News / Providers asked to re-double efforts on agency spending

19 July 2017

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In a letter to provider chief executives, the oversight body’s chief executive Jim Mackey said it was important that the service built on this momentum to achieve further savings.
Mackey Total agency spend reduced in 2016/17 by £700m compared to 2015/16 and represented 5.8% of total NHS pay bill as opposed to 7.4% the previous year. Spend continued to fall in the first two months of 2017/18.

NHS Improvement also praised the ‘great achievement’ of getting monthly agency spend lower than bank spend – the first time this has been the case since agency controls were put in place. There has also been a significant reduction in the number of senior managers being paid on a day rate basis since the very senior manager (VSM) policy was introduced in October 2016.

However, Mr Mackey underlined that spending on agency staff was still at an unsustainable level, both from a quality and economic viewpoint, and more work was needed to reduce spending to ‘a more normal level’. ‘There are still too many price cap breaches and use of off-framework agencies,’ he said. ‘The sector therefore needs to re-double its efforts in applying price caps and using approved frameworks to procure agency staff, with the only exception to this being where there is an identified safety risk.’

The controls on VSMs have had a positive impact and trusts were improving their rostering efficiency and job planning and turning around vacancies quicker. ‘However there is still further to go in terms of ensuring consistency of application and many trusts are yet to realise the full potential of what can be achieved here,’ he said.

Looking ahead, Mr Mackey called for all trusts to ensure they had a staff bank in place across all staff groups and that these were working collaboratively across their health systems. A survey is currently aiming to establish trusts’ baseline position in this area. NHS Improvement has pledged to assess different technology solutions that may be needed to support collaborative banks.

The oversight body is also looking ahead to next winter. ‘We want to help providers create working environments that encourage substantive working within A&E departments, but that still have the ability to respond to short-term fluctuations in demand,’ the Mackey letter said.