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Health secretary expects trusts to employ more full-time nurses as use of agencies falls


Health secretary Jeremy Hunt has said he expects the numbers of qualified nurses in permanent NHS employment to continue rising, in spite of its severe financial pressures.

Mr Hunt said the numbers of substantively employed nurses should rise, as NHS providers reduce their use of more expensive agency and locum staff.

”I would expect as agency nurse numbers come down you would see some increase in substantive staff”

Jeremy Hunt

It comes against a background of NHS providers needing to make huge efficiencies, and some trusts having been asked in the summer to justify growth in their clinical staffing pay bill.

Mr Hunt said that overall, during his time at Richmond House, there had been an increase of around 10,000 whole-time equivalent nurses in the English NHS.

He said that, in response to the Mid Staffordshire care scandal and the subsequent report of the Francis inquiry, the NHS “had over recruited from agencies and that has caused enormous pressure on finances”.

“They have done it for exactly the right reasons. They’re absolutely determined to make sure they have enough manpower, but the reality is an agency solution is not a sustainable solution in the long run, it’s not a sustainable solution financially or in relation to quality care,” he told Nursing Times’ sister title Health Service Journal.

“We are now bringing that number down and we are proud of the work [NHS Improvement] has done,” he said. “We think we might be able to reduce the total NHS agency bill by about £1bn this year compared to last year, which would be an incredible achievement in one year, and do that without impacting on patient care.”

“The CQC do show a lot of teeth, you just don’t see them publicly”

Jeremy Hunt

Mr Hunt said, at the same time, he would expect to see an increase in substantive nursing staff. He said: “There will be some replacement, it won’t necessarily be one on one replacement, but I would expect as agency nurse numbers come down you would see some increase in substantive staff, yes.”

Asked about the trade-off for trust chief executives between investing in clinical staff and balancing their books, he said trusts needed to look beyond that “binary choice”.

“If they are asking that question it shows that they haven’t understood the way to tackle this challenge and I would say to those boards, ‘Look at the trusts delivering the highest standards of care, they are also the ones with the lowest deficits or in surplus,’” he added.

Mr Hunt pointed to improved use of electronic rostering systems as a means of reducing agency staffing and saving money.

“The biggest example of something we get wrong, which in fairness was brought to my attention by the junior doctors dispute, was the inflexibility of rostering and the lack of proper e-rostering systems in the NHS which drive a lot of people to become agency workers because some people do need to have flexibility if they have families,” he said. “We need to be offering that in the standard NHS contract.”

Jeremy hunt new website

Jeremy hunt new website

Jeremy Hunt

Mr Hunt said the Care Quality Commission was an essential “lock in the system” to prevent trusts making savings at the expense of patient care.

He said he was confident the CQC would use its powers where necessary. “The CQC do show a lot of teeth, you just don’t see them publicly,” he said. Its failure so far to use its full powers to prosecute NHS trusts was “not necessarily a bad thing”.

He said he believed the CQC was improving standards in a similar way to Ofsted, which he said has no intervention powers over schools, but by publishing judgements.

“The purpose of having the [CQC’s] four point ranking is to create a learning culture,” he said. “For me, the more we can achieve change by people trying to move themselves up the CQC’s four point scale and the less we can achieve it by prosecuting people or heavy handed regulation the better.”


Readers' comments (6)

  • This is all very well from Mr Hunt, but where does he imagine these nurses will come from, given the fact that many trusts have vacancies that they are already unable to fill?

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  • As an agency nurse I will do all I can to avoid re entering the poor pay and conditions of NHS employ! I don't get a better wage as an agency nurse, I have had no pay rise for 4 years and would love the 1% per annum the NHS staff get but I do get a work life balance!! I would rather change career and take a pay cut / retire than go back to how I was treated in the NHS! Good luck finding these extra full time staff Jeremy!!

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  • Badly worded title. What Hunt says he wants to increase substantive posts not make all nurses work 37.5 hours a week.

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  • Mr Hunt please read this

    NHS Employers conducted a survey asking NHS provider trusts in England for information about the current nurse workforce demand and their views on supply issues. The information collected has informed our response to the Migration Advisory Committee (MAC) review of nursing on the shortage occupation list.

    On 15 October, the Home Secretary agreed to the temporary inclusion of nursing on the shortage occupation list due to increasing concerns raised by employers about available nurse supply. The inclusion of nursing on the list is an interim measure whilst the MAC gather evidence to assess whether there is a national shortage of nurses and to determine if nursing should be included on the list beyond this interim period.

    This report provides analysis of the survey data collected and should be read in conjunction with the NHS Employers submission to the MAC call for evidence on the partial review of the shortage occupation list.

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  • Mr Hunt had better have a word with the NMC. 4000 nurses are referred every year and 2000 go onto hearings. Even the nurses who have had 'no case to answer' are leaving nursing.
    Others I know personally through a support group are doing training in other healthcare professions such as podiatry where they can work with or without a regulator. Obviously they are choosing without a regulator.
    Trusts and providers should be fined for inappropriate referrals and for trivial 'offences' and the NMC should start and treat referred nurses as innocent to proven guilty and not the definitely guilty until proven guilty. Many more nurses would then remain in nursing

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  • Well Said....I'm no Longer working for the NHS....and right now doing a career change. You should take note of Australia when they Increased Nurses wages and Improved working conditions. Within the first year 30,000 nurses and midwives returned to Nursing.

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