The health secretary, Jeremy Hunt, has announced he is to introduce curbs on the use of employment agencies in the National Health Service as bills for temporary staff soar. But are the high rates charged by agencies the problem – or is the demand for temporary staff caused by staff shortages the real issue?
What has Jeremy Hunt said?
He says the annual bill for agency staff rose from £1.8bn to £3.3bn over the past three years. He claims hospitals are paying up to £3,500 for a doctor to work a single shift.
We're cracking down on rip-off agency fees & use of management consultants in the NHS: every £ possible must go on direct patient care.
— Jeremy Hunt (@Jeremy_Hunt) June 2, 2015
This seems a lot - are the figures correct?
The figures are correct. But rates charged by agencies for doctors vary widely due to the circumstances. So the £3,500 a shift cited by the health secretary relates to a 30-hour shift in the winter.
To put the total bill into context, Monitor, which regulates foundation trusts, last month reported that agency staff costs as a percentage of total staff costs was 6.4% in the last year.
However, foundation trusts had planned to cut agency spend by 44% in that period. In fact, it rocketed by 29% year on year.
A round up of the quarterly performance of foundation trusts for year ending March 2015: http://t.co/5TK7Yme4tC. #NHS pic.twitter.com/r5hJpEDQCC
— Monitor (@MonitorUpdate) May 22, 2015
So why is so much being spent on agencies?
Monitor found that overspend on agency staff arose from a need to “cover vacancies and unplanned demand”. Foundation trusts have consistently cited recruitment difficulties, particularly in qualified nursing and medical staff and in accident and emergency, the regulator said.
Do doctors and nurses agree?
Mark Porter, the British Medical Association council chairman, says reliance on agency staff is a “sign of stress on the system and the result of poor workforce planning by government”.
We need to address the root causes of the recruitment and retention problem in many parts of the NHS, especially emergency medicine.
Peter Carter, the chief executive and general secretary of the Royal College of Nursing, said that instead of relying on agencies, efforts should be made to retain a skilled and experienced workforce.
A lack of investment in nurse training and cuts to nurse numbers mean that trusts now have no choice but to pay over the odds for agency staff and recruiting overseas.
What’s causing the underlying recruitment crisis?
Zofia Bajorek, a researcher at the Work Foundation, wrote her PhD thesis on the management of temporary staff in healthcare emergency departments. She says would-be doctors and nurses were being put off from training due to the “culture of blame” surrounding the NHS.
The NHS is not getting good press. There’s a culture of blame and it is putting a lot of pressure on staff.
The Mid-Staffordshire scandal and heavily scrutinised performance of emergency departments earlier in the year are examples of the sort if criticism turning people off from joining the NHS, Bajorek said.
Sickness absence due to stress was also leading to an increased demand for temporary staff, she said, which requires improved workforce planning to tackle.
What does the opposition have to say?
The shadow health secretary, Andy Burnham, said the decision to cut 6,000 nursing posts in the early years of the last parliament has left the NHS “in the grip of private staffing agencies”.
If the government is serious about breaking the hold staffing agencies have over the NHS, then ministers need to recruit more nurses and increase training places immediately.
