Health Secretary Jeremy Hunt has ordered a clampdown on recruitment agencies supplying the NHS with doctors and nurses as a package of measures to reduce costs.
New rules will set a maximum hourly rate for NHS agency staff, ban the use of unapproved agencies and limit agency spending for NHS trusts in financial difficulty.
Hunt said that the Government was investing the additional £8 billion that NHS chief executive Sir Simon Stevens says the health service needs by 2020. He claimed: “Now the NHS must deliver its side of the bargain for patients by eliminating waste, helped by the controls on spending we’re putting in place.
“Expensive staffing agencies are quite simply ripping off the NHS. It’s outrageous that taxpayers are being taken for a ride by companies charging up to £3,500 a shift for a doctor.
“The NHS is bigger than all of these companies, so we’ll use that bargaining power to drive down rates and beat them at their own game.”
NHS agency staff costs soar
Use of NHS agency staff has risen from £1.8 billion to £3.3 billion in the past three years.
Tom Hadley, director of policy at the Recruitment and Employment Confederation (REC), decribed Hunt’s language and tone as “outrageous”.
“Agency nurses play a vital role in ensuring safe staffing ratios and quality patient care in an NHS that cannot find sufficient permanent staff,” he said.
“[Hunt] is scapegoating agencies for the NHS’s own mismanagement of workforce planning. Nobody objects to there being set parameters for pricing of agency staff, but they already exist in the form of NHS framework agreements.”
“Patient safety must always come first, so any plans for a cap on spending must ensure that it does not prevent trusts from providing safe staffing levels when there are no alternatives” – Dr Peter Carter, RCN
Andy Burnham, shadow Health Secretary and Labour leadership contender, said: “The decision to cut 6,000 nursing posts in the early years of the last Parliament, alongside big reductions in nurse training places, has left the NHS in the grip of private staffing agencies. The Tory Government is responsible for this monumental waste of NHS resources.”
The NHS agency staff cap will initially apply to nurses, but will be extended to other staff. Capped rates will be reduced from the initial set level over time.
The plan will see increased scrutiny on managers’ pay, with approval required for any consultancy contracts over £50,000. The total bill for management consultants in the NHS was more than £600 million last year.
Dr Mark Porter, British Medical Association (BMA) council chair, said: “Much of the excessive spending on management consultants has been driven by successive governments’ top-down reorganisations, as hospitals struggle to navigate complicated bidding processes. This must be brought under control as it is diverting much needed funds away from frontline services.”
He added: “Greater reliance on agency staff is a sign of stress on the system and the result of poor workforce planning by government. Increasingly, locums are employed as hospitals can’t attract staff to take up full-time posts, so we need to address the root causes of the recruitment and retention problem in many parts of the NHS, especially emergency medicine.”
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN) said: “Further detail on these plans is needed to answer questions such as how a maximum rate will be set and whether it will vary based on location and experience.
“Patient safety must always come first, so any plans for a cap on spending must ensure that it does not prevent trusts from providing safe staffing levels when there are no alternatives.”
Hospitals can’t attract staff to take up full-time posts, so we need to address the root causes of the recruitment and retention problem in many parts of the NHS, especially emergency medicine” – Dr Mark Porter, BMA
The REC’s Hadley added: “We are disappointed that the Department of Health has not consulted around the introduction of these new rules and await more detail about exactly how they propose to reconcile them with NHS trusts’ legal responsibility to ensure safe staffing levels on wards.
“What happens, for instance, if there is a cold snap and a trust needs staff instantly to manage an influx of demand but they have already reached their newly imposed cap on overall spend?”