NHS staff could be banned from agency work, says workforce plan

Published on: 30 Jun 2023

Substantive NHS staff may have to be blocked from undertaking work for the service through agencies and instead have to sign up with the temporary staffing banks operated by trusts, says the new NHS long-term workforce plan.

The plan warns “the NHS has relied too much on temporary staffing”, and said that “use of agency staff is expensive and offers poor value for money for the taxpayer”.

It added: “There is also increasing evidence that use of temporary staffing – particularly agency staff – can negatively impact on patient and staff experience, and continuity of care”.

The proposed increase in substantive NHS staff proposed by the plan is intended “the reduce the NHS’s reliance on agency [staff]… while still retaining the ability to utilise bank staff in a cost-effective way”.

The plan continues: “We estimate that the reliance on temporary staffing in FTE terms would reduce from 9 per cent in 2021/22 to around 5 per cent from 2032/33 onwards, with most bank staff fulfilling the requirement for temporary staffing.”

As part of the move away from the use of agency staff, the plan states: “We propose to support NHS providers to develop and implement policy that prevents substantive staff from offering their services back to the NHS through an employment agency, and instead do so through their local collaborative bank.”

The government’s press release announcing the plan stated: “The NHS plan aims to reduce reliance on expensive agency spend that could cut the bill for taxpayers by around £10 billion between 2030/31 and 2036/37.” However, this claim is not repeated in the plan itself.  

According to NHSE, there are currently 23 collaborative “banks” across NHS trusts in England, with a further 10 planned. NHSE says this represents a nearly 50 per cent increase since the NHS people plan was published in 2020 and covers almost half of all trusts in the country.

There has been a push for trusts to reduce their agency spend, particularly off-framework expenditure, in recent years given the high costs they can incur.

It comes as staffing agencies that adhere to NHSE’s national price caps framework have warned they are being “pushed out” of the market due to a lack of flexibility.

Kate Shoesmith, deputy chief executive of the Recruitment and Employment Confederation, which represents several agencies, said government inaction has led to the recruitment crisis becoming “ingrained”.

Commenting on the publication of the NHS long-term workforce plan, she added: “NHSE wanting to reduce their expensive staff bills is understandable but has been unachievable because of its failure to attract and retain staff. This has left agencies playing a more crucial role in staffing than their original purpose to plug gaps.

“Rather than condemn and sideline agencies, these agencies show the NHS how to give healthcare workers flexible working, more regular pay, feelings of esteem and more frequent time away from the hectic frontline.”