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Nurse turned politician calls for cap on agency shift charges


The government should set a cap on the amount NHS providers can pay for using agency staff during the current nursing shortage, according to a nurse who entered politics to defend the health service.

The call from National Health Action Party spokeswoman Kathryn Anderson followed news yesterday that some trusts were paying almost £150 an hour for temporary staff to fill shifts during public holidays.

Sky News asked hospitals in England how many agency staff they employed on the 5 May bank holiday and at what rates.

“The NHS should be using its ‘purchasing  power’ to negotiate a better deal”

Kathryn Anderson

The broadcaster highlighted specific examples where trusts were either using high numbers of temporary staff or paying them particularly large sums.

It found around 30% of nurses on duty that day at both Shrewsbury and Telford Hospitals Trust and Heatherwood and Wexham Park Hospitals Foundation Trust were from an agency.

Meanwhile, University Hospitals Bristol Foundation Trust paid an agency £1,800 for a 12-hour nursing shift and nearby Taunton and Somerset Foundation Trust paid almost as much for a mental health nurse.

An investigation carried out by Nursing Times in the wake of the Francis report in March 2013 predicted a significant rise in agency spending, as trusts reacted to concerns about safe staffing. This situation has subsequently been made worse by a national shortage of nurses.  

Ms Anderson, who has herself worked as an agency nurse, criticised the government for allowing the situation to happen “through its cuts to NHS staff and funding”.

Kathryn AndersonKathryn Anderson

However, she added: “From first-hand experience I know that hospitals do not use agency staff lightly – senior ward staff need to jump through hoops before an agency nurse is allowed.”

Ms Anderson also noted that agencies gave hospitals flexibility to deal with situations such as increased demand and sickness absence.

“The agencies charge a premium for providing this service. In addition to reversing funding cuts and properly staffing the NHS with nurses, the government should consider a cap on the hourly amount an NHS hospital will pay an agency,” she said.

“The NHS should be using its ‘purchasing  power’ to negotiate a better deal,” she said, adding that a capping system had been introduced in the Australian state of Victoria in 2002.

A Department of Health spokesman said: “We encourage all trusts to maintain a tight grip on their staff costs and we will hold poor performers to account.”


Readers' comments (12)

  • michael stone

    '“The NHS should be using its ‘purchasing power’ to negotiate a better deal,” she said'

    I agree with that - agency staff should be a last resort, but if agencies know that, and use it to unreasonably inflate the rates they are charging, that needs looking at.

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  • Nurses do agency either because they want the flexibility it offers or want the money it offers.

    The alternative to agency is a well ran local 'nurse bank' that offers equitable rates of pay to substantive staff. NHS Trusts should have national standards to support them establishing this.

    If there aren't any agencies, nurses will join the nurse banks.

    Now while this could sort out the nurses and the midwives, the medical staff - well, that's another issue. Help us sort that out Ms Anderson. Oh, and don't forget to come back and tell us how poor performing Trusts have been held to account DH.

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  • A member of my family has recently been made redundant from a management positions at a local NHS Trust. She is a nurse by background and has retained her clinical skills. The Trust are seriously short staffed and employ agency staff constantly at a huge cost. The Trust has now refused to allow my relative to join their nurse bank on a zero hours contract, on a Band 5 to do clinical work as they feel its wrong to make managers redundant and then allow them back into the Trust as clinicians. However, they will continue to pay agency nurses exorbitant fees to work on wards they don't know rather than pay the going rate for a nurse who knows their systems - its potty!!

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  • If the NHS bank can pay the £30 to 50 /hr the agency staff take home, and that money is taxed at 20% just like agency money then every nurse will join bank

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  • My local bank pays band 5 midpoint. As I am a band 7 there is no way I will work extra for less than my normal rate...

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  • 2 August 2014

    The main problem of the NHS Hospital is staffing shortage be it caused by sickness, holiday, leave or absence. If the hospitals can sort this out without utilizing agency or locum staff. It would minimize the cost of getting temporary staff.

    However, there are factors to consider, why do we still have problem in staffing shortage:
    1) H.R. is slow in processing potential employees.
    2) An applicant sudden lack of interest working in hospital.
    3) The inadequate take home pay of staff grade employee, high cost of living, inflation rate rising every year- rent, food, fuel, fares, energy, utilities.
    4) The lack of incentive on high cost area.
    5) The relentless stress and overwhelming pressures, increase in workload and demands of the job.

    These is why an individual will consider to work as a locum or agency. The flexibility, financial rewards compensate for the hassle and misery cause by the factors mentioned above.

    By the way locum and agency pay taxes, they got expenses and family to support. So its NOT a form of cheating or defrauding the system like many people think. This is a making an honest living. Rather than some people choose to receive social benefit in their entire life.

    Some agency charge a lot of administration fee. That does Not mean, you pay a locum £30 or £50 an hour. Well, its business somebody has to earn a living and pay taxes and bills. This is another subject matter to discuss.

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  • There's clearly shortages of nurses in hospitals and even more so in the community, which makes it tough to deliver good quality care. Pay freezes/cuts, downbanding, caps, lack of overtime rates and worsening pensions (increased contributions + older retirement) would lead people moving from bank to agency work. There's a lot of hoops before agency staff are used, in some instances even leaving shift unfilled by the trust would be considered.
    Some permanent staff also work bank and agency, to get best remuneration for themselves to support their family and pay their bills. Some places are very tough to fill vacant shifts and have to use agency. Plans to kerb agency use there only increases risks to patients and reduces their care there, unless senior staff, execs and MPs like to donate some of their time to work as HCAs with direct patients care. I'm sure these patients would place quality of staffing levels + care above money spent to deliver that care.
    Not enough money? wastes caused by top-down reorganization, hiring of consultants doing what managers should be doing, costs + effects of redundancies, downbanding + suspensions, and waste / recycling can all save organizations millions if managed better.

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  • + to add costs of not looking after staff's health + well-being leads to loads of hidden costs, as well as some freelancing to make ends meet.
    Agencies + organizations are head hunting good quality staff to fill their shortages, and are more likely to take them from organisations that don't look after their staff as well.

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  • Just a stab in the dark, but with some half decent human resources planning, agency fees could be kept to an absolute minimum. Sadly, as the NHS is broken up and the component parts sold off we will see more and more stupidity like this.

    'There will be no top down re-organisation of the NHS'

    I do hope the electorate make them pay and vote the lyers out at the next GE

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  • heaven for bid we should pay nurss what they are worth

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