Caps on the amount hospital trusts can spend on agency staff come into force today.
Under the rules hourly rates for doctors, nurses and other clinical and non-clinical staff are capped at a percentage above basic rates.
These percentages – 150 per cent for junior doctors, 100 per cent for other staff and 55 per cent for non-clinical workers – will taper downwards until an across the board limit of 55 per cent comes into effect from 1 April 2016.
All trusts are required to report weekly on the number of shifts where they have made payments in excess of the caps, but the caps apply directly to NHS trusts and foundation trusts in financial difficulty. Ambulance trusts are initially exempt.
In a report health sector regulator Monitor and the Trust Development Authority said payments in excess of caps would be scrutinised and “excessive use and failure to make rapid improvements to workforce management may lead to regulatory action as appropriate”.
A consultation carried out by these organisations received more than 3,400 responses. Of the 108 NHS trusts that responded, more than 90 per cent were in favour of caps in principle but the majority of clinicians who responded, including more than 2,000 doctors, were against them.
The report said: “The price caps represent the maximum that trusts can pay and should not be interpreted as standard or default rates. Trusts will want to, and should, continue to secure the majority of agency staff at rates below the price caps.”
In 2014-15 health service spending on agency workers increased to £3.3 billion, leading health secretary Jeremy Hunt to comment that expensive agencies are “quite simply ripping off the NHS”.
The rules include a “break glass” clause where caps can be overridden “on exceptional safety grounds”.
The report said where pay rates fixed in framework agreements were higher than the caps, trusts should not pay beyond the cap.