‘Myopic agency caps risk NHS catastrophe’ – REC

Filed under Press release

Thursday, 07 April 2016


Centrally-imposed restrictions on the amount that NHS trusts can pay for temporary doctors and nurses risks understaffed wards and patient safety, new research from the Recruitment and Employment Confederation (REC) shows. 


Responding to a survey conducted in March, 63 per cent of healthcare recruitment agencies said they expect locum doctors and agency nurses on their books to focus on the private sector in response to the latest pay cap, which came into effect on 1 April. A third (31 per cent) said that candidates will leave the profession altogether. Just 3 per cent said they expect candidates to take up permanent role in the NHS.


Demand for temporary staff from NHS trusts has increased since the caps were imposed. In June 2015, a third of healthcare recruiters (33 per cent) said they received more than 100 requests for staff per week from each NHS trust they work with. The latest data shows that almost half of healthcare recruitment firms (47 per cent) are now receiving more than 100 requests to fill shifts every week from each NHS trust they supply.   


Nine in ten recruitment firms (87 per cent) said that since the first cap was enforced in November 2015 they have found it more difficult to fill temporary NHS vacancies.


Eight in ten (79 per cent) healthcare recruitment agencies said they work with NHS trusts which are routinely breaching the caps. This is supported by data released recently by the MSI Group showing that 96 per cent of trusts have exceeded the agency pay caps.


REC chief executive Kevin Green says:

“Everyone knows that efficiencies have to be made in the NHS, but rather than a considered plan to improve staffing we’ve seen a policy which is myopic and ill-conceived.

“At a time when demand for temporary staff to fill gaps is increasing, locum doctors and agency nurses who have provided a lifeline to the NHS are having their pay cut to such an extent they are choosing to work outside of the public sector or leave the profession altogether.

“All the evidence suggests the cap is exacerbating the skills shortage crisis rather than alleviating it, and NHS Improvement has so far failed to produce evidence to the contrary. We believe that shifts are going unfilled in hospitals across England as the Department of Health instructs hospitals to put finance before patient safety.

“How many doctors and nurses have left agency work in favour of permanent roles? Are there fewer staff on wards since November? What has the impact of the cap been on performance within the NHS? These are questions that NHS Improvement needs to answer.”

NHS spend on agency staff accounted for 2.9% of the NHS's overall annual expenditure in 2014/15.

In March 2016, the House of Commons Committee of Public Accounts found that “the NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.”


REC NHS agency doctors and nurses infographic 

Click the thumbnail for the full infographic. 



Notes to editors:

    1. In March 2016, the House of Commons Committee of Public Accounts found that “the NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.” See page 3: http://www.publications.parliament.uk/pa/cm201516/cmselect/cmpubacc/709/709.pdf 


    2. According to MSI Group, 96 per cent of NHS trusts have breached the NHS agency pay cap. See: http://www.msigroupltd.com/news/agency-staffing-pay-caps/bp49/


    3. During live webinars in June 2015, January 2016 and March 2016, the REC asked member agencies that supply healthcare professionals:


    On average, how many requests for staff do you get from each trust you supply into on a weekly basis?

                                             Jun-15                         Jan-16                         Mar-16

    Total respondents                   64                                92                                73                                   

    0-50                                         42%                             48%                             32%

    50-100                                     25%                             17%                             21%

    100-200                                   11%                             16%                             23%

    200 +                                       22%                             19%                             24%                                                                                                     

    4. In March 2016 the REC polled member agencies that supply healthcare professionals during a live webinar and via an online survey:

    Since the new cap on individual staff pay and agency fees was introduced in November 2015, finding agency healthcare professionals willing to fill temporary vacancies within NHS trusts been:

    Total respondents: 77

    a) Easier                                                                                                          1%

    b) More difficult                                                                                               87%

    c) About the same, no easier and no more difficult                                       12%


    Are you working with at least one NHS trusts that is routinely breaching the current caps?

    Total respondents: 67

    Yes                                                                                                            79%

    No                                                                                                             21%


    What effect do you believe a 55% cap in April will have on the behaviour of your candidates? (Select all that apply)

    Total respondents: 73


    They will leave our books and become a permanent NHS employee    3%

    They will become bank staff                                                                    11%

    They will seek out work in the private sector via an agency                    63%

    They will leave the profession all together                                                31%

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