11.10.16
Trusts required to publish agency spend details
NHS trusts and FTs will face greater accountability over their spending on agency staff in the latest financial control measures.
In a letter to all NHS trust chief executives and finance directors, Jim Mackey, the chief executive of NHS Improvement, said that although the NHS had met its efficiency targets in the first quarter since a new programme of financial measures were introduced, more steps will be introduced in the next quarter to tackle areas such as agency spending.
As a first step, all NHS trusts and foundation trusts will have to provide their monthly agency spending broken down by cost centre and service line, as well as anonymous lists of their 20 highest-earning agency staff and agency staff who have been employed for more than six months.
Mackey said NHS Improvement regional directors will write to the trusts with further measures to tackle agency spending. These include national publication of trust’s agency expenditure across regions, and ensuring trust boards keep track of spending on agencies and are holding executives accountable.
Chief executives will be required to report to NHS Improvement about areas of concern, including off-framework use, high-price overrides and on-call rates.
The regulator added it will intervene where trusts have problems with areas such as high on-call rates, grade inflation, high bank rates and payments for hours not worked.
NHS Improvement’s predecessor, Monitor, introduced a cap on hourly rates paid to NHS staff last year in an effort to limit the money spent on agency staff, leading health secretary Jeremy Hunt to say the NHS was “turning the tide” on agency spending.
However, the cap did not apply to three-quarters of shifts worked immediately after it was introduced, and the number of unfilled shifts at most trusts has increased or remained the same since the introduction of the cap.
In addition, Mackey said that from quarter 2, NHS Improvement will include trust level financial and performance information in its quarterly report and require all trusts to post their quarterly finance and performance reports online “in a transparent and timely manner”.
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