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Revealed: Unfilled shifts increasing after agency cap introduced

The unfilled shift rate in hospitals is more likely to remain fixed or increase since the cap on agency staff was introduced, according to an NHS Improvement survey of trust agency executive leads.

The series of surveys, conducted since the beginning of this year, and released in response to an FoI request, consistently found that the number of unfilled shifts observed had increased or remained the same.

In the most recent survey, covering shifts in April, 66 of the 102 executive leads (65%) said they had seen no change in the number of unfilled shifts for overall staff, and 30 (29%) said they had seen an increase. Only 6% said they had seen a decrease.

The cap, limiting the amount trusts can spend on agency staff, was introduced last November to try to reduce the NHS deficit.

Health secretary Jeremy Hunt said recently that the cap had allowed the NHS to ‘turn the tide’ on agency spend, but a survey in April found that three-quarters of shifts worked in the 10 weeks since the cap was introduced breached it.

The survey also found that the agency leads were most likely to experience shortages of nurses, midwives and health visitors, with 33 saying they had seen an increase in unfilled shifts for these roles.

NHS Improvement warned earlier this year that nursing numbers are not enough to meet patient demand.

There were similar results in the previous survey, which covered unfilled shifts in February and found that 50% of respondents had seen no change in unfilled shifts and 38% had seen an increase.

Furthermore, when asked about the quality of work from agency and locum staff, 13% of respondents in the February survey said they thought it had got worse, and none of them thought it had got better. In April, 7% said they had observed a decrease in the quality of work.

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Rachel   22/06/2016 at 13:06

The government need to wake up and realise that agency and locum staff are a necessary part of a properly functioning NHS, and that they deserve to be paid properly for their time and skills. Cuts to spending on agency and locum staff is not good for any of us.

John   22/06/2016 at 13:36

The failure to address the recruitment and retention issues, combined with the looming retirement bubble but still cutting agency costs is symbolic of a lack of coherent workforce planning.

Stephen   22/06/2016 at 15:07

This is timely news as we are launching an Uber style app at the Healthpluscare show next week. You can see it at www.staffer.halthcare. It makes agencies obsolete and puts the power of hiring temps directly in the hands of the buyer on their smart device. It's free to use, you can post unlimited shifts or instantly hire temps the way you get an Uber car. You can have a prepay or 30 day account, all temps are compliant, verified, managed and uniformed with a rating system. This is a game changer and we are already getting pre registrations. If you want to know more, email me

Mike H   23/06/2016 at 17:41

@stephen I'm not sure you get the point; Drs (and probably nurses) aren't doing the shifts as the rate of pay (for extra shifts after 48 hours already worked) is not worthwhile. It doesn't matter if the job is listed on an agency or an app. The salary no longer makes up for the stress and the deprivation of liberty! Additionally I'm not keen on anybody skimming cash from my expertise or effort whatever the mechanism. Cab drivers seem to feel the same about uber

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