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”
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.
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.
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.
Pay restraint for NHS nurses set to continue to 2020
“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, 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.