News / Phased introduction for agency nurse spending rules

Three new mechanisms for cutting agency staff spending were proposed in a consultation last month. These would see an annual ceiling on total agency spend for each trust, mandatory use of frameworks for procuring agency staff and limits on the amounts individual agency staff can be paid per shift.

However, only the first two were introduced, effective from 1 September. The national arm’s length bodies said they planned to introduce the ceiling on individual shift pay later in the year after they complete further work.

Each trust has been sent their annual limit for agency spending and will be able to apply for an exception if there are specific local needs. The spending ceiling does not apply to ambulance trusts. However, all NHS trusts, foundation trusts receiving interim support from the Department of Health and foundations in breach of their licence for financial reasons must follow the rules. Monitor has strongly encouraged all other trusts to comply.

Peter Blythin, director of nursing at the NHS Trust Development Authority acknowledged a number of existing local frameworks worked well to support local nurse directors to find high quality agency staff. But he added that more can be done to give trusts greater powers to have more control over their use of agency staff.

‘The creation of an assurance process to make sure local frameworks are providing high quality staff at the right price, the introduction of ceilings to ensure boards can have a focused programme on reducing over-reliance on agency staff where it exists and future measures to limit the inflated costs associated with some agency arrangements, will all help to ensure that local providers can, in future, be better equipped to focus on the important issues of high quality staff and patient safety whilst becoming more efficient,’ he said.

NHS Providers chief executive Chris Hopson said reducing the growth in agency spending was an important element in returning the NHS to financial balance.

He added that the issue was complex and measures must be implemented collaboratively.

‘It will be important that Monitor and the TDA are supportive of providers that are having to make difficult decisions where there is a conflict between meeting national requirements on staffing levels, and complying with the new rules,’ he said.

‘We recognise that setting the amount that individual agency staff can be paid per shift is complex and must take account of regional factors. However, price caps would make a key contribution to reducing agency spend.’