Speaker1: [00:00:00] Why hasn't it been addressed in ten years? People have lives and they have choices. Let's not overreact. There are actually quite a lot of people out there who are ready to work in NHS settings, but are not going to go back. Nurses are going to say that's not good value for that shift. A million people went to work this morning as agency temps in the private sector, public sector. All over the economy. More jaw jaw and less war war. 

Speaker2: [00:00:26] Voices of Care, the healthcare podcast. 

Speaker3: [00:00:31] Neil, welcome back to Voices of Care.

Speaker1: [00:00:33] Well delighted to be here, Suhail. Always a great chance to dig into some of the issues we're seeing in terms of one of the most important workforces we've got. 

Speaker3: [00:00:40] Absolutely. And I was racking my brain, I think the last time you were here was the year where we had three prime ministers back in 2022.

Speaker1: [00:00:47] Unpredictable.

Speaker3: [00:00:49] It was unpredictable. I want to start with politics, actually. And sometimes politics makes strange bedfellows. Jeremy Hunt, Wes Streeting, quite different politicians, but both, ten years apart, have gone on record as saying that recruitment agencies, healthcare recruitment agencies are ripping off the NHS. Are they?

Speaker1: [00:01:10] In a word, no. You would expect me to say that. I think it's really important when we get to these headlines and politicians have a difficult job, they have to get a point across and they're often quite robust. You ask the question, well, what's the problem that they're complaining about here? And why hasn't it been addressed in ten years? And for us, there are very high-cost shifts inside the NHS that frankly, I think as an industry we don't want to exist. And we know the NHS don't want to exist, but a lot of those are driven by the way the system currently works. And for us, the bulk of agencies are signed up to frameworks wanting to supply on framework at good cost and are bringing staff to the NHS that would not otherwise be available in terms of getting those shortlists down. So for me, I think you get a free punch as a new Secretary of State for Health, we've taken it now. But really, Mr. Streeting, as it was with Jeremy Hunt ten years ago, it's about sitting down at the table and discussing how do we manage a market that makes sure that we get high-quality patient care, great opportunities for health staff and good value for the taxpayer? And I think we can do that. The answer is more jaw jaw and less war war. 

Speaker3: [00:02:32] That's well put. And just to paint a picture for us, agency working has been around. It's been ubiquitous for decades in the NHS and indeed social care. And it's played a big part over the last few years, pandemic, and post-pandemic. 

Speaker1: [00:02:46] Well, this is I think one of the most important points, which is agency work as a model, has been around for a long time. In fact, the REC celebrates its centenary in 2030. So to give you a sense of how long the industry's been working. We've always had a part of the membership who are staffing partners, and that's the way we view it with the NHS, with the care system. Those businesses are set up primarily with the goal of ensuring the NHS is successful and drawing into NHS and care work people who perhaps are not ready, not at this stage able to fill the requirements of substantive work, and also, obviously those people who want to mix and match what they do. So the industry as a whole, we have 3000 members, 500 of them are in some way supplying health or social care, whether that's domiciliary care or it's nurses or it's doctors. There's a lot in the industry that is all about helping get things done, you know, during the pandemic, we have really good case study evidence that shows that agencies were far quicker at getting doctors who were available, nurses who were available on to wards to help with the pandemic than any of the other forms of engagement. We know, for instance, we talk about bank and agency as different forms of engagement for temporary staff. They are different. Bank workers look different to temporary workers in terms of how they engage. We need both. It's obviously always going to be the case that the NHS needs a really stable, substantive workforce. Bank and agency have the role to play around the edge. And for us, that's about having a proper discussion with trusts, with the government about how we manage that for the best interests of the country.

Speaker3: [00:04:42] And just let's tarry there a little bit. Bank and agency, that dichotomy, the rhetoric of Julian Kelly, the chief financial officer, NHS England, recently talked about very proudly that agency spend had been pushed down over the last couple of years by 1.5 billion. Now, the context for that is that bank spending has tripled over the last few years. Is that necessarily cheaper or better value for money?

