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Agencies claim new rule will ‘make staff shortage even worse’


Banning trusts from hiring agency nurses who are also employed as substantive staff in the NHS will exacerbate the health service staffing shortage, claims a body representing the recruitment industry.

The Recruitment and Employment Confederation has issued the warning ahead of the introduction of new restrictions on how the NHS uses agency staff from the start of next month.

“NHS trusts up and down the country will not be able to cover shifts”

Kevin Green

It is the latest fightback from the agency sector in response to attempts by the government and NHS leaders to reduce the amount that the health service spends on temporary staff.

From 1 April, trusts have been told by the regulator NHS Improvement that they should no longer employ any agency workers who hold substantive roles at other trusts.

The move is designed to encourage nurses and doctors to seek overtime shifts via internal NHS banks, rather than agencies, as part of further measures to clamp down on costs.

It has already sparked anger this week among nurses on social media site Twitter, who argue that it will reduce their income, and unions that claim they were not consulted on the move.

But the REC said it had also collected survey evidence indicating the potentially negative impact of the new rule on the ability of trusts to continue to fill gaps in their rotas.

It found that in 48% of 199 healthcare staffing agencies more than half of the temporary nurses, doctors, and allied health professionals on their books were also employed substantively in the NHS.

Meanwhile, the survey found that 77% of healthcare recruiters expected the candidates on their books to prioritise finding work in the private sector rather than the NHS in response to the ban.

In addition, 56% of agencies expected some nurses and doctors to stop working additional shifts in the NHS altogether and only 18% thought some staff would transfer to banks for additional work.

The REC also reiterated the findings of research that it carried out last month in partnership with the National Institute of Economic and Social Research.

It suggested that substantive NHS staff were deterred from signing up to internal banks due to factors, including unreliable communication, old-fashioned payment procedures and lack of “professionalism in comparison to specialist agencies”.

Recruitment and Employment Confederation

Agencies claim new rule will ‘make staff shortage even worse’

Kevin Green

REC chief executive Kevin Green said: “NHS trusts up and down the country will not be able to cover shifts.

“The NHS is facing one of the worst ever staff shortages,” he said. “This new ban will remove a lifeline and make a difficult situation worse.”

Mr Green said he acknowledged “costs must be controlled” and claimed the REC was “committed” to working with NHS Improvement to develop flexible staffing models that worked for “all parties”.

“However, now is not the time to make it more difficult and less attractive for doctors and nurses to take on additional shifts,” he warned.

Agency workers in the NHS accounted for 0.8% of the total NHS employment in 2015, according to the confederation.

A spokeswoman from NHS Improvement said: “From the very introduction of the agency rules, we have always said that patient safety is a priority.

“Our measures are encouraging staff to come back to the NHS because it’s widely recognised that permanent staff offer better quality care to patients, due to things like familiarity with hospitals and staff training and revalidation,” she said.

“Importantly, the money that hospitals save from reducing agency spend is money that can be reinvested into frontline services and this is a much better use of money for patients and taxpayers,” she said. “We know that the rules represent a big change for staff, but unlike this research we believe that what drives nurses and doctors is their compassion for patients.”

She added: “We know from working with the REC that many agencies and agency staff are willing to reduce costs for the benefit of patients. We will continue to work with trusts to support them to motivate and encourage staff back into the NHS, and with the REC on making sure the agency rules work well with agencies.”

The REC surveyed 199 recruitment agencies specialising in healthcare

QuestionsNumber %

Question 1: Approximately, what proportion of your agency workers are also employed substantively in the NHS? (Choose one)



















Question 2: What do you think will be the impact of these new rules? (Select all that apply)


Candidates will focus on the private sector rather than the NHS for additional shifts



Candidates will transfer to hospital banks for additional work



Candidates will choose not to work additional shifts at all



No impact



Don’t know



Not applicable






  • A separate survey has been set up to get an idea about how many nurses working for trusts also work for an agency, and how the new rules will impact upon their decisions regarding working additional hours.

Readers' comments (9)

  • There is no better way than all these measures (stopping bursary for nurse students, banning agency staff, Brexit, compulsory academic IELTS, banning employment of people from abroad and so on).... to lead the NHS towards privatisation! Good luck!

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  • You really couldn't make it up. A real terms pay cut equivalent to 8-12%, people trying to earn a bit extra to keep there heads above water and this.
    “We know that the rules represent a big change for staff, but unlike this research we believe that what drives nurses and doctors is their compassion for patients.” NURSE!!!!!
    Whoever wrote this, whatever medication you are on - double the dose.
    I've got an idea, why not cut wages by 10%, get rid of unsocial hours and weekend payments. Then have the overtime rate at basic with disciplinary action taken against anyone who doesn't cover any extra hours when requested by a manager. Every nurse will be outraged, the fallout at home and the strain put on relationships huge but our compassion for our patients will pull us through.
    You only have to look at all wanna be nurses hammering on the doors of universities, their compassion driving them on to fight for a place on an oversubscribed course to pay £9k a year in fees for 3 years where you have to work shifts on placement. Oh hang on......

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  • Is there anybody who is in a relationship they are not happy in? A relationship they would like to be out of but don't really have the guts to do the decent thing and just tell the other half of the equation the truth?
    Don't worry, just act like a complete an utter ****hole, if they tell you that they are unhappy just bat away their concerns nonchalantly or better still say you are doing things to improve but then do the absolute opposite. Sooner or later they will get that sick and tired of the situation they will do what you didn't have the guts to do and finish it. When that happens you can then feign shock and say its what they wanted not you. You know exactly what the government is doing now with the NHS.

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  • The Tory government are getting what they want privatisation right in front of our eyes and we are letting it happen!!!we need to join together and come out in force to oppose this!!

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  • I used to love for the NHS, I still want to be there for my patients but my 1st duty is with my family and myself. So bye bye the NHS . Here I am nursing home and private hospitals.

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  • Why can't they understand that the best way to stop agencies nurses is to give better working conditions and better pay to NHS nurses

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  • Had enough, I am semiretired but will not be re-validating. I work for extra cash doing something else, not as well paid but wow no stress
    Have come across similar comments. Warn off anyone who is thinking of doing nursing for a career they are fools

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  • How sad but how right you are anonymous 11:47.

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  • Nurses stand up don't put up with it !

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