Hospitals to be named and shamed for spending too much on agency staff

Health officials are to name and shame hospitals which spend too much money on agency staff as new figures showed the NHS in England is paying £250 million a month for agency workers.

The announcement came as a senior health official expressed disappointment in agency doctors and companies for trying to “cash in” on the NHS.

The health service could not afford to carry on “forking out for hugely expensive agency staff”, NHS Improvement chief executive Jim Mackey added.

Last year, health officials announced a package of measures to clamp down on agency spending – including caps on the hourly rates – after it emerged that the NHS in England spent more than £3 billion on agency workers in 2014/15.

NHS Improvement said the NHS saved £600 million since the measures were introduced last October – with three-quarters of trusts reporting a reduction in spending.

But the health regulator said spending was still “too high” as it announced further measures to curb the amount of money paid to agencies.

These include the publication of league tables of agency spending on best and worst performing trusts and the collection of anonymised information on the 20 highest earning agency staff, per trust, and of long-standing agency staff.

NHS Improvement has also introduced a new approval process for the appointment of any interim very senior managers who charge more than £750 a day.

Meanwhile, NHS trusts have been told to object to excessive rates – particularly by medical agency staff who are able to negotiate their own fees, often at prices well above the cap.

“The NHS simply doesn’t have the money to keep forking out for hugely expensive agency staff,” Mr Mackey said.

“The progress we have made in a single year is really promising and trusts have responded well to the caps. They’ve worked hard to cut these bills and, in many cases, improved the way they manage their workforce.

“But there’s much more to be done, especially to reduce how much trusts pay for medical agency staff and bringing staff back into the NHS.

“Over a third of the agency bill is spent on medical agency fees, so we need to ensure agencies and doctors do their bit to make sure they’re not overcharging.

“With hospitals across England struggling with patient demand, trusts need all the support they can get and trying to cash in on the NHS just isn’t on.

“We need everybody to pile in, and patients deserve that effort from us to make sure they’re getting the right care, from the right staff, at the right time. We’re committed to making sure hospitals can spend their money on their care and not on excessive agency fees.”

Dr Anthea Mowat, chairwoman of the British Medical Association’s representative body, said: “Greater reliance on agency staff is a sign of an overstretched NHS and the result of poor workforce planning by the Government.

“The new measures are nothing really but a sticking plaster – simply naming and shaming trusts or individuals will not address the underlying issues causing an over-reliance on agency workers.

“Increasingly, locums are employed because hospitals can’t attract staff to take up full-time posts.

“Caps do not address the root causes of the recruitment and retention problems in many parts of the NHS, especially emergency medicine.

“The Government must tackle these issues with alternative interventions such as improving working conditions, better rota management and flexible shift patterns to help bring down agency costs.”

Josie Irwin, head of employment relations at the Royal College of Nursing, said: “The cap on agency pay is not tackling the root cause of the problem. Years of poor workforce planning has created a nursing shortage, and the standalone measure of cutting agency nurses’ pay is likely to make the problem worse.

“Many nurses have no choice but to take on agency work because they cannot live on their NHS salary alone, as Government policy means nurses have suffered a 14% real terms cut in income since 2010.

“Collecting individual data on those who earn most from their agency work will further erode the trust of a workforce where morale is already low.

“We need a workforce strategy which fixes the current problems and prepares for the future. As part of this, to help resolve high spending on agency staff, the Government needs to restore the cost of living gap in nurses’ pay.

“Collecting and publishing agency data in isolation will be ineffective without also publishing vacancy data, to help get to the heart of workforce planning problems by also looking at recruitment and retention patterns.

“The NHS must be freed from the perpetual loop of short term decisions which ultimately impact on patients.”

Meanwhile, the health regulator has announced that it is to step in at three trusts that are struggling financially.

NHS Improvement said that three organisations – East Sussex Healthcare NHS Trust, Gloucestershire Hospitals NHS Foundation Trust and Brighton and Sussex University Hospitals NHS Trust – are to be put in financial special measures.

The bodies are between them forecasting a deficit of more than £73 million this financial year.

The trusts will now get additional support from NHS Improvement to help them get back on track with their finances.

NHS Improvement said that the five trusts which were placed in financial special measures in July are “responding well”.

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