New rules banning permanent NHS staff from doing agency shifts at other trusts are to come in force from April, sparking criticism from nurses.
The regulator NHS Improvement wrote to trusts in February warning them about the forthcoming new rule on not using agencies to employ staff substantively employed elsewhere in the health service.
“This will make it fairer and more attractive for people to become permanent NHS staff”
It forms part of new range of measures designed to clamp down further on agency costs, including a significant reduction in the use of personal service companies – often used to reduce an agency worker’s tax bill – and each trust agreeing an improvement target on medical locum spending during 2017-18.
The measures were designed as a follow-up to the success of previous controls, including caps on hourly rates and targets on individual trust spend, which the regulator said had saved the NHS around £1bn since they began being introduced in October 2015.
NHS Improvement said at the time that the majority of savings made by the NHS so far on agency staff had come from nursing, admitting that more needed to be done to curb spending on locum doctors.
In line with this admission, when the regulator originally announced the introduction of the new ban on agency work at neighbouring trusts, the wording of part of its statement led to confusion that the rule would only apply to locums.
But letters now being sent to staff by trusts confirm that the intention of the regulator is to ban NHS providers from employing any agency workers who hold substantive roles at other trusts.
The move, which comes in from 1 April, means permanent nursing staff wanting to do extra shifts will have to be employed through the trust’s staff bank instead.
“We do not support this agency cap and we were not consulted”
Royal College of Nursing
A letter from one trust that was posted on social media site Twitter told its staff that “with effect from 1 April 2017 an important change has been introduced across the NHS”.
“Staff who have a substantive contract with one NHS employer will no longer be able to access additional work as either additional hours, overtime or through a bank contract,” it said.
“Therefore, if you hold a substantive contact with [the trust], regardless of the number of hours per week, you will be unable to undertake any activity through an agency at other trusts on or after 1 April 2017,” said the letter.
“Likewise, agency workers who have substantive contracts at other trusts will be unable to work at [the] hospital through an agency,” it added.
Danielle Tiplady, a nurse in London who started the “Bursary or Bust” campaign while still a student, was one of those who took to social media to criticise the new rules.
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“Many of us do agency shifts simply to get by. Now we are banned??? Absolutely shocked,” she said on the social media site Twitter.
The union Unison used the site to ask its members for feedback on the new rule. It said: “NHS Improvement have announced new rules – they want to ban all NHS staff from doing any agency work in the NHS. How would this affect you?”
Meanwhile, the Royal College of Nursing said its members had “reacted angrily” to the letters from their trusts informing them of the ban, and it would be contacting NHS Improvement and the government about it.
The college noted in a statement that the ban came at a time while NHS staff were waiting for a government announcement on pay that had been “suppressed for many years”.
In addition, the college criticised the regulator for imposing the new agency working rules without agreement or consultation with itself or other unions on the NHS Staff Council.
An RCN spokesman said: “We do not support this agency cap and we were not consulted. We support the right of our members to work in whatever way is best for them and their families.
He added: “There is no obligation on nurses to join a hospital bank. It is the employer’s responsibility to ensure that shifts are filled. It is not right that nurses should work for less than they are worth.
“We will be taking this matter up further with NHS Improvement and the Department of Health,” the spokesman said.
A spokeswoman for NHS Improvement confirmed that the rule would definitely apply to all NHS staff and that this had been stated in the letter sent to trusts in February by the regulator’s chief executive Jim Mackey.
However, she said the regulator recognised that the rule represented “a big change that staff are asking about” and that it would be supporting trusts to ensure they were doing all they could to communicate the changes clearly.
She said: “We sent a letter to trusts in February stating that these new measures apply to all agency staff, but we will be working closely with trusts to support them with communicating and putting these changes in place.
“It is important to note that nurses or doctors who are permanent NHS staff can still work additional hours at another trust but this should be as part of that trust’s bank and not through an agency,” she told Nursing Times.
When asked by Nursing Times how the rule would be policed, the spokeswoman said that NHS Improvement had provided some guidance to trusts but had not been “prescriptive”.
She said that the regulator would not begin collecting data on it from trusts until around July, the beginning of the second quarter the 2017-18 financial year.
She noted that the exact data that would be collected was yet to be confirmed, but that the system would probably operate in a similar way to its existing agency caps, with “significant breaches or concerns” that might indicate problems being investigated by the regulator’s regional teams.
When the measures were announced earlier this year, Mr Mackey, stated: “Our latest figures show the tremendous effort trusts have made to save money through our agency controls, and we’re really pleased we can say the NHS has an extra £1bn this year to pump back into improving services for patients.
“These new rules will make sure most agency staff get paid and taxed in the same way as their NHS staff colleagues,” he said. “This will make it fairer and more attractive for people to become permanent NHS staff, which is great news for hospitals and patients.”
- A 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.