New rules to reduce agency spend in the NHS

Nick Elvin

New rules have been published aimed at helping NHS providers get the best quality agency staff while reducing their overall costs.

The measures were launched by the NHS Trust Development Authority and the health services sector regulator Monitor, who report that in recent years, the amount of money spent on agency staffing has increased to around £3.3 billion per annum. Some providers acknowledge that it is increasingly difficult to locally secure best value on the quality and cost of agency staffing where no national rules currently exist.

The new rules will see an annual ceiling for total agency spend for each trust between 2015/16 and 2018/19; mandatory use of frameworks for procuring agency staff; and limits on the amount individual agency staff can be paid per shift, which will be implemented later in the year after further work by the two organisations.

Peter Blythin, director of nursing at the NHS Trust Development Authority said: “Whilst a number of existing local frameworks work well to support local nurse directors to find high quality agency staff, there is a recognition that more can be done to give trusts greater powers to have more control over their use of agency staff in the future.

“The creation of an assurance process to make sure local frameworks are providing high quality staff at the right price, the introduction of ceilings to ensure boards can have a focused programme on reducing over-reliance on agency staff where it exists and future measures to limit the inflated costs associated with some agency arrangements, will all help to ensure that local providers can, in future, be better equipped to focus on the important issues of high quality staff and patient safety whilst becoming more efficient.”

Responding to the launch of new rules, Ann Swain, chief executive of The Association of Professional Staffing Companies (APSCo) said: “Despite engaging with The Department of Health to offer the benefit of our and our members’ knowledge and experience of working on large public sector procurement contracts, to help the Department find practical solutions to the NHS’s current staffing predicament, the Government has instead chosen not to consult with the sector and come up with what I can only describe as a knee-jerk reaction.”

“It’s not enough for the Government to look at the recruitment supply chain as the whole problem. The rising cost of temporary staff in the NHS is caused not only by recruitment supply chain issues, but also by a more complex set of circumstances and is, in APSCo’s view, a symptom of ineffective workforce planning in the NHS, and a wider issue regarding clinical skills and staffing shortages in the UK.

“Limiting annual spend on agency workers is all very well, but this doesn’t address the ongoing shortage of staff within the NHS. Without other measures, trusts will be forced to engage lower quality staff as the ceiling is approached.

“We do welcome the mandatory use of frameworks, but this alone, without properly managing supply chains and working in partnership with recruitment firms to ensure that all parties are committed to the success of the aims of the framework, is unlikely to solve all their problems.

“Limiting the spend on individual staff is positive as long as it is not just a blanket measure applied without any intelligence. Rate bands for specific roles can work extremely well, but usually only in situations where there is a relatively small, engaged supply chain that is committed to the success of the client’s aims.

“We cautiously welcome the Government’s plans but we would suggest that they do not deal with the commercial realities of large supply chains, and government needs to do more to work in partnership with the recruitment sector.”