Last week the Telegraph reported that one NHS Trust – Barking, Havering and Redbridge University Hospitals Trust – had paid £3,893 to cover a 24-hour Bank Holiday shift for a gastroenterologist, while a Freedom of Information request revealed that since 2017, 16 trusts have paid more than £3k a shift for agency and bank doctors. Among the other examples were Sheffield Teaching Hospitals Trust that paid more than £3k for a 24-hour shift four times between April and June this year. 

Saffron Cordery, deputy CEO of NHS Providers, told the Telegraph that NHS trusts had little choice. “It reflects the immense pressures trusts face – sometimes at substantial financial cost – to fill gaps in rotas that could otherwise harm patient care. There are almost 100,000 vacancies in the NHS, and shortages of doctors have been exacerbated by concerns over pensions, leading to further delays and disruption for patients,” she said.

In his letter, Carberry says that if the frameworks that the NHS uses to procure temporary staff remain focused only on buying the cheapest option, quality of care may suffer, and that firms with high standards are increasingly finding they can’t afford to work with the health service. And he warns that agencies leaving the market would mean staff shortages that will cost more to fill through high-cost, emergency routes.

Pointing to the high level of cost savings that agencies have already delivered for the health service, Carberry said: “Increasingly, agency providers deliver at rates below [those of] NHS banks” and noted that “fees paid to agencies have come down substantially as we reach the fourth year of caps”.

In the letter, the REC points out that where government enforces unrealistic frameworks it creates instability and an unsustainable market. This always ends up leading to higher costs for the taxpayer in the long term: “Government learned from the Carillion collapse what happens when unsustainable contracts are forced through by public procurement – only firms willing to take uneconomic business remain... Some recent procurements are pitched at levels that are likely to drive firms to exit NHS on-framework supply.” 

This could have especially serious consequences as we run up to high demand winter months.

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