Many of you will be aware that Jim Mackey, Chief Executive of NHS Improvement, wrote to all trust Chief Executives on 27th February 2017 outlining new rules to be brought in concerning the supply of agency staff to the NHS. These new rules prevent trusts from engaging agency staff for additional shifts if they are already employed as substantive staff within the NHS.
Immediately prior to this letter, the REC were informed by NHSI that these rules would only apply to medical locums. The opening paragraphs of the letter also indicates that these new measures are being implemented in order to tackle excessive spending on medical locums. However, the letter goes on to possibly suggest that all staff are under scope, and the wording in the appendix to the letter did not make it clear who the new rules would apply to. The REC wrote to NHSI as matter of urgency for clarification, and they have confirmed to us that indeed, all staff will be covered by these new rules.
We understand that this will come as very disappointing news to many members, and could have significant impact on the commercial viability of businesses in the sector. It will be particularly frustrating for agencies that have worked hard to get onto framework agreements – especially without knowledge of the introduction of these restrictions. The timing is even more alarming, as agencies will be required to implement this from 1 April, and, combined with new IR35 changes, will have a detrimental impact on patients, agencies and clinicians.
Whilst we understand the need for the NHS to reduce spending on agency staff, we don’t believe that these measures are in the best interests of patients nor the ability to provide a safe level of staffing within hospitals. It seems illogical that at the time of one of the biggest staffing and recruitment challenges the NHS has ever faced, NHSI would systematically curtail the contribution of recruitment professionals. The letter also does not appear to have a contingency plan i.e. a ‘break glass’ clause for patient safety as contained in the agency rules. This is a major concern given that we know that clinicians often refuse bank roles: often because they are less flexible than agency shifts: last minute cancellation rates are higher; payment mechanisms are not as quick as agencies; and locums want consistency and continuity in assignments with a hospital – which is achieved through strong relationships with agencies.
The REC will be meeting with representatives from NHSI at a NHS Staffing Conference and we will be raising the concerns of members with them, as well as challenging them on the lack of proper engagement and communication with framework suppliers, agencies and other stakeholders. In addition, we are also due to meet with NHSI on Tuesday, 21st March 2017 where we will be able to have more detailed discussions with them.