New rules have been published limiting the amount of cash NHS trusts and foundation trusts that are 'in financial difficulty' can spend on agency staff.
The measures include an annual ceiling on total nursing agency spend for each trust, mandatory use of approved frameworks and caps on the amount individual agency staff can be paid per shift.
The measures, announced by Monitor and the NHS Trust Development Authority (TDA), apply to all NHS trusts and foundation trusts in financial difficulty, although other foundation trusts are “strongly encouraged to comply”. Trusts will be required to make monthly reports covering agency spend.
Ceilings on nursing agency spend, which apply from 1 September and cover the period from 2015-16 to 2018-19, will be percentages of total nursing staff spend. The rules on frameworks will apply from 19 October. More work is continuing but caps on pay for nursing agency staff are planned “later in 2015”, with rules on other agency staff “to follow shortly”.
Trusts wishing to use off-framework arrangements, or seeking to adjust their spend ceiling, will need to get approval from Monitor and the TDA.
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”.
Peter Blythin, nursing director at the TDA, said: “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 while becoming more efficient.”
Ruth May, nursing director at Monitor, said: “We’ve worked hard with the NHS to develop this set of rules which will support boards and in particular chief nurses to reinvest the money currently spent on agency staff into providing the best care for patients.”