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Hunt sets out controls to clampdown on agency staffing costs

Jeremy Hunt has unveiled a package of tough new financial controls to clampdown on rip-off staffing agencies charging the NHS extortionate rates. 

However, the health secretary’s proposals, which include setting a maximum hourly rate for agency doctors and nurses, have received mixed responses across the industry. 

It is hoped that the measures will help bring down spiralling agency staff bills, which cost the NHS £3.3bn last year. In some cases, the NHS is paying agencies up to £3,500 per shift for doctors, and the total bill for management consultants was more than £600m last year. 

Further proposals include banning the use of agencies that are not on approved frameworks; putting a defined cap on total agency staff spending for each NHS trust in financial difficulty; and requiring specific approval for any expensive consultancy contracts over £50,000. 

Hunt said: “The path to safer, more compassionate care is the same as the path to lower costs. Simon Stevens said the NHS needed an extra £8bn by 2020 and the government has invested that. 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.” 

Tackle root causes not symptoms 

But Dr Peter Carter, chief executive and general secretary of the RCN, said: “The health service needs to focus on the root cause of this problem, not just the symptoms. A lack of investment in nurse training and cuts to nurse numbers mean that trusts now have no choice but to pay over the odds for agency staff and recruiting overseas.” 

He added that it is right to clampdown on excessive spending but this will only work alongside longer term solutions, like converting agency staff to permanent staff, and continuing to increase training places to catch up with demand. 

“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,” said Dr Carter. “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.” 

The DH has said that initially the agency pay cap will apply to nursing staff, but will be extended to other clinical, medical and management/administrative staff. Capped rates will be reduced from the initially set level over time. 

Also, the pay packets of some NHS senior managers will be trimmed. Currently, more than a fifth of all directors in the NHS earn more than £142,500 – the amount the Prime Minister is paid. Mr Hunt is asking Trust bosses to justify why. 

Commenting on the announcements, Chris Hopson, chief executive of NHS Providers, said: “Our members tell us they recognise the need for the provider sector to return to financial balance as quickly as possible and that reducing rapidly growing agency staffing spend is an important priority in this task. It is vital that every penny of the NHS budget should be targeted at delivering high quality care and not wasted. 

“Our members tell us that NICE guidelines, the CQC inspection regime and clinical guidance from NHS England following the Francis Report, amongst others, have effectively instructed providers to increase staffing levels and that use of agency staff has been the only way to meet these guidelines. We therefore look forward to working with NHS system leaders on how the trust level cap on agency staff spending will actually work in practice. 

“Trust leaders will want clarity on which is more important if there is a conflict - meeting central requirements on staffing levels or staying within any new cap.” 

But Tom Hadley, director of policy at the Recruitment and Employment Confederation, told the BBC that the language and tone from Jeremy Hunt is “outrageous”. 

“Nobody objects to there being set parameters for pricing of agency staff, but they already exist in the form of NHS framework agreements,” he said. 

The CEO of NHS Employers, Danny Mortimer, welcomed the latest move and added that there is potential for NHS trusts to reduce spend on agency workers through further improvements in flexible working, technology and arrangements with local agencies.

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