NHSI targets use of agency admin staff

NHS Improvement has proposed measures to limit spending on admin and some clinical agency staff, which could limit the use of agency cover in finance and other support functions.

Trusts have reduced overall agency spending by more than £1bn since April 2016, when agency rules were introduced. But the oversight body said the volume of agency shifts had increased since the beginning of this financial year, largely due to rising demand, and despite a significant reduction in agency prices.

The consultation proposes two measures – the first would require trusts to use framework agency workers only when filling non-clinical and unregistered clinical shifts. Non-clinical and unregistered clinical roles include healthcare assistants, estates, admin and some allied health professionals.

In the medium term, restricted use of off-framework agencies for these roles should be part of trusts’ strategies to stop using off-framework agencies for all staff groups, the oversight body said. And, though trusts have reduced off-framework shifts by more than 70% since 2016, NHS Improvement believes further savings could be achieved.

Only 37 trusts use off-framework agencies for non-clinical and unregistered clinical cover and NHS Improvement said it would work with these providers to move the spending onto bank or framework agencies by April 2020.

The second measure bears down on agency admin shifts by requiring trusts to use bank, substantive or fixed-term staff instead. This will help providers meet new admin agency expenditure ceilings that will be introduced in 2019/20, NHS Improvement said.

Finance staff account for 14% of admin agency spending, typically used to cover sickness or maternity leave and help with short-term projects. There would be exemptions for the latter – if they last fewer than six months – and for shortage specialties, including clinical coders. Interim very senior managers would still be covered by separate rules.

The consultation closes on 22 March and, subject to responses, agency rule changes will be introduced from April.