In an address to healthcare leaders in