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16 May 2023
Meet enferm, resolving staff shortages, retention, burnout and more

Meet enferm, resolving staff shortages, retention, burnout and more

As part of our quick fire questions series – or QFQs – we spoke to Josh Sprigg, founder and CEO of enferm about the crisis in nursing, creating a way for healthcare workers to thrive and adopting of new technologies.

My mindset and outlook on the world shifted drastically when I almost lost my three-year-old son.
After spending weeks at the hospital, it was here where I witnessed, first-hand, the incredible triumphs that were made possible by nurses, and temporary staff alike (and the direct impact I could make via my recruitment company).
This was an unforgettable moment of fate, a nuclear moment in my life that invigorated me to make my life’s work a pursuit that ensures everyone receives the same level of care that I was so fortunate to experience.
It was at that moment I had complete clarity on my life’s purpose.
From despair to clarity. My son was saved by the dedication and skill of the nurses that day. An emotional triumph in defiance of an acute shortage of doctors and staff at the time.
The result for me was a powerful recognition that this could impact life and death, and if I could help solve some of the issues around staffing shortages, I could positively impact the lives of family, friends and communities around me.

Tell me about the business – what it is, what it aims to achieve, who you work with, how you reach customers and so on?

Enferm is a staffing solution that connects nurses to healthcare providers looking to fill available shifts. We resolve staff shortages, staff retention, staff burnout and more, whilst giving nurses the freedom to work where they want and when they want.

Founded in 2015 with just a laptop and access to an internet cafe, Enferm was born.

Now with over 5,000 enferm nurses and growing, our mission is to empower the people of this thriving community by innovating a seamless solution to centralise their career and development from University, to Retirement.

Enferm prides itself on being data informed and lead as well as innovative in its approach to the adoption of new technologies such as AI/ML and web3.

Enferm’s mission aims to redefine the healthcare workforce by providing a service tailored to the short-term and longer-term needs of the individual nurse or organisation. Empowering them.

How has the business evolved since its launch? When was this?

As I began building the company, I quickly understood that making an impact would be reliant on working with the NHS. And in such a closed and regulated industry progress was extremely slow in the early days.
To make a difference we needed to work with the National Healthcare System (NHS), not against it.

As you might expect, the primary goal of the NHS is to ensure the quality of care and safety of patients. A goal that relies heavily on consistent and adequate numbers of skilled healthcare professionals being available.
Yet, growing shortages of full-time nurses and other healthcare professionals led to the NHS’s increasing reliance on agency staff (as well as reliance on foreign workforce to resolve staffing shortfalls), which handed the power to staffing agencies that were lucky enough to be on the NHS approved suppliers list. And in turn, could happily dictate staffing rates.

So in 2016, to regain a bit of control, the NHS introduced a cap on the hourly rates paid to agencies. The main objective of the policy was to bring payments made to the agency staff closer to the salaries of NHS payroll staff. As part of this reform, the NHS also relaxed the strict criteria for new agencies applying for NHS contracts.
This was my big break.

As most entrepreneurial minds do, I leapt at the opportunity, taking advantage of the new healthcare reform and securing my first NHS contract, which then led to all National Clinical Frameworks and an oppurtunity to accelarate our supply and services via Tech in 2020/21, this was the first merger enferm conducted with an international tech company. Transitioning our business from a service model to a tech enabled service, to a future tech driven service.

Tell us about the working culture at enferm?

With a mission to create the best possible way for healthcare workers to thrive, this is no small task, so energy, commitment and unity is key within Enferm.

We have an awesome team in an open plan office with a variety of music continuously on the go, lots and lots of tea flowing, and a guarantee of a laugh. If you walked in today, you would think madhouse! Post it notes cover the walls, never a quiet moment, with collaboration and teams on the phones or gathered around a whiteboard challenging each other.

As we have grown the company and introduced new tech-driven ways of working, we have definitely gone through our spotty teenager phase, which has allowed us to have a mature outlook in our way of thinking and also our ability to adapt together.

Our values are simple; “There’s no place for ego’s” / “Ubuntu” / “We do the right thing” / “Fail fast, Fail safe”

How are you funded?

Enferm is a self funding, reinvesting organisation.With the majority of growth coming from referrals from its nurses, enferm has now engaged with ex-googlers to work on delivering the hyper focused, hyper localised marketing strategy that will utilise and leverage data to target staff shortage areas as a priority.

Since trialling a low budget marketing campaign at a cost of £400! enferm saw a jump in application now exceeding 3,000 new applicants. As an organisation we have the ability today to scale up to £25 million Monthly Revenue once the automated onboarding journey is finalised.

enferm has run in loss and/or breakeven as it reinvests all of its growth into expansion. Scaling up to a multi international team.

We have been self funded to date, achieving more national coverage and revenue than competitors who have raised upwards of £30million.

What has been your biggest challenge so far and how have you overcome this?

