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Readers’ panel: should NHS trusts be 'named and shamed' for high spending on agency staff?

NHS Improvement have announced plans to name trusts with the worst record on agency spending by publishing league tables trusts in England. Nursing Standard readers have their say. 
nhs trusts

NHS Improvement have announced plans to name and shame trusts with the worst record on agency spending by publishing league tables trusts in England. Nursing Standard readers have their say

Beverley Ramdeen is a senior lecturer in adult nursing at University of Hertfordshire

Instead of naming and shaming trusts in this way, NHS Improvement should focus on developing a better understanding of the factors that lead to high spending on agency staff, such as recruitment problems or a lack of leadership, and tackle those instead. Consider the message this sends to patients and the impact it could have on their confidence in the standard of care being delivered. With the ongoing debate on agency staff pay, this proposal would only serve to increase prejudice against agency staff.

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NHS Improvement have announced plans to ‘name and shame’ trusts with the worst record on agency spending by publishing league tables trusts in England. Nursing Standard readers have their say 


NHS Improvement plans to publish league tables detailing
 agency spending by NHS trusts. Picture: iStock


Beverley Ramdeen is a senior lecturer in adult nursing at University of Hertfordshire 

Beverley RamdeenInstead of ‘naming and shaming’ trusts in this way, NHS Improvement should focus on developing a better understanding of the factors that lead to high spending on agency staff, such as recruitment problems or a lack of leadership, and tackle those instead.  
Consider the message this sends to patients and the impact it could have on their confidence in the standard of care being delivered. With the ongoing debate on agency staff pay, this proposal would only serve to increase prejudice against agency staff. 


Mark Pittman is an emergency nurse practitioner at St Joseph’s Hospital in Newport, South Wales 

Mark PittmanIdentifying all NHS costs should be the norm and this includes consultants, managers and suppliers. But agency nurses are easier targets than managers, who don’t deliver hands-on patient care yet cost the NHS a fortune. 
Nurses are susceptible to stress and illness, which can lead to staff absences or positons left unfilled. Patient safety must come first and agency nurses are ready to step in at the drop of a hat. Demand and supply drives agency costs and this proposal will do nothing to improve staffing levels. 


Lauren Ferrier is a third-year mental health nursing student at Robert Gordon University in Aberdeen 

Lauren FerrierThis as an obvious attempt to deflect blame for external staff spending onto NHS trusts, who have little option, as budget cuts have limited their ability to hire permanent staff. There is plenty of evidence of a direct correlation between nursing staff numbers and patient outcomes and creating fear over agency spending may result in unsafe staffing levels. As well as risking patient safety, this could have a negative impact on staff retention and increase sickness absence rates. 


Jane Scullion (@JaneScullion) is a respiratory nurse consultant at Glenfield Hospital in Leicester

Jane ScullionThe use of agency staff indicates a lack of resources in the NHS, set against rising demand and complexity. Naming and shaming doesn’t solve the fundamental year-on-year cuts to permanent staff, problems with recruitment and retention and the overall lack of investment in a sustainable workforce. Agency staff plug gaps and provide essential care – they should not feel marginalised for being needed. Changes to working conditions and investment in permanent staff is the only answer, especially with winter coming. 


Readers’ panel members give their views in a personal capacity and do not represent their organisations

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