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Nurses may switch to agency work due to deteriorating conditions in NHS

Research also highlights poor relationships between agency and permanent staff.
Agency nurse

Many NHS staff switch to agency working because of concerns about deteriorating job quality rather than higher rates of pay, research suggests.

The report on use of agency workers in the public sector in the UK was published by the National Institute of Economic and Social Research (NIESR), and was commissioned by the Office of Manpower Economics.

The findings were based on interviews with agencies, employers and focus groups comprising mostly nurses, between April and November 2016.

Some agencies said the higher proportion of older and experienced agency workers was due to perceived deteriorating permanent employment conditions in the NHS.

The report also highlighted poor relationships between agency and permanent staff a finding that echoed an RCN survey last year, which found that 64% of agency nurses felt they

Many NHS staff switch to agency working because of concerns about deteriorating job quality rather than higher rates of pay, research suggests.


Picture: Tim George

The report on use of agency workers in the public sector in the UK was published by the National Institute of Economic and Social Research (NIESR), and was commissioned by the Office of Manpower Economics.

The findings were based on interviews with agencies, employers and focus groups comprising mostly nurses, between April and November 2016.

Some agencies said the higher proportion of older and experienced agency workers was due to perceived deteriorating permanent employment conditions in the NHS.

The report also highlighted poor relationships between agency and permanent staff – a finding that echoed an RCN survey last year, which found that 64% of agency nurses felt they were not well respected in the NHS.

Caps on spending

The government has tried to curb spiralling agency costs in the NHS, which have contributed to a £2.5 billion deficit, by introducing caps in November 2015 on how much each trust can pay agency staff.

The report highlights that NHS Improvement figures show the average price paid for an agency nurse has dropped by 18%, and the NHS saved up to £600 million during the first year of the caps.

Increasing cooperation

A number of trusts raised the idea of harmonising the operations of agency banks on a regional level, to avoid bidding wars between trusts aiming to attract a limited supply of workers.

Some trusts revealed scope for more flexibility between permanent roles and making them more attractive. One trust had looked into re-distributing tasks of doctors and nurses to support roles; another trust mentioned similar possibilities such as upskilling band 3 healthcare support workers to nurses.

Report co-author, NIESR researcher Nathan Hudson-Sharp, said the future of agency working in the NHS needed a much more comprehensive approach, which allowed NHS employers to ‘address underlining issues around staff shortages, training, workforce planning, recruitment and retention.’


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