NHSI adds ‘break glass’ clause to ensure safe staffing within health service

NHS Improvement has added a “break glass” clause to ensure safe staffing within NHS trusts.

The proposals will enable NHS trusts to safely hire non-clinical staff such as admin and maintenance and facility (estates) agency workers where there is an “exceptional and direct risk to patient safety”.

The change is contained in the body’s response to a consultation into reducing expenditure on non-clinical agency staff in the NHS. The consultation was on a proposal to restrict the use of off-framework agency workers to fill non-clinical and unregistered clinical shifts, and a proposal to restrict the use of admin and estates agency workers, with exemptions for special projects and shortage specialties and ran from 8 February 2019 until 22 March 2019.

The response also reveals the body, which is responsible for overseeing foundation trusts and NHS trusts, will exempt all IT staff from the restriction on the use of agency workers but adds it expects trusts to strengthen efforts to increase value for money from their IT staffing arrangements.

NHS Improvement added it agrees with the feedback to the consultation, requesting an extension to the implementation period of the changes so they will now go live on 16 September 2019. During the intervening period, the body added it will work to support trusts to implement the changes and build staff bank capacity.

Responding to today’s announcement, Sophie Wingfield, head of policy and public affairs at the Recruitment & Employment Confederation, said: “The REC called for the addition of the ‘break-glass’ clause and it is good to see NHSI include this. Back-office staff often play a vital role, which if left unfilled will have a detrimental effect on patient safety.

“However, this is really just a silver lining. With over 100,000 unfilled vacancies in the NHS, agency workers are a vital part of the staffing of the health service and are essential for maintaining patient safety during the critical staff shortages we currently have. What we need is a change of attitude towards agency workers in the health and social care service, and an acknowledgement of the experience and expertise that they bring to NHS trusts up and down the country.”

Also commenting, Greg Wood, director at Your World Recruitment, told Recruiter: “This is a very positive and sensible attitude that NHSI has adopted, which will assist them in securing the staffing levels they require. Also, it gives them the flexibility where there are specific projects to bring in the highly skilled workers for short-term project periods to support the NHS in its drive for efficiency in the future.”

Meanwhile Paul McQue, managing director at MPA Recruitment, told Recruiter today’s developments were welcome and significant news for the recruitment sector.

“As the report has suggested, since the start of 2018/19, the volume of agency shifts has increased, largely due to increased activity. Despite a drop in agency prices, these conditions have created a challenging environment for trusts. It was extremely encouraging to read within the correspondence that 73% of Trust staff agreed with the proposal to restrict the use of ‘off framework’ agency workers; as this area in particular has been one of the key factors in driving larger agency costs throughout the UK.
 
“Here at MPA, we invest in significant infrastructure to be able to supply in excess of 3,500 staff each year to the NHS, and we are proud of our place as a large-scale ‘framework partner’. Any cost control over the use of non-framework agency supply will hopefully drastically reduce the NHS’s exposure to those off framework agencies inflated margins and rate schedules. 

“It’s also extremely encouraging to hear that this will also trigger a change of attitude towards agency workers in the health and social care service, and an acknowledgement of the experience and expertise that they bring to the NHS up and down the country.”

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