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Early data suggests new agency price cap may be working


The number of NHS shifts by agency staff that breached the new pay caps fell by two-fifths in the first six weeks of the policy, data suggests.

According to the data from Monitor, the total number of shifts breaching the price caps set last year dropped by 40% between the weeks starting 23 November and 28 December. The total number of shifts dropped from 35,662 to 21,277 (see chart below).

“This is still a seller’s market, with the NHS on the losing side”

Jim Mackey

The largest drop occurred in the qualified nursing, midwifery and health visiting group, which fell by 47% from 14,913 breached shifts to 7,848, showed the data, which was obtained by Nursing Times’ sister title Health Service Journal.

The number of medical and dental shifts that breached the capped rates fell by 23%, from 10,358 to 7,944. Allied health professionals fell by 43%, health science staff dropped 19% and support staff such as healthcare assistants fell by 22%.

Hospitals are allowed to breach the new price caps if they satisfy exceptional circumstances criteria, including ensuring protection of patient safety.

As reported earlier this week by Nursing Times, more than a quarter of trusts asked Monitor to raise their ceiling on agency spending last year.

Monitor would not answer questions on the total number of agency shifts there were in the NHS during the six weeks to allow a comparison of the overall proportions, nor did it supply data for the first weeks of 2016.

It was also too early to say how much money has been saved by the policy, which the Department of Health estimated would lead to £400m in savings.

However, it is understood Monitor intends to publish more substantial data on the implementation of the agency caps in coming months.

Monitor chief executive Jim Mackey said: “The measures we’ve introduced to drive down the cost of agency staffing in the NHS are having a positive impact. Now we need to keep up the pressure.

“Staff who work through agencies or as locums need to realise that the market is shifting. In future, they will be better off seeking substantive employment within the NHS and picking up extra shifts through staffing banks rather than relying on the high rates paid by agencies,” he claimed.

“This is still a seller’s market, with the NHS on the losing side and, while agency staff can be vital for the NHS, their overuse is unaffordable and unfair on other staff not working an agency shift,” he added.

The agency cap came into force in November and set the maximum total hourly rate that trusts could pay for agency workers. Initially the level was set at 55% above basic pay for non-clinical staff, 100% for nurses, clinical staff and consultants and 150% of basic pay for junior doctors.

On 1 February the price cap will drop to 100% for junior doctors and 75%t for other staff. On 1 April it will drop again to 55% of basic pay for all staff.

Jim Mackey

Jim Mackey

Jim Mackey

This rate includes money payable to the agency, so workers will receive less than the headline rate.

NHS trusts are only able to source agency nurses from approved national frameworks with fixed prices. From 1 April these rules will be extended to doctors and other staff.

The changes were brought in to tackle overspending by the NHS on temporary staff. NHS leaders said last week trusts will spend £4bn on bank and agency staff in 2015-16.


Readers' comments (2)

  • How much does this Mackey get paid??

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  • Most of the staff working agency are also employed full time by the NHS. They have to top up their salary working agency to give them a decent living wage.

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