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NHS Improvement ‘pauses’ start of unpopular new agency rule

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The regulator NHS Improvement has suspended the introduction of its new rule preventing permanent NHS staff from doing agency shifts at other health service providers.

It has written to trusts today telling them to “pause” the start of the controversial rule, in order to “engage with the sector”, following the raising of concerns by nurses, as revealed by Nursing Times.

“We have listened and responded to the feedback from nurses about the latest agency rules”

Jim Mackey

Under its original plans, NHS Improvement had told trusts that from 1 April they should not employ any agency workers who hold substantive roles at other NHS employers.

It would have meant that permanent staff wanting extra shifts would have to be employed through the trust’s bank instead.

But Nursing Times has been told that letters – see attached PDF below – have now been sent to trust chief executives, directors of nursing and medical directors, instructing them to hold back from implementing the policy.

In the letter, NHS Improvement chief executive Jim Mackey said: “I can confirm that NHS Improvement is pausing until further notice the instruction that trusts should ensure that staff engaged through an agency are not substantively employed elsewhere in the NHS. To be clear, this new rule will not start from the 1st of April and your normal processes can remain in place.

“We will review the timeline and system preparedness for any further changes to this policy and will engage with the system and staff as appropriate. Note that we are still proceeding in full with the other agency policies recently announced,” he said.

“To be clear, this new rule will not start from the 1st of April”

NHS Improvement letter

NHS Improvement has also written to the Royal College of Nursing, which had previously expressed its anger over the rule and said it had not been consulted about it.

An NHS Improvement spokeswoman told Nursing Times that the regulator had become aware that there was “lots of concern” about the policy, which forms part of efforts to bring down the level of agency spending by the health service.

She said: “We have got an instruction to bring down the cost of agency. But we absolutely want to do that working with providers, not against them.”

In contrast to the pause on the rule on external agency shifts, the introduction of IR35 taxation rules will still go ahead from 1 April, meaning nurses working additional shifts will be subject to the same taxation regardless of whether the shift is worked through an agency, bank or on a substantive basis.

Jim Mackey

Jim Mackey

Jim Mackey

In a statement, Mr Mackey said: “Trusts have taken great strides on cutting back agency costs, saving over £700m this year alone. We know that the nursing workforce has contributed the lion’s share of the savings made, and we are grateful for these efforts, on top of the excellent care and commitment they offer patients day in day out.

“We have listened and responded to the feedback from nurses about the latest agency rules on substantive staff,” he said. ”We’re committed to getting it right for nurses and doctors alike and making sure the system and the way staff can work is fair and equal, which is why we’re taking more time to work with the sector.

“We will be supporting trusts with the new tax rules which come into force next week, and will continue with our focus on getting medical locums to match the success nurses have achieved in bringing costs down,” he added.

As exclusively revealed earlier this week, interim findings from a snapshot survey of nurses revealed anger, frustration and even “despair” felt by those likely to be affected by a ban on agency shifts.

janet davies

janet davies

Janet Davies

As reported yesterday, the RCN wrote to the government last week calling on it to retract the new rule.

Responding to the pause, RCN chief executive and general secretary Janet Davies said: “This was an ill-conceived plan by NHS Improvement and today’s u-turn will be welcomed by nursing staff across the country.

“It is right to withdraw it and we will be seeking urgent meetings before any further plans are drawn up,” she said.

“For many NHS nurses, the only way to ensure a decent level of income is to undertake additional work through an agency. They would not have to do this if NHS pay had kept pace with inflation in recent years,” she added.

Unison head of health Christina McAnea said the suspension of the plan was the “right thing to do”.

“It would have been completely wrong to penalise NHS staff and stop them from topping up their wages, when the government has been holding down their pay for years,” she said.

Unite

Pay restraint for NHS nurses set to continue to 2020

Colenzo Jarrett-Thorpe

“It’s good that NHS Improvement has put these plans on hold. Now what’s needed is for ministers to give health employees a decent pay rise, so that their wages don’t fall further and further behind salaries in the rest of the economy,” she added.

Unite national officer for health Colenzo Jarrett-Thorpe also welcomed the statement from NHS Improvement indicating that the regulator had “pressed ‘pause’ on this edict”.

“It would have been grossly unfair - after the Pay Review Body recommendation this week of a measly one per cent increase for NHS staff – that health workers struggling, in many cases, to make ends meet were denied opportunities to boost their incomes,” he said.

“We hope to work with NHS Improvement and other staff side unions to ensure that already hard-up NHS staff do not suffer further detriment as a result of the general NHS drive to reduce spending on agency and locum staff,” he added.

“It’s the right thing to pause and think again”

Kevin Green

Kevin Green, chief executive of the Recruitment and Employment Confederation, which represents staffing agencies, said: “We are delighted NHS Improvement has seen sense and stepped back from this hastily proposed ban which risked throwing the NHS into chaos.

