• The recent Nordic Regional Report highlighted how the assets of the six largest banks (Danske Bank, DnB, Handelsbanken, Nordea, SEB, and Swedbank) comprise roughly 90 percent of the total assets of all of the region’s publicly-listed banks with most of their business concentrated within the Nordic-Baltic region. Mergers following the 1990s banking crisis, and a subsequent period of dynamic growth, have made these banks bigger and more systemically important. For example, banking assets in Denmark and Sweden amount to approximately 400 percent of GDP in each country.
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"This, alongside recent actions in relation to market manipulation, such as Swift Trade, Samuel Kahn and Rameshkumar Goenka, have helped firms better understand the types of behaviour we consider manipulative and therefore expect to be reported as suspicious," said the spokesman who believed that Libor fines also contributed to the increased number of potential misconduct.
Jeff Wayne on getting the War of the Worlds released, securing Richard Burton and the stage finale at the O2February 1st, 2014
Speaking to Vibe, Jeff, 70, said: “I had no expectations. When I composed and produced it, my contract with CBS didn’t have any guarantee that they had to release the record.
As we hit December I’m starting to reflect on what has been another eventful year at Interim Partners. At the beginning of 2013 I had targeted 15% growth for our revenues in health and it looks like we will comfortably get there. Critical to achieving the growth was to recruit someone else to join me in the health practice, and we successfully did that with the appointment of Annaliese Rogers in May, who focuses on commissioners whilst I concentrate on providers.
Predicting growth for 2014 is exciting but difficult. We will have two consultants in the market for a full 12 months, without any destabilising effect of handover and inductions. I think we can expect to grow our revenues in health by 30-40%, which has only been made possible by the capacity increase. The end of 2012 for me was personally frustrating as I could see my performance plateauing, purely down the capacity constraints of not having enough hours in the week. That issue has been resolved (for now at least) with the appointment of Annaliese. Should we hit another capacity limit at some point in 2014, it would be a nice problem to have.
Health remains Interim Partners’ most buoyant market, the key metric of market strength being the number of monthly requirements coming through. The underlying drivers of market demand over the last couple of years have been inflation, productivity challenges, executive turnover and pressure on emergency services. These are not going anywhere, but we now have a new one: quality.
Post Francis report into Mid Staffordshire, and the subsequent Keogh review into trusts with above average mortality rates mean that the spotlight is shining brightly on quality of care – and that comes at a cost. Want safer services? You need a better quality and higher number of staff. As a client said to me recently, “The biggest single determinant of quality of care is the quality of your staff”. It’s not mandated yet but I think we will soon see minimum staffing or nurse to patient ratios being brought into hospitals trusts, and trusts already struggling to meet savings targets are going to be in greater trouble as they recruit extra clinicians and add to their pay bill.
How trusts balance the need to maintain quality and deliver savings will be one of the key issues going into 2014, and I’m sure will be a big driver of demand for interim resource.
2014 should also be the year that the non-medical clinical resources framework will be renewed. The framework was put in place by Buying Solutions (now Government Procurement Solutions) and is designed to cover the supply of any non-medical non-clinical temporary workers into the NHS, including interims. I’ve long been a critic; the framework isn’t discerning enough and no one uses it. I estimate spend on interim staffing in the NHS to be around £100million, based on an annualisation of a monthly spend figure from December 2012, which I then subsequently doubled to take into account the probable spend on interim resource by the NHS which is done with off-framework suppliers.
With spend levels that high, one might reasonably expect a framework to rationalise the supplier base for its customers and squeeze margins. Instead the current NMNC framework has no less than 35 suppliers listed as approved suppliers of interim management resource. Many I have not heard of, and some of them I know have been removed from the framework since it came into place in 2010 because they have done no business through it. Which makes you wonder: if interim providers with no track record in health or no real intention of doing business in the sector have been added to the framework, how robust the process actually was in the first place? How effective is a framework when an NHS customer has the option to choose between 35 suppliers on a list, and who even then may not know which of those are genuinely doing any business in health? It’s probably worse than open market conditions; without the framework that same NHS customer would probably ask neighbouring organisations for a recommended supplier or use a search engine, with both methods probably offering a better chance of identifying first time the right quality of provider.
I think clients recognise these shortcomings, which is one reason why it isn’t used as much as it should be. The second reason is that it is not publicised or policed effectively enough – my guess is that less than 20% of clients ask me if we’re on the framework before they will do business with Interim Partners. Most simply don’t know about it, or they are not under pressure from a procurement department to adhere to it. And if clients are apathetic, so am I. Why should I offer framework margins on a role if I am in competition with other providers who are off framework? We offered a margin discount based on an assumption of volume, but where is the effort from GPS to ensure spend is channelled through framework suppliers so that we have greater assurances on volume?
So in 2014 I hope we see a better approach from Government Procurement Solutions. We need greater levels of trust and emotional investment built into the framework so that customers and suppliers are properly engaged to use it. This means a more robust process to identify and assess genuine providers of interim resource into the NHS, so that customers of the framework have a smaller number of quality orientated providers to choose from, and great assurances that those providers have a strong track record of providing interim resources into the NHS. Also needed are better levels of promotion and policing of the framework so that the suppliers know that customers are incentivised to build relationships with fewer suppliers and volumes are more assured.
Overall my predictions for 2014 are positive and I look forward to working with you all to continue improving the NHS. As always, I am keen to hear you experiences of the health sector this past quarter and year, and what you think lies ahead for the new year.
Steve Melber is the Director of Healthcare at Interim Partners.