In part 2 of Jay Sihota's blog, responding to health secretary Jeremy Hunt’s remarks about ‘rip-off’ recruitment agencies operating in the healthcare sector, the operations director at H1 Healthcare believes government is going about cutting costs the wrong way.

Spending

Health minister Jeremy Hunt’s comment that the “NHS is bigger than all of these companies, so we'll use that bargaining power to drive down rates and beat them at their own game”, shows his attitude to agencies in general.

Continually driving down rates of framework suppliers and yet increasing levels of compliance is an unsustainable plan. For years, everyone in the NHS has agreed that there comes a point where you can’t demand high standards and great service and supply the increasing demand, for less and less money. 

If the NHS, the RCN and hospital workers all agree on this, why do they think agencies can manage it? The term “beat them at their own game” does not encourage collaborative working and savings. Instead, it’s aggressive and divisive and totally unhelpful. 

This is not a game. It’s not a fight. It is a UK-wide problem that needs all stakeholders to come together and solve. 

Meanwhile, while the minister plays the usual political point scoring game with NHS staffing issues, he is light on actual solutions. 

The rise of neutral vendors to manage multiple agencies has not had the impact of reducing costs in real terms. It simply adds a link in a chain, increases supplier administration and makes supplying the NHS less attractive. 

Policing 

Since the introduction of framework agreements, the benefits of them have not been realised, mainly due to the lack of policing and enforcement. It has left those agencies like H1 Healthcare – who reduced their rates and agreed increased compliance levels to be part of the framework solution – wondering why they did. 

If the government was serious about the framework agreements and wished to reward those agencies who were willing to be flexible with charge rates and who agreed to increased compliance levels and inspections, they could simply instruct NHS accounts not to pay non-framework invoices.

This would stop the excessively expensive agencies supplying instantly, you would then see a mix of nurses migrating to framework agencies’ nurse banks, taking up substantive posts and thus achieving cost savings. 

To do this would mean the NHS would need to go through a pain barrier. The question is: what is more painful? Continuing with ‘rip-off’ agencies or a period of staffing challenges while a transition takes place? Either way, medicine that works rarely has a good taste.

The myth that if agencies didn’t exist there would be more nurses in the NHS is just not true. In many cases agencies have helped retain nurses in the profession and can demonstrate how many care workers have been encouraged to study nursing. On the whole, agencies are not the problem; a lack of trained nurses is the problem – it’s that simple. 

Agencies have provided the NHS with the vital staffing cover they need. We have committed to working with the NHS on a case-by-case basis to increase the number of nurses that take up substantive posts and reduce agency spend in areas that require it, such as seasonal wards, sickness and maternity leave. 

Together we need to help produce clear career pathways for nurses and doctors that encourage them to do a mixture of agency and substantive NHS posts. 

This will allow the NHS to respond to changing demands as the healthcare landscape changes. More restructuring, admin, management meetings and implementing neutral vendors will not produce more nurses. It will only increase inefficiency and costs of the system that needs more nurses, not political soundbites and sensationalism.

H1 Healthcare is a government framework supplier of nursing and care staff to NHS Scotland and an approved subcontractor to the English Framework.

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