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Monitor nurse director says trusts will be able to breach agency rules

  • 12 Comments

Caps on hourly rates for agency staff working in NHS trusts will be able to be breached if there is a risk to patient safety, the senior nursing advisor at regulator Monitor has reiterated to chief nurses in defence of the new rules.

Last week the government proposed that from November caps will be applied, which by April, will see agency staff paid no more than 55% above the hourly rate of permanent NHS staff.

“There will be times of course when the safety of patients requires agency staff to be brought in”

Ruth May

The pay cap, along with a limit on trusts’ overall agency nurse spend, are among measures developed by Monitor and fellow regulator the NHS Trust Development Authority.

This week nurse leaders at Nursing Times’ inaugural Directors’ Congress raised concerns that the set of measures to reduce agency spend could leave wards understaffed.

However, Monitor’s nursing director Ruth May said in her keynote speech at the event that the rules would not stop chief nurses from hiring agency workers.

“There will be times of course when the safety of patients requires agency staff to be brought in and nothing being announced will prevent you from doing that,” Ms May told delegates at the congress in Brighton.

“But we are confident the controls should increase trust bargaining power and they should enable trusts to manage their workforce in a more sustainable way,” she said. “Let me be clear – patient safety always comes first to you and to me.”

During a later session at the event she was asked to reassure nurses their concerns had been taken into consideration when developing the proposed rules.

“We have a clinical advisory board of nine nurses and nine doctors advising us about how we take forward the views of frontline service leaders,” she told the audience of nursing directors.

“They should enable trusts to manage their workforce in a more sustainable way”

Ruth May

She added that she believed the guidance included enough “break glass clauses” – which permitted trusts to breach the cap on grounds of clinical safety – to “allow you on the frontline at 9pm on a Friday evening or whenever it is to make an escalated decision”.

In September, ceilings on agency nurse spend – but no other health professional groups – were announced. Ms May said she agreed with other nurse leaders that the move “felt as if it just focussed on the nursing profession”.

Since then, she said, there had been a “big shift” in focus to apply further controls to the entire workforce.

“I said, ‘we need this for doctors as well as nurses and they listened’. That’s why the caps are now there for all clinical staff, not just for nurses. That’s a big shift, even from September when the first bit of guidance came out,” said Ms May.

 

Nursing Times' Directors' Congress

Monitor’s Ruth May took part in a panel debate at Nursing Times’ Directors’ Congress chaired by editor Jenni Middleton

  • 12 Comments

Readers' comments (12)

  • Well, she would say that, wouldn't she? She's wrong, of course.

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  • I have worked as an agency nurse in NHS hospitals and got slightly above the staff rate. Agency nurses dont have the benefits of paid holidays and sick pay.
    The money paid to the agency, over and above what the nurse gets, is why it appears in the press that agency nurses are racking in £hundreds. They are not

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  • We have a hell of time recruiting nurses which I am sure has to do with what Nurses can work working for an agency. How can we ever match what they pay?
    Nursing home owner

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  • As a Nurse and owner of a Nursing Agency, I find the latest guidelines appropriate for the temporary workforce supplied to the NHS from an independent agency provider. In my opinion, over recent years Frameworks such as CCS etc have served very little to control agency rates, resulting in a supplier led service controlling charge rates instead of a client ( NHS) led service.

    I welcome the stringent controls being proposed, after all, this is public money that is being abused and hopefully this will see an end to agencies who are not focused on patient care but pure profit.

    That said, the flexibility of using a temporary staffing resource does and will always have advantages for the NHS to react to situations such as Winter pressures, specialing patients with individual needs, acute shortages and sickness cover.

    It just needs to be controlled and managed by the client ( NHS), not the temporary staffing provider

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  • I work for my lava NHS trust on the NHS bank since retired from my substansive post I have only had a 1% pay rise in the last 3 years and I'm looking for a good agency to work for. If the NHS pay peanuts then they deserve to lose good staff We all go to work for pay even if the government sees nurses as angels of mercy who's life is given to the care of the sick and dying we still have to make a living wage

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  • NHS staff are entitled to sick, holiday, pension, job security plus training. What are agency nurses entitled to?

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  • Substantive staff are paid a salary, Employers NI, pension contributions, sick pay, lots of annual leave, continued professional development, occupational health, compliance and other costs in addition to an annual salary.

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  • The problem with large scale use of agency nurses is that there is loss of accountability and continuity for the service user as care providers use/abuse the agency nurses when insisting on poor standards in lieu of better management. No comply, no work.

    Good managers should be able to cover things like sickness on a routine basis.

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  • "...over recent years Frameworks such as CCS etc have served very little to control agency rates, resulting in a supplier led service controlling charge rates instead of a client ( NHS) led service."

    In a free market, you cannot blame the seller for "succeeding". The situation which this capping exercise seeks to "correct" is entirely of the NHS's making - as in every other area, the NHS are "babies" in the commercial world. It's commendable that your agency is run for altruistic reasons but it's naive to expect every business to be the same: money needs to make money, otherwise you might as well leave it in the bank.

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  • how much longer before nurses are going to be made slaves

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