Battling through the pandemic – The pandemic has no doubt been a huge strain on businesses across the globe. And by my recollection this was an incredibly stressful time for enferm. With so much uncertainty from hospitals and from staff, the team and I found ourselves right in the eye of the storm.

But within any crisis comes opportunity, and luckily for enferm, this was a global crisis which their business could directly support!
With demand through the roof, the pandemic posed a new challenge for us; ‘how can we service all of our customers, without letting anyone down?’
With a small team and little to no credibility, we knew that we needed to invest in technology to solve the problem.

In February 2021 I met a Swiss tech company who had already begun developing a workforce management solution. Despite not having the capital to acquire the business, I offered equity in exchange for the tech. A deal that came to fruition, and enferm had the tech stack.
With new foundations for ramping growth, enferm had acquired a solid staffing engine, and with it we gained the trust of the NHSI (NHS Improvement), which led us to close contracts for Health Trust Europe, All Wales and the Priory National Framework.

In quick succession enferm were awarded multiple “National Clinical Frameworks”, and scaled quickly from a team of 6 in 2020 to a team of 50 in 2022. Hiring staff across four different countries, and opening offices in London, Milton Keynes, Serbia and India.

How does enferm answer an unmet need?

As we in the UK are very aware there’s a real crisis in nursing but the facts are shocking.

In 2019 the UK government put in place their plan to increase the nursing workforce by 50,000 by March 2024. @7000 of that target was to come from the retention of nurses who would otherwise have retired or left the profession entirely.

However, with 12 months left to deliver on this target we know nurse vacancies have flatlined @40,000; demand is outstripping supply. This is compounded by the startling fact 1 in 9 nurses left the profession in 2022, the highest number in a decade, and 50% of nurses report they question their future in nursing, particularly those working in NHS hospitals.

Nurses today are 4 times more likely to cite work-life balance as the reason for leaving nursing than a decade ago, and this is now the second most common reason after retirement. Even those retiring are increasingly doing so early or earlier than they planned to, again due to work life balance and concerns about burnout and well being.

Nurses feel hugely undervalued and under supported. Three quarters of nurses work beyond their contracted hours, equating to an estimated 365m of unpaid work a year.  They also feel they have no one to turn to but themselves: a third of nurses feel too guilty to take holiday time, as it results in more pressure on their colleagues and further impacts the quality of care patients receive, and most report they continue to work when unwell for the same reason. The stark reality is many nurses currently feel they will have no option but to give up on the nursing career they trained hard for and love, resulting in more vacancies.

At Enferm we know more nurses than ever are looking for, and deserve, real choice. Choosing to do the work they love around the life they want to lead. They want true flexibility in working where and when they want, with fair reward. They want a solution designed specifically to meet their needs, one that really makes it possible for them to choose to stay in nursing and care for their patients.

Enferm provides nurses not only with that choice and flexibility about when and where to work, but through our technology and people teams we enable our nurses to find the work they want quickly, remain in control of how much or how little work they do, get support, advice and training when they need it, safe in the knowledge that they will get paid promptly for every minute worked.

For the many nurses thinking about leaving their profession or seeking a better work-life balance, Enferm provides a real opportunity to continue in their careers.

What’s in store for the future?

Regarding growth plans, Enferm is currently gearing up to do a full fundraise in 2023 with the focus on the below:
  1. M&A Strategy (Buy and build)
  2. International Expansion support and backed by the Mayor of London, London and Partners programme for International Expansion
  3. Build of new tech such as Web3 and a primary focus on AI/ML Data

In Enferm’s growth plans one of the biggest areas for reinvestment is into the low socio economy funding programme to improve equality and diversity in careers in the Healthcare sector, Enferm will fund and support the university registrations and fees of nurses. By utilising web3 theory Enferm also prides itself on being one if not the first Healthcare Decentralised Autonomous Organisations, allowing for governance from its people and the distribution of funds back into its community.

True people empowerment.

What one piece of advice would you give other founders or future founders?

Don’t think- Do!
It is far too easy to be so focused on identifying all details and potential outcomes, that you simply don’t ever get out of the starting blocks.
In my experience, the moment you do start your business, you almost immediately have to pivot and adjust, but you’re doing so with real life scenarios and data. This makes your startup more robust, agile and resilient. So get started!

And finally, a more personal question! What’s your daily routine and the rules you’re living by at the moment?

I quit drink and partying over 4 years ago to make the most of my personal time and time with my son who is with me most of the time and I feel like I must constantly evolve. I am addicted to adrenaline! I have almost completed my skydiving licence, and I love to clear my head by riding my Harley Davidson Sportser 883 on long windy roads across the country. My getaway.

My main interests are associated with stimulating subjects such as Macro economics, politics at a global level and I also have a fascination for space and theories on time.

Josh Sprigg is founder and CEO of enferm.