organisational context.

The research highlights the importance of considering both economics-based and organisational literature when discussing PRP in the public sector, and the implications for motivation and PRP design.

The results indicated that the design of PRP schemes could influence their effectiveness and outcomes, and the research suggests how the challenges of designing and implementing PRP schemes can be overcome in the public sector.

The review highlights that when implementing PRP schemes there may be gender differences in their overall effectiveness (especially in education) and there must be consideration for how fairly the PRP scheme is perceived.

The paper uses literature from economics and behavioural sciences when looking at the motivational implications for PRP in the public sector.

The authors wanted to find out if hiring temporary staff at busy A&E departments had a negative impact on the work of permanent staff.

They did semi-structured interviews with managers and permanent staff at two London NHS hospitals with different policies for hiring temps. Hospital A prioritized the use of NHS professions for its bank and agency nurses, as well as doctors and locums. Hospital B focused more on using its own internal bank staff as temps.

The findings showed the generally negative effect of using temporary staff on permanent staff. But the reaction of permanent staff depended on the type of temporary staff. More experienced temps could generally be trusted to get on with the job, whereas the inexperienced ones required more supervision.

The authors proposed an approach to improved practice beginning with “macro-level managers” who could maintain service quality as a higher priority than contracting costs. They could also encourage permanent staff to do occasional temporary shifts. The co-authors also felt that “meso-level managers” could be given the role of hiring “preferred temps” where possible.

The purpose of the research was to assess whether hiring temporary staff at NHS hospitals had a negative impact on the quality of work of the permanent staff. The authors wanted to test the hypothesis that taking advantage of the flexibility of temps was a “false economy” because it distracted permanent staff from focusing fully on their own tasks

The authors selected two London hospitals with different approaches to temporary staff recruitment. Hospital A was a major NHS Foundation Trust and teaching hospital. It used NHS Professionals (NHSP) for the provision of bank and agency nurses, as well as doctors and locums. Meanwhile, Hospital B used its own internal bank staff as temps. Managers at both hospitals were asked to assess the work of the temps and its impact on permanent staff.

Results showed the generally negative effect of using temporary staff on permanent staff. But it depended on the nature of the temps. The more experienced temps could generally be trusted to get on with the job, whereas the inexperienced ones required more supervision. Other potential problems included the temps’ unfamiliarity with procedures that slowed down their work, and sometimes a lack of motivation as they were only there for a short time.

Based on the results, the authors proposed an approach to improved practice beginning with “macro-level managers.” They said that they may usefully be tasked with maintaining service quality as a higher priority than contracting costs, and ensuring that policies reflect the need for adequate staffing levels. They could also encourage permanent staff to do occasional temporary shifts.