“It’s the right thing to pause and think again having listened to the feedback from us, our members and other stakeholders like the RCN, and to the voices of all the nurses and doctors who work so hard in the NHS,” he said.

“We are committed to working with NHS Improvement to help develop flexible staffing models for the NHS that ensure safety and sustainability for patients and workforce alike,” he added.

The REC said it had held two meetings with NHS Improvement over the past month to discuss the proposed ban, including one with over 40 representatives from its member agencies, and that it had also written to the regulator calling for it to delay its introduction.

  • 12 Comments

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Readers' comments (12)

  • What a joke!!!!!!!! And these are our "Leaders" ????? God Help Us.

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  • "But rest assured we will find other ways of abusing our nursing staff"

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  • You have to spend money to make money and I'm sure I'm not the smartest person in the world and for some reason little me can come up with the only solution that can help this situation to stop or slow down the amount of agency booking in the trust is to INCREASE NHS STAFF PAY AND THEIR FLEXIBILITY !!!!!!!! And use band 7, 8's, chief executives, head of nursing etc who are on Great pay rates to come and cover shifts when they are short instead of having them in offices sitting down on their big pay while the band 5 and 6's are over worked trying to save their pins and looking after more than they can cope with patients. Trying their best to give them patient centred care. And last but not least make admissions to hospital beds consultant led only instead of allowing junior doctors to admit unessacary patients because they are not experience enough to make the decision to send patients home with out patient appointments and that way they will save money on beds and have only real sick people in hospitals. Then they will save on agency cost and bed blocking. And overall less patients in hospital taking up beds that sick people need. This solution sounds like a win win situation to me. I didnt take a minute to think of this. Doctors, nurses, teachers, police officers, social workers etc are the people that keep this country going so why are we not treated like royalty??????????

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  • I work as an agency nurse due to financial reasons and being a single mum.With the introduction of the new rule about IR35,I have now decided to stop being a nurse.I can't afford to live on a NHS wage and I wouldn't be able to work more shift due to medical reasons.
    Many more nurses like myself will be affected.
    I love being a nurse but I don't live on air and bills need to be paid.

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  • well, well, well I can't say that I'm shocked and its only going to get worse.

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  • I am still in a state of disbelief that anyone would devise a plan to get rid of anyone in a substantive post from doing agency work, suggesting insteadc that they work overtime as if that doesn't happen everyday; when staff leave late and without proper breaks.
    Join the staff bank I hear.....
    When we talk about Staff Bank I hope that it isn't referring to NHSP which if I am not mistaken is an AGENCY. So all that will be left as is overtime, wait a whole month to get a small amount in your salary.

    The advantages of working as an Agency staff is that it facilitates the opportunity to keep up your second skill which is not always possible in the post you were employed in.
    Pick up ideas from other trust.
    Meet different people.
    Keeps you grounded and reminds you what it is like to be the new person.
    Pay you the following week to help you get out of debt and pay bills.
    One also needs you dispel the idea that patients are cared for less successfully by Agency Nurses.
    Nursing skills, care, patiences and compassion, surely is an intergal part of the individual Nurse irrespective of who pays them. Chances are the person is just a poor Nurse, but in their substantive post they are not criticised, corrected, or asked not to come back.

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  • Michelle

    "It has written to trusts today telling them to “pause”...in order to “engage with the sector”".

    So...would it not have made sense to hold a consultation with the people (i.e. us nurses) who would be affected by this BEFORE the planned ban was announced? This is a joke and a shambles. Hope it never sees the light of day again.

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  • why do they think they have the RIGHT to dictate what nurses can and can't do in there free time! Not in any other profession would this happen! I don't even work as an agency nurse and this has enraged me so much that I've contacted an agency to join up! So sick of year after year seeing the minimum wage increase and nurses pitiful 1% rise. Soon it will be better paid to work at mcdonalds!

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  • Did anyone heard the news today the cost of living has gone up so while our pay remains stagnant our food and bills goes up and don't ask about Brexit, some retailers is using this as an excuse to increase their prices. What the power that be may not take into consideration is they may ban nurse in substantive post from working as agency in a sly way to entice people back to the NHS. What it might do is encourage some nurses to leave the NHS. I think those in charge are silly.

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  • I suspect that the changes are borderline illegal, which is why they have held back from implementation. They appear not to have consulted with unions prior to implementation, again, borderline illegal? Is this really who we want running the health service? I understand costs need to be reigned in but is penalizing the majority of the work force the way to do it? This has raised more questions than answers and the biggest question for me is: why is the CEO of the NHS so out of touch with front line workers that he signs off on a policy that can only have a negative fiscal impact on thousands of his employees, forcing many of them to seek work elsewhere? And in an era when one in five trained nurses is set to retire in the next few years. It displays a painful ignorance of the hardships endured by a profession that is the backbone of the organization he purports to run. This would not happen in any other profession, the reason being, they are held in higher regard by government and more importantly, would not hesitate to take industrial action. Perhaps it is time we did the same.

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