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Agencies struggle to meet NHS demand following pay cap


The ability of recruitment agencies to find nurses and doctors to fill gaps in hospital shifts has worsened since the introduction of hourly pay caps, it has been claimed.

A survey by the Recruitment and Employment Confederation, revealed 80% of 97 agencies that responded said they could only supply staff for up to half of the requests made by the NHS in January.

“Patient safety is at risk if these departments are understaffed”

Victoria O’Brien

This compared with 53% out of 61 agencies last June, before the introduction of the hourly caps in November and suggesting agencies are struggling to persuade workers to take on shifts because of lower rates of pay.

The REC said demand for staff had stayed broadly the same – 33% of agencies received more than 100 requests per week on average in June, compared with 35% in January.

However, the regulator Monitor said that 64% of trusts had told it that it was no more difficult to fill a shift following the introduction of the caps. It also confirmed that 36% of trusts had said it was more difficult to fill shifts.

REC policy adviser Victoria O’Brien said: “Recruiters are receiving the same level of demand from the NHS now as they were before the caps, but the amount of vacancies they are able to fill has dropped considerably because fewer nurses, doctors and allied health professionals are prepared to take the shifts.

“This certainly begs the question, how is the NHS compensating for this shortfall? Are there fewer healthcare professionals on wards because of the caps?” She said: “We warned NHS Improvement about the dangers of rushing through caps at the worst time of the year.

“Skills shortages in areas such as A&E and critical nursing are well documented and quickly spreading to other staffing groups. Patient safety is at risk if these departments are understaffed,” she told Nursing Times’ sister title Health Service Journal.

Last week, the National Audit Office’s review of workforce supply said it did not believe the agency caps alone would address the NHS’s reliance temporary staff.

In a report, it said: “While these measures may encourage some agency staff to return to permanent NHS positions, our view is that they are unlikely in themselves to address fully the underlying causes of the increased demand for temporary staff.

“Reducing trusts’ reliance on temporary staff in a sustainable way is likely to require a broader, more strategic plan which also covers actions arising from the review of operational productivity in NHS providers,” it added.

“The challenge we have been set by government is to get a grip of NHS finances”

Jim Mackey

Monitor has been urged to ensure the policy, announced by Jeremy Hunt last year, does not leaving NHS wards understaffed and there have been calls for it be more transparent over data related to the agency caps implementation.

Last month the regulator said the hourly rate caps, which were reduced further at the start of February, were having a positive effect with the number of shifts breaching the rates falling by 40% in the first six weeks of the policy.

Monitor chief executive Jim Mackey said: “We know that clinical leaders are taking decisions every day to make sure wards are staffed safely, with rotas based on the needs of patients and sound clinical reasoning.

“The challenge we have been set by government is to get a grip of NHS finances, which we are doing,” he said. “However, this should not be at the expense of patient safety – the two must go hand in hand.

“Staff are better off seeking substantive employment within the NHS and picking up extra shifts through staffing banks than relying on agencies,” he added.


Readers' comments (8)

  • Put agencies out of business and the NHS will really struggle.

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  • I believe the NHS is attempting to dictate the terms in pulling nurses back to institutions and government stifling individual entrepreneurialism in favour of management self interests. We can also see this in other demands by the NHS on agency requisites - that's fine I'll just go private - oops isn't that just fuelling exodus to privatisation. And as for monitor I they supporting the dysfunctional Carter approach? Monitor the organisation dictating government cut backs - sounds like another bunch of government hacks making the situation worse. Home owning (built on people's suffering) post thatcher-rite baby boomers management and government are simply pushing right wing ideology in all its naff forms. And that's not to say I'm of the left but I can see dysfunctional nonsense of privatisation when I see it.

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  • I don't trust anything that comes out Mackey's mouth-

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  • Mackey or Tacky? Lol - tag team response. Your go lol.

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  • There's more than one way to make savings in the NHS rather than looking at the back bone of how the NHS can continue to run on a daily basis. Look at procurement, expensive equipment contracts, leases, contracts to companies to cover jobs that was once covered in-house by 'estates'. Once that has been done trim middle management layers! Finally look at agency spend and actually action the reasons why staff leave which include and not restricted to: being non family friendly hours, provisions of childcare, inability to get annual leave when you would like it, harassment, bullying, lack of support.

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  • Of course the rates breach will drop because as you say in the opening few paragraphs agencies have failed to meet the staff requirements so therefore there will be less breaches. We are being devalued in having our rates reduced. We have spent many years training and enhancing our skills. We are skilled staff which step into roles with very short notice and travel the country to help hospitals and patients. Flexibility is my reason for working agency and the meagre enhanced agency rates only cover the additional costs I have to cover eg sickness, holiday and travel. If you go to a hospital at a weekend there are always spaces to park that's is more often than not due to all the management and office staff required to report pointless figures to the government. Which could be spent on actual nursing staff.

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  • I left the NHS due to bullying by management, inflexibility, stress and low pay. I now work agency and I am paid a fair wage for the job I have to do. Agency work is flexible with less stress too. I travel to other cities with no petrol allowance to cover shifts but its well worth it. I would never return to the NHS. Most NHS staff I speak to have to work agency to top up their meagre NHS pay to give them a decent living wage.

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  • To follow on from James Atkin's thread regarding making savings in the NHS, has the government thought of enforcing caps on pharmaceutical companies' prices for medication? Some of the costs rival those of solicitors, as far as I can see! And I think we all, except presumably those in post, agree with trimming middle management layers!

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