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New rules on agency nurse spending include annual limits

Monitor and the Trust Development Authority publish new rules on agency nurse spending, including annual limits on what the NHS trusts can spend on agency staff

New rules have been published today by Monitor and the Trust Development Authority to cut the ‘astronomical’ amount NHS trusts are spending on agency nurses. 

It follows a leap in NHS spending on agency staff across England from £1.8 billion three years ago to £3.3 billion in 2014/15. 

An annual ceiling will now be set for every NHS trust, capping the amount they can spend on agency staff over the next four years. 

Each trust will today be notified of its annual limit and will be able to apply for exceptions if there are specific local needs.

The annual ceiling will be calculated depending on how much a trust spent on agency staff as a proportion of their total nursing staff spend in 2014/15. 

The ceilings range from allowing a trust to spend 3% of their total nursing staff spend on agency nurses to 12%. 

For example, trusts who are performing well and spend 3% or less of their nursing staff spend on agency nurses will be expected to continue to do so over the next four years.

But trusts with high agency nurse spends of 12% or more will be expected to reduce this by 2% per year to reach a spend of 6% by 2018/19. 

There will also be limits on the amount individual agency staff can be paid per shift, and these will be introduced later in the year.

Monitor’s nursing director Ruth May said: ‘Trusts are working hard to reduce the amount of agency staff they use, and this is something we’re actively supporting through initiatives like our agency support team.

‘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.’

The RCN has welcomed the move, but warned that the new rules must be implemented without putting patients at risk. 

RCN general secretary Janet Davies said: ‘Astronomical amounts have been spent paying agencies for temporary nursing staff over the past few years and it is simply not an effective use of NHS funds. 

‘However, it’s crucial that these plans are carried out in a way that does not risk patient safety, especially at those moments where care is under extraordinary pressure. 

‘These rules cannot get in the way of hospitals securing staff through agencies at short notice if they are essential to meet patient need. 

‘If patient safety remains the utmost priority, these plans could have a lasting impact on hospital finances – and ultimately patient care.’