Senior nurses have criticised the government’s plans to cut spending on agency nursing.
Monitor and the NHS Trust Development Authority have written to all NHS provider chief executives to give them individual ceilings for the proportion of nursing expenditure their trusts can spend with temporary staffing agencies from 1 October.
This should bring all providers’ agency spending to within 3% of their overall nursing expenditure.
Although those with highest rates of agency spend will be given longer to reach this target, nursing directors have voiced concerns over the caps.
“While all of us are committed to reducing the reliance on temporary staff, we have to ensure that the assessed needs of patients are met”
“As we move into winter and the inevitable move to opening additional beds I cannot see how we can staff them without use of agency [personnel],” said a nursing director from one large trust who asked not to be named.
Liz Rix, chief nurse of University Hospitals of North Midlands Trust, said: “While all of us are committed to reducing the reliance on temporary staff, especially agency staff, we have to ensure that the assessed needs of patients are met.”
Another nursing director said the caps unfairly target nurses. She said: “Medical expenditure is far more of an issue yet no one will challenge the consultants working as permanent locums for £100-£150 per hour.”
Other parts of the health secretary’s clampdown on “rip-off agency staff ” involve a ban on trusts securing nursing staff from agencies that are not on approved “framework agreements” from 19 October, and a cap on the hourly rates trusts pay for agency nurses.
“Combined with difficulties recruiting staff from overseas, we have set the scene for a premium-cost market to continue to evolve”
This is expected to be announced by 1 December, giving Monitor more time to consult with provider organisations.
Karen Dawber, director of nursing and governance at Warrington and Halton Hospitals Foundation Trust, said she understood the
financial rationale, but said: “We have, at least for the next two years, a national shortage of nurses. Combined with difficulties recruiting staff from overseas, we have set the scene for a premium-cost market to continue to evolve. We need to encourage nursing staff working for agencies to return to the NHS.”
Janice Sigsworth, director of nursing at Imperial College Healthcare Trust, was involved in developing the guidance on the caps and said it should not affect safety.
“It should be about supporting efforts to minimise vacancies as well as ensuring sufficient day-to-day flexibility within organisations so we can still book an agency nurse if quality and safety demand it,” she said.