- Jo Faragher
Unsurprisingly, the REC has reacted with anger at the caps placed on pay for NHS agency staff pay, which were introduced this week. One of the key sources of that anger is that the final decision to introduce the caps was made just five working days after the close of an official consultation on the issue.
It makes for great headlines when politicians pick out isolated cases where NHS Trusts were forced to pay out more than usual to get the skills they need. It makes them look like the good guys when they parrot off figures claiming that some doctors earn up to £500,000 per year, or that agency nurses are making thousands of pounds per shift.
But while managing costs in the NHS is to be admired, introducing pay caps on agency staff simply doesn’t address the underlying issue – that hospitals don’t always have access to the particular skills they need at that particular time, so they may need to outsource them. These agency staff, as the REC points out, provide crucial front-line services that help save lives; it’s not as though Trusts are simply overspending because they can’t plan their workforce.
The caps could even exacerbate the shortages: just because you choose to work as a locum doctor or bank nurse does not necessarily mean you want to sign up to a full-time, permanent role in the NHS, particularly in the context of such severe cuts to services. So limiting spend on this type of worker does not automatically improve long-term workforce planning.
There are many stories already of doctors who have moved overseas to escape the increasingly cold atmosphere they experience in the NHS – around 1,500 UK doctors move to Australia or New Zealand each year, for example. Demographics will also play a role: a recent survey found that over half of GPs plan to retire before they are 60.
The caps will be phased in over a number of months until April next year. From then, NHS trusts will not be able to pay agency doctors and nurses more than 55% more for a shift than a permanent member of staff.
The REC has asked the Government to postpone the next stage of the changes and consider the concerns raised in the consultation period, but it’s unlikely this will happen. Perhaps it will take a drastic or even tragic illustration of how enforced staff shortages can impact upon patient care before the changes are reconsidered.