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”
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”
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.