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New rules launched to reduce agency spend in NHS

Over the last few years, the amount of money spent on agency staffing has increased to around &pound3.3 billion per year. 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 measures being set out today follow wide-scale engagement with local nurse directors and finance directors and are designed to strengthen significantly providers’ ability to secure the best deal on the quality and cost of local agency staff.

The new rules will see:

an annual ceiling for total agency spend for each trust between 2015/16 and 2018/19 trusts are being sent individual ceilings today and will have the opportunity to apply for exceptions if there are specific local needs

mandatory use of frameworks for procuring agency staff

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.

Ruth May, nursing director of Monitor, said, "Trusts are working hard to reduce the amount of agency staff they use, and this is something we’re actively supporting through initiatives like our agency support team.

"We’ve worked hard with the NHS to develop this set of rules which will support boards and in particular chief nurses to reinvest the money currently spent on agency staff into providing the best care for patients. Today’s guidance is another step in delivering a safe and secure NHS that will meet the needs of patients long into the future."

Nick Simpson, chief executive of healthcare recruiter MSI Group, said, “Data we obtained under the Freedom of Information Act revealed that a total of 248 agencies supply the sector – 60% of which do not work within any of the three NHS approved staffing frameworks.  This clearly highlights the scale to which individual NHS Trusts have been forced to work with off framework suppliers which take advantage of hospitals’ desperation to maintain patient safety levels amid chronic staff shortages. “

“It’s encouraging to see that the Government is taking steps to crack down on unscrupulous staffing agencies which operate outside of NHS approved staffing frameworks.  Largely unregulated & lsquo;off-framework’ agencies have been free to set their own rates and are not subject to the stringent compliance audits that & lsquo;on-framework’ suppliers must undergo to maintain their approved supplier status.   These new rules will set a transparent and level playing field which will benefit all parties.  

“MSI Group provides nurses and HCA's through NHS framework agreements - including the National Collaborative Framework for the supply of Nursing and Nursing related staff (formally known as LPP)  - to ensure that NHS trusts never have to compromise on value and compliance."


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