Speaker1: [00:05:09] Well, this is, I think, a really good point. And we think in terms of a staircase, substantive staffing followed by bank staffing followed by agency staffing. Agency workers are typically more willing to travel further for work. Bank staffing is typically staff who are employed by the NHS and are willing to take some shifts near to where they are. The characteristics of those workers are different. And then when you get into bank, we've got emerging evidence across the board that bank rates are often now higher than agency rates. Bank rates often come with additional costs because you're dealing with people through NHS systems. And of course, you've got staffing providers who are supporting banks as well as supporting on framework agency and in emergency cases of framework agency. So this is a complex market. And it's not true to say that bank is cheaper than agency now. So when we talk about the full costs it's worth remembering, come back to Jeremy Hunt, when caps came in ten years ago, the government's line then was if evidence emerges that we have to do the same with bank as with agency, then we'll look at it. I think evidence has emerged that that's the case, and that's why some of the comments from, for instance, Secretary of State are disappointing because fundamentally the industry that's moved on cost in the last decade is agency.

Speaker3: [00:06:34] Now, that's interesting because we've danced around this or the sector's danced around this floor around frameworks. I mean, ten years, nearly, setting caps. I mean, you're on record for saying that they're not fit for purpose. They need to be looked at again. Can you address that point, but place it in the wider context, because I'm fascinated that the government has recently announced a plan to heavily use independent for-profit providers to support a laudable aim, which is reducing the elective care delay. But the for-profit providers around the agency seem to be demonised.

Speaker1: [00:07:11] Well, I think there is some ideological inconsistency there, but I think in lots of policy, if you start from looking for ideological consistency, you will be looking for a long time. I think some of this is about the practicalities and pragmatism. Clearly, if you're using a hospital, a private hospital to supply, that model is kind of entirely handing things out of the NHS. What agencies do is help things be done inside the NHS. So if we care about public sector delivery of healthcare. Actually, agencies are enabling that to happen, and those agencies are willing to go through a discussion about frameworks and cost controls that make sense to sustainability. And it's that point about sustainability that I really want to focus on.

Speaker3: [00:08:11] It's one of the missions of the five missions of the Prime Minister, a sustainable footing for the NHS. 

Speaker1: [00:08:17] Exactly. And so what is sustainable? I'm going to tell you now that I think it's unsustainable for the NHS to imagine it can meet its needs in a world where it employs everyone who supplies care in NHS settings. I think it's also unsustainable to address cost-wise, to address the entire backlog through outsourcing care to the private hospital sector. There must be a growth in the ability of the NHS itself to deliver, and we know what the challenge there is. We don't have the throughput of medical professionals that we thought we had, that we think we need that will take time to address. We are very sensibly trying to address it now, but the bit that I think we forget about is that the workforce themselves have agency. They have choice. They are actually quite a lot of people out there who are ready to work in NHS settings, but are not going to go back to a full-time, substantive job. And so there's a discussion to have about, well, how do we make substantive jobs more flexible, more agile, but also how do we make well-costed framework agency supply attractive to staff. And this is where, you know, my kind of feedback for NHS England. My feedback for the Department of Health has been pretty consistent over the last few years. 

Speaker1: [00:09:44] And there's a deal of, I wouldn't say frustration, but impatience on our side of the table to say, look, we are ready to help you solve this problem. And we accept that some of that involves us changing. But that has to start with not preaching to the sector, but sitting down and working through what we can do. Because I've been talking for years about if you freeze on framework agency nurse rates for year after year after year, when we have an inflation spike, when pay for substantive nurses goes up strangely enough, nurses are going to say that's not good value for that shift. They'll turn the shift down. And eventually you get to a point where a medical director of a trust is panicking, and they're going to those very high value of high-cost shifts that we all want to see eliminated. And a big part of this, actually, for me, is understanding that when we talk about agency spend, we're largely just talking about wages for workforce. And when agency spend goes up, often it's driven by some of these very high-value, high-cost shifts that could have been sorted out if we had a more sustainable approach to frameworks.

Speaker3: [00:10:56] And in any protestations to ban agency, which obviously Mr. Streeting alluded to back in November, I think in your phrase saves pennies but unfortunately will cost pounds for this very point. 

Speaker1: [00:11:10] Well, that's exactly the point. You end up finding a workaround because anything else is impossible. And that workaround is going to be more problematic, more costly, and likely drive you, hold you back in the laudable goal of ending all framework agency shifts or restrict them to the most emergency cases because you want trusts to be in a position to schedule agency workers a week, two weeks, three weeks out, not having an agency calling around on a Sunday morning to get someone to drive 200 miles to do a midwife shift, and then being surprised that that costs you a couple of thousand pounds. 

