Editorial

Agency limits will only work if the cap fits

Limits are to be imposed on the amount of money that many NHS organisations can spend on agency staff, it was announced last week. Every NHS trust that is yet to acquire foundation status – and those that have done so but since run into financial difficulty – will have to keep a tight lid on their spending on temporary nurses and other clinicians.

Limits are to be imposed on the amount of money that many NHS organisations can spend on agency staff, it was announced last week. Every NHS trust that is yet to acquire foundation status – and those that have done so but since run into financial difficulty – will have to keep a tight lid on their spending on temporary nurses and other clinicians.

The new rules represent an attempt to curb the astonishing amount of money the health service hands over to agencies. Last year the collective bill was £3.3 billion, up dramatically from the £1.8 billion tally three years previously.

These nurses serve an invaluable function in keeping the NHS running

Behind the headlines lies a complex story. There are many reasons why employers choose to bring in temporary members of staff, and it should be remembered that doing so is not always more expensive. There are many ‘on-costs’ involved when employing someone permanently that are not reflected in the employee’s basic salary.

It should also be remembered when considering such issues that agency nurses serve an invaluable function in keeping the NHS running, plugging gaps in the workforce when a regular member of staff is off sick or when someone leaves and the recruitment process drags on.

Another consideration is that many nurses choose to work for agencies because they can pick and choose their days and hours. There is greater variety to the work and less ongoing responsibility, so fewer meetings and less paperwork. The health service could do more to improve the working lives of its staff so that agency working is less attractive.

Hopefully employers will respond positively to the new rules and recruit additional permanent staff so that there is a little slack in the workforce to cover unexpected absences. The danger is that once the cap is reached, there will be no money available for temporary cover, with potentially serious consequences for the staff left holding the fort and, more importantly, for patients and service users.

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