Health services are deeply affected by political and 'macro-ethical' [ 22] issues such as financial and resourcing decisions, contractual arrangements, and workforce changes.
The company employs 3,500 people on a salaried basis, with the rest of its workforce on a short-term contractual basis.
Examples of contractual approaches to flexibility include 'outsourcing' the workforce, where the employer sub-contracts the provision of labour to an intermediary such as an agency.
A final issue concerns the relationship with the workforce, with specific regard to the contractual relations.
This measure resulted in changes in the number of permanent staff and flexible, therefore less predictable, contractual relationships with a growing part of their workforce.
"We are considering cost cuts," he said, although he later praised the expertise of the British workforce and said he did not wish to alter their contractual arrangements.
The results showed that the academic primary care workforce was geographically static but somewhat unstable in terms of contractual arrangements.
Interview topics aimed to elicit in-depth insight into scopes of service, contractual arrangements, and factors impacting on the sessional employment models, such as workforce, funding, inter-professional relationships and clinical skills.
That leaves most organizations lacking a clear total workforce perspective and no integrated strategy to engage workers at the right time, cost, and contractual arrangement.
Further, contractual approaches are not likely to be a major contributor to an increase in the health sector workforce, though they may help to addresses shortages in specific circumstances [ 25].
