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REC says Simon Stevens trying to make agencies scapegoats for NHS trusts' financial difficulties

Hadley says, “Agencies are not & lsquo;ripping off’ the NHS. The overwhelming majority of NHS trusts manage their agency spend through framework agreements which cap prices. Rates are negotiated by central government and recruitment agencies must adhere to them. By not acknowledging the existence of these agreements, and that it is trusts who sometimes decide not to operate through them, it almost sounds like Sir Simon is trying to make our members scapegoats for the financial difficulties some parts of the NHS are finding themselves in.

“Poor workforce planning has left the NHS short of nurses, and although they are advertising they can’t find people willing to take on jobs as permanent employees.  They then turn to agencies that can provide nurses at the last minute or on short to medium term contracts to ensure safe staffing levels are maintained.

“What he doesn’t mention is that many agency nurses have previously had long careers as NHS employees but because of pay freezes, poor management and inflexible schedules have decided it suits them better to seek work via agencies who can help them find shifts that fit round their family life and allow them to work where and when they choose.

“Pay will vary depending on experience and skill set but generally speaking a Band 5 agency nurse will earn &pound20-&pound25 per hour and an agency will charge a fee to the trust of between 10-20 per cent to cover the costs of finding, vetting and supplying the skilled nurses they need.”

Kevin Barrow, partner at international legal practice Osborne Clarke, also commented. 

"There has been a lot of media coverage over the weekend about NHS spend on agency staff. As with all areas of public expenditure there is no doubt some unnecessary overspend.

However, agencies help the NHS by providing a flexible resource model, which helps with seasonal fluctuations in demand. Agencies invest heavily in systems and processes to enable them to do this,, and are particularly good at finding the right people to fill awkward temporary vacancies. If the NHS was good at finding people to work those shifts it would run the process in house already. If properly operated this flexible  model helps the NHS minimise costs.

And as a large number of nurses approach retirement without wishing to give up altogether and at a time when the NHS can ill afford to lose them, we imagine they will, like many senior doctors, work through agencies to supplement income in a flexible way that allows them to work when they want to. The big question is: what can the Government do to stop these working practices if there is a huge skills shortage (caused by decisions at Government level in previous eras) and it's how the relevant professionals want to work?

Slavery is illegal in the UK and skills shortages are going to become very serious, so we imagine that supplies via agencies on a flexible basis will continue.

Having said that Osborne Clarke considers that three things are likely to shake up this market in 2016-2017:

There may be a new generation of framework contracts significantly narrowing the NHS supplier base and (perhaps) allowing NHS Trusts to impose harsher terms on suppliers.

There may be increased scrutiny of alleged breaches of contract by staffing companies (in terms of charging more than framework agreements strictly permit)

The probable end of umbrella expenses schemes in 10 months, and attacks on the use of PSC and sole trader arrangements, may have a very significant affect on the economics of health/care staffing with the loss of tax efficiency possibly leading to a rise in NHS costs.


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