More than one in five NHS finance directors fear new controls on agency spending will hamper effort to recruit enough nurses to provide safe care, reveals a new survey by the King’s Fund.
Twenty seven out of 97 finance directors who took part in the survey felt the measures, announced by health secretary Jeremy Hunt in June, would affect their ability to ensure safe staffing.
Thirty said the measures would not affect safe staffing, but the remaining 40 said they did not know.
Mr Hunt said he was bringing in tighter controls to prevent staffing agencies “ripping off the NHS”.
“Trusts remain focused on improving the quality of care and are planning to recruit more nurses”
The measures include setting a maximum hourly rate for hiring workers, like nurses, and capping the total amount trusts can spend on agency staff.
However, the body that represents staffing agencies has claimed agencies are being used as a “convenient scapegoat” for the NHS’s staffing woes, as previously reported by Nursing Times.
The views of trust finance directors were canvassed as part of the King’s Fund’s latest quarterly monitoring report looking at how the NHS is performing.
The idea of controls on agency spending garnered a mixed response, a selection of comments from contributors revealed.
“We need a workforce solution to ensure that we can recruit sufficient nurses and doctors,” said one finance director from an acute trust. “The increase in temporary staffing is not just down to a lack of controls.”
Meanwhile, a finance director from a mental health trust described the policy as a “publicity stunt” that would harm staff welfare.
“It will put additional pressures on safe staffing and on existing staff to work bank hours, leading to higher stress levels and sickness,” said the director, adding that it was “not well thought through”.
Others said the proposals showed a lack of understanding of how the service worked and the reasons behind staffing shortages.
“I do wonder whether the government understands that the shortage of nurses compared to the number working for agencies may reflect two years of no pay awarded to the NHS, followed by a very poor pay settlement the last two years,” said a finance director at a community trust.
However, some felt the policy could help. “If it works properly, it should reduce the attractiveness to nurses of working for agencies, thus, there will be more available for substantive recruitment,” said another director from the community sector.
The majority – 59 out of 97 – said they did not think the stricter controls on agency spending would significantly reduce the total amount they forked out for agency staff.
Just 11 directors felt the plans would indeed lead to a substantial reduction in agency spending.
However, the survey also found three quarters of trusts were planning to recruit more permanent nurses in the next six months.
The King’s Fund said this suggested trusts were prioritising quality, despite mounting financial pressures.
“Rising costs, cuts in the payments they receive for treating patients and increasing demand makes 2015-16 the most challenging year for NHS providers this century,” said the think-tank’s chief economist John Appleby.
“The majority expect to be in deficit by the end of the year,” he said. “Despite this, trusts remain focused on improving the quality of care and are planning to recruit more nurses.”
The survey found a third of trusts planned to reduce their overall number of permanent staff, but the results suggested this will mostly affect non-clinical staff, as more than half these trusts said they still intended to recruit more nurses.
For the fourth quarter in a row, staff morale topped the list of concerns raised by finance directors.
Professor Appleby said measures like capping agency fees and limiting staff pay increase would not be enough to cut costs and boost productivity in the NHS.
“The most promising opportunities like in changing clinical practice to deliver better outcome at lower cost,” he added.
“This is something that can only be achieved by engaging NHS staff in a new mission to deliver better value,” he said.