Proposal to restrict use of agency workers in NHS (2024)

NHS trusts could be banned from using agency staff in band 2 and 3 roles and asked to restrict the number of health workers moving from substantive to agency work,under new government plans.

The Department of Health and Social Care is this week unveiling a package of "tough reforms" for the NHS with the aim of cutting wasteful spending and ensuring the health service delivers value for money.

“I am determined to make sure the money is well spent and delivers for patients"

Wes Streeting

As part of this, the government and NHS England have announced joint plans, which will go out to consultation, to reduce NHS reliance on agency staff.

It comes as the health service spent £3bn on agency staff last year, with some NHS trusts being charged up to £2,000 for a single nursing shift.

Under the proposals, NHS trusts would be banned from using agencies to hire temporary entry-level workers in band 2 and 3 roles, including healthcare assistants and domestic support workers.

In addition, the reforms would prevent NHS staff from resigning and then immediately returning to work in the health service as agency staff.

A consultation will be launched by NHS England on the proposals in the coming weeks, seeking views from staff, unions and NHS provider organisations.

Health and social care secretary Wes Streeting said: “For too long desperate hospitals have been forced to pay eye-watering sums of money on temporary staff, costing the taxpayer billions, and pulling experienced staff out of the NHS.

“We’re not going to let the NHS get ripped off anymore.”

Mr Streeting noted that chancellor Rachel Reeves made a £22.6bn investment in health last month, as part of her autumn budget.

“I am determined to make sure the money is well spent and delivers for patients,” he said.

“These changes could help keep staff in the NHS and make significant savings to reinvest in the frontline.”

Mr Streeting is due to unveil these reforms, as well as others, tomorrow during his speech at the NHS Providers conference, being held in Liverpool.

Government plans to clamp down on failing NHS managers’ pay

Senior NHS managers who fail to improve patient care could be denied pay rises, as part of the government’s radical reforms for the NHS.

Under new plans, there will now be financial implications for people in 'very senior manager' (VSM) roles, such as chief executives, if they are failing to improve their trust’s performance.

Mr Streeting said: “I’m prepared to pay for the best and I will defend financial incentives to attract and keep talented people in the NHS.

“It’s a big organisation that should be competing with global businesses for the best talent.

“But there will be no more rewards for failure.

“We have got to get a grip on runaway spending and make sure every penny going to the NHS benefits patient – changes will not be popular but it’s a case of reform or die.”

The government is set to publish a new framework for VSMs before April 2025, which will clamp down on poor performance, while rewarding senior leaders who are successfully turning their services around.

In response to the plans, the Recruitment and Employment Confederation (REC) has written to Mr Streeting to seek reassurance about the future of agency workers in the NHS.

In the letter, REC deputy chief executive, Kate Shoesmith, warned that the ban was “short sighted and ill informed”.

She said: “Banning agency workers represents a fundamental misunderstanding of where the flaws in the NHS staffing lie given contingent workers play a valuable role in maintaining NHS staffing levels and [it gives] people the choice they want to work in a more balanced, flexible way.”

The REC has argued that banning agency workers would not resolve staffing issues and would instead shift the burden of staffing costs to NHS banks.

In addition, it warned that the ban would prompt many staff to “leave the sector” rather than move into permanent roles.

Also responding to the announcement, Unison deputy head of health, Alan Lofthouse, said: “Chronic staff shortages due to years of underinvestment and poor workforce planning from the previous government won’t be solved overnight.

“But ministers do need to get to grips with the huge sums being paid out to agencies.

“Better flexibility for staff, decent overtime rates and improved pay are what’s needed to bolster the NHS workforce.

“That’s where the focus should be, not penalising low-paid workers trying to juggle work around their other commitments.”

More on agency nursing

  • Push to ‘protect’ agency nurses as law changes loom
  • Discrimination of agency and bank nurses ‘affecting safety’
  • Agency and bank nurses a ‘missing voice’ from safety investigations
  • Agencies object to use of their nurses to cover strikes
  • Robert Francis calls for regulation of senior managers
Proposal to restrict use of agency workers in NHS (2024)

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