Speaker3: [00:11:47] No, absolutely. I want to just dive into that word agency in the other form that you used it, that these clinicians and non-clinicians that use agency, the REC have established quite an important campaign, I think last year, 'the Voice of the worker' because the preferences of workers seems to be sometimes missing from some of the rhetoric. Can you expand upon that work that you've done? So I think it informs this debate because we need all stakeholders to come to the table, including the people who work these shifts. 

Speaker1: [00:12:17] Yeah. Look, I think there's something in all of this that is really important. And if you go back to the workforce plan that was prepared under the previous government, I mean, lots of laudable stuff in there. But to my mind, when you look at it, what is missing is a sense that the workforce are a group of individuals with individual goals and individual differences. It's quite doctors and nurses, and manpower planning-ish to use one of my wonky labour market words. People have lives and they have choices, and they have the ability to do things. Look, a million people went to work this morning as agency temps in the private sector, public sector all over the economy. And for sure there are cases where their experience could be better. And our engagement on the current employment rights bill is all about doing that. But the truth is, as our temp work works campaign shows, for the majority of people working temp, it's active choice. It's something that works for them now. And it gives you a position where in many sectors you've got skilled workers sitting on their sofa on a Saturday night planning the week ahead with the app open for maybe 2 or 3 agencies that they're signed up to, going I'll take those shifts there. That shift there. And then I'll take Mum to the hospital appointment then, and I'll go and see the school play then. Giving people real choice because they've got complex lives. Best example of this in the campaign is a lady called Claire who is a radiographer, to be frank. 

Speaker1: [00:13:51] She'd had it with where she was working as a substantive employee. She still loves radiography. So she's now doing some agency shifts as a radiographer, but she's actually fixing that skill shortage we talked about that supply shortage we talked about because she runs her own radiography training business now. And what agency does what flexible and agile working does is give people those choices. And unless we focus on resolving the NHS workforce demand through better choices for staff, and some of that is about how we can help government trusts move on the offer for substantive staff. And some of it's about the choices we have in bank and agency, but that focus on workers and their needs feels incredibly important because of course, government has traditionally had a slightly bifurcated view of agency, and I am often fond of pointing it out to politicians. But if you're Wes Streeting, agency is expensive in every other sector of the economy. I'm constantly told that agency is cheap and undercutting. Neither is true. It's a function of the market. It's a function of the choices that individuals make. And here we just need a discussion about what are the guardrails we want to put around this market. And if we have a sensible discussion about that, we can actually offer better working lives for medical staff and care workers, whether they're substantive bank or agency. And I'm going to lay a reasonably big bet we can reduce costs in a sustainable way to the NHS.

Speaker3: [00:15:32] Okay well, let's see what the listeners of the podcast say. That's a big vision there. You talked earlier. If we could just take the lens back a little bit beyond healthcare. I mean, the REC represents 3000 members. Paint the picture a little bit for us. A million people out on temporary work. The REC represents all of these individuals and the sector as a whole. I think the industry status report came out last year, gross value added. It's a much larger sector than people perhaps perceive. 

Speaker1: [00:16:00] Well, we talk about it as one pillar of the UK's world leading professional services industry. It's absolutely true that we have fantastic businesses exporting from the UK, headquartered here, working labour markets all around the world. As with the winner of our Lifetime Achievement award last year, Bev White from Harvey Nash had spent the week before the awards in New York hosting an event at the New York Stock Exchange with the Goddard Space Flight Center from NASA. I mean, that's world-leading professional services talking about the future of the science workforce in the US. And across our membership, I think increasingly clients in the private sector are coming to understand agencies as specialists in the way that they would their lawyers or their accountancy firms. And I think there's a little bit of that that needs to wash into our discussion in health and social care as well. Value added for the industry is over £40 billion a year. That makes us, when you add in secondary effects, a bigger sector as part of the UK's professional services sector than either law or accountancy. And you think about how they're celebrated. Together, the professional services are one of the eight focus sectors for the industrial strategy. 

Speaker1: [00:17:22] So there's a lot of potential value there. At a time when we know jobs are changing fast, and particularly in the UK, we're looking at a shrinking labour force as many Western European countries are over the next few years. At this point, people who are partisan, one side or the other will tend to think that Brexit has hove on to the rise, and it actually hasn't. By far, the bigger change is that the baby boomers are retiring to be replaced by smaller cohorts in younger generations. Well, amongst the baby boomers, and we're just publishing some career returners guides, we need to be thinking about how we can keep some of their labour in the labour market a bit longer. And that speaks to flexibility and agility. But it's also about how we help companies, in particular in the private sector, but also employers like the NHS think through the balance of what capital does, what the machines do and what people do, particularly in caring professions. That is a much more complex and difficult world for employers than the one we've had for maybe the 40 years up to 2015, when we had a relatively loose labour supply, both in terms of domestically and in terms of flow from Europe.

Speaker3: [00:18:40] And you've said, I mean, that feeds into, as you say, all facets of the socio-economic policy. We had the Deloitte Consumer Tracker coming out in January. And you said there's a reason for cautious optimism to use your phrase, because it was a tough year last year, and I think we've had the longest labour market contraction for best part of two decades. 

Speaker1: [00:19:02] Yeah. One of the things about recruitment is it's a bellwether. And you can chart the way it goes, which is first temporary labour goes off a little bit as people pull their horns in and then people think, oh, we'll just put a hiring freeze in place and they stop hiring permanent staff, and then things get a little bit brighter and they start bringing temporary staff in. And then finally they get some confidence and they start bringing permanent staff back. Very important to bear in mind the long wavelength of the pandemic when we talk about labour market performance. We did next to nothing in 2020, as we all kind of sat on our hands and worked out what the hell was going on. Then, when hiring unlocked, maybe in the second calendar quarter of 2021, we had this massive sugar rush where I think looking back, net business' probably over hired a little bit. That took us through to maybe the summer of 2023. And then for maybe a little longer than maybe two years, beginning of 2023, we've had this long downturn. Now, what we've seen is for the last six months, employers every month have either been saying they're getting more confident about their business or their confidence about their business is staying roughly the same. Their confidence about the economy always lags. It's driven by what's been in the news. So they're still broadly cautious on the economy.

Speaker3: [00:20:27] Placement and permanent placements have been quite low in recent debates or recent data.

Speaker1: [00:20:32] But that seems to be recovering as well. So at this point, clearly the budget was a bit of a body blow to businesses. You know, it's a lot of cash to take out, particularly of some sectors like hospitality and retail in terms of the way the National Insurance rise is done. But we're seeing just tentative evidence that shock is playing through a bit quicker than maybe we expected. Last week we published our employer surveys, 600 businesses across the country telling us their outlook. And it's in the right direction. It's more cautiously optimistic than I would have expected on most counts, they're looking at taking their hiring up during this year. Slight rise in the number of firms looking at dropping workforce numbers. But we're talking about 5% to 14%. So you could say it's almost trebled. But 14% of firms looking at cutting workforce numbers after the body blow of the budget is actually broadly expected. So my view is let's not kind of, let's not overreact. Things aren't as bad as maybe some of the media narrative makes out. They're also not as good as we'd like them to be. But I still firmly believe that through particularly sort of late spring on, we'll see a bit of a recovery in the labour market. We just need to watch for signals as well, because how the labour market works is changing. So we, amongst others, published job board adverts as a tracker. Just watching now to see if there's a secular shift away from using job boards to using other forms of recruitment. We know X Hiring is coming, for instance, to the United States, and it will ultimately come to the UK. As recruiters, when I go and talk to businesses around the country, a real sense at the moment that we're being thrown back on the traditional virtues of the industry, which are about knowing your candidates, knowing what they want, knowing your clients.

Speaker3: [00:22:31] Essential human aspects.

Speaker1: [00:22:33] Absolutely. And I think when we think back to how important the health and social care workforce is and how important taking care of those workers is, one of the reasons, you know, many staff in this sector say they come to agency is not just to add a bit to income from a substantive staff, although, you know, a majority of RCN members take agency shifts.

Speaker3: [00:22:58] Yes.

Speaker1: [00:22:59] And it's also for those who are doing it a bit more regularly. It's more about control than it is about wages. And you know, if you're at NHS England or you're at the Department of Health, there's a potential big win there in terms of retaining people in the health service by improving employee experience.

Speaker3: [00:23:21] And that retention is going to be really important. You said market sentiment and there's quite a lot of negative narrative. And I'm going to throw a dose of positivity in there if I may. Your report a couple of years back sort of highlighted that if we... I want to talk about skills, because you've gone on record as saying this is a hugely competitive market, it's going to remain tight. The government has Skills England, the new levy, the renamed levy, if you want to call it that way. I think you've gone on record saying if we get this right, we potentially can unlock quite a significant number, 39 billion. That's what I've got in the back of my head in terms of value add.

Speaker1: [00:23:56] Two Elizabeth lines a year, every year to the economy.

Speaker3: [00:23:59] Wow.

Speaker1: [00:24:00] And yes, I'll say this for the benefit of REC members in the North now, some of those Elizabeth lines in the North. But that sense of getting to the heart of the real problem in the British economy, which is if the economy isn't growing, everything becomes a zero-sum game. So funding the NHS becomes a zero-sum game with the tax rate. So, you know private sector businesses', body blow with NI. But those businesses would also say but we understand you've got to fund the NHS. The only way you do both is you grow the economy. So the big and I think positive news of the new year is this shift to focusing in centrality on growth from the chancellor. That has to flow through to decisions. The detail of what's in the employment bill, planning, approvals. And when we think about, the NHS, thinking about reforming how the NHS does its business to make sure that every penny of that huge budget is well spent. We do see kind of trade-offs happening. Talking to an REC member recently, sometimes diktats arrive from on high. You see, for instance, contractor locum doctors going into trusts where they'd happily take a substantive role. But the trust has been told they can't hire them substantively.

Speaker3: [00:25:29] A bit more joined up, dare I say, strategic?

Speaker1: [00:25:31] I think I think it's about the framework of that workforce plan. So much of this is about getting people around the table and working out what a good plan looks like and following it diligently. You know, one of the things that often surprises politicians when we get to talking about this is actually REC, and agency relationships with the unions are pretty good because the unions can see their member's interests are often well served by a positive relationship with their agency. And I think broadly, if we all park our pride at the door, there's a lot that we can do together to meet that service standard. And fundamentally enable the NHS to be a driver of growth because we know inactivity is high and waiting lists are holding people away from work. If we get those waiting lists down, more people in work, more activity, it's more tax, it's more funding for the NHS. 

Speaker3: [00:26:24] No, absolutely. You recently I think make that conversation even more candid is that you can bring expertise about perhaps what isn't seen at the surface. You recently appeared before Parliament to give your insights about some, we won't go into all the details. There's so much detail around the employment bill, but you raise the spectre of false self-employment and that one of the main things, one of the great lacuna in the Bill is that there is no specific proposal to regulate umbrella companies. Now, this has a huge impact across many sectors. But in healthcare, because it's that level playing field that perhaps impacts this whole issue around what does this all cost?

Speaker1: [00:27:08] Yeah. And I think it's a fairly general theme in business feedback to government at the moment, which is, you know, if you want to play by the rules and you play through the government systems, there are costs associated with that. Valid or invalid doesn't really matter. You play by the rules. If you don't play by the rules, what happens to you? Increasingly, firms are concerned that concerned, the enforcement is weak. And if you look then at umbrella companies, which is where your pay rolling staff through temporary contractors, through a third party, who are the actual engager. There is certainly a heart of that industry, perfectly valid, particularly where people are working for multiple agencies. But there is also a structure there that allows for people to be being paid at rates which are clearly not kind of tax compliant. And we often see that as these umbrella companies wheedle their way into different sectors, that it becomes very difficult for compliant firms to compete or for firms who are working with compliant umbrellas to compete.

Speaker3: [00:28:27] Or fully employ their own staff.

Speaker1: [00:28:28] Indeed. So there's a whole piece here about what is the structure for ensuring there's a level playing field, by definition that will benefit those agencies that government want to encourage which are compliant ones. So you know, the businesses who played in frameworks from the beginning are the ones who've had the biggest uphill challenge over the last ten years by comparison to those who chose not to play and to do things other ways. I think we've got to redress that balance.

Speaker3: [00:29:08] And going back to your clarion call, you can do that best around the table and shed some light, because the umbrella industry, I think something like 500,000 approximately people are paid through that. So an important point. I wanted to end the discussion. Just a bit of a crystal ball looking in any danger of predicting too much. But it's a very important year. We've got the industrial strategy consulted on, you know, 2035 being the big year. We've had the back-to-work white paper that's come out recently. Two factors that really spring to mind based on some of your public pronouncements. Firstly, the tight labour market and the importance of or the remaining importance, I think you've done a survey where significant numbers of employers still want to attract international talent. Now, the zeitgeist around immigration is very different from when we spoke two years ago. So put that into context where a labour market that's this tight and how important that will remain as a part of that.

Speaker1: [00:30:07] So there's a lot going on in those questions. I mean, we've talked about the tightness of the labour market. The domestic labour force is just gradually shrinking and people have choices and they can work in different ways. And as we've seen with kind of Australia, Saudi, the Gulf more broadly, the United States, countries are looking at the UK and thinking, well, they produce bright people who are well trained and we can potentially pay them more. And there's a real risk of a bit of flight out of the UK. Immigration is never the answer to every problem. And I'll say on behalf of the private sector, there is a little bit of a challenge in the debate right now because immigration for work was so high a couple of years ago. Leave aside the Hong Kongers and the Ukraine programs because they're very understandable humanitarian points. But almost all of that was for health and social care, which cannot be sustainable in the long term. You need to have a domestic pool and then you will need sensible, skilled migration from elsewhere. I think most businesses would say that if you talk to people and you know all the polling shows, if you ask people, do they think immigration is too high, they will say yes. And at the rates of net migration we've had for the last couple of years. I mean, that doesn't seem an unreasonable position. Net migration will come down. If you ask people, do you think a skilled nurse should be able to come to the UK to work with the NHS? Do you think a builder should come to work in housing construction? Actually, almost any job.

Speaker1: [00:31:46] The standard answer is actually if they're coming to work and they're coming to pay tax and they're coming to play by the rules, then yes, they should. So we need a nuanced debate about that which places immigration as part of the labour market context, but doesn't ignore the fact that our FE system has been underfunded for the last decade, and it returns £20 for every pound you invest in it. That doesn't ignore the fact that we've got to do better at retention. We've got to do better at job design. And all of this actually requires a different approach to how we think about the labour force, private and public sector. So in the Department of Health for Health and Social Care, but actually broadly. And in the industrial strategy, the thing I've said to Johnny Reynolds about the industrial strategy is don't you dare publish an industrial strategy that has a lateral that reads skills, because that just does what we were talking about earlier. It just treats people as the passive recipients of training. Have one that's called workforce and productivity, because if it's called workforce and productivity, it's about how we design jobs, how we engage people with jobs, how we make money in what they do or deliver great care in the public sector and how people progress. If we have that debate, then we can start to unlock growth in a much more fundamental way. That removes the zero-sum game from do I raise taxes and annoy businesses and hold down growth to fund the NHS, or to damage the NHS to keep taxes low? There's a real challenge there, but what it requires is going back to where you started.

Speaker1: [00:33:18] We've got to get beyond the headlines here. We've got to be more medium and long-term about what we're thinking. You know, the thing I've said about the employment rights bill is the most wonkish thing in the REC's election manifesto was have a workplace employment relations survey. No one listening to this will have ever heard of WERS, but it's like manna from heaven in my labour market geeky world. It is how we know what's really going on in the British workforce. It was run once every 5 to 7 years until 2011 when it was last run. So we are now 14 years since we last had any serious data on what it's like to work in Britain. And that feels, given the decisions that we're trying to make. That feels like a big lacuna. It's a bit of a symbol of a government that's willing to lean in on how the private and public sectors design jobs, engage people, retain them, and set guardrails for flexibility. But flexibility that supports people. That's the thing. Go back to my appearance in appearance in Parliament the other week. A million people went to agency, went to work as agency workers this morning. You've got to protect them without taking away the opportunities that they're very happy to have taken this morning. That means get round the table. 

Speaker3: [00:34:37] I hope the Department of Health is listening to that. 

Speaker1: [00:34:41] Maybe they are.

Speaker3: [00:34:42] Next time you join us, you have to shed some light about what was said around the table. Fingers crossed.

Speaker1: [00:34:47] Fingers crossed.

Speaker3: [00:34:48] Neil Carberry, thank you very much, as always, for your time and for your candour.

Speaker1: [00:34:51] Thank you, Suhail.

Speaker3: [00:34:52] My pleasure. If you've enjoyed this episode of Voices of Care, please like, follow, or subscribe wherever you receive your podcasts. And if you want to find out more about how we're turning the dial on the debate around health and social care, please visit newcrosshealthcare.com/voicesofcare. In the meantime, I'm Suhail Mirza. Thank you very much for joining us and look forward to seeing you on the next episode.

Speaker2: [00:35:12] Voices of Care, the healthcare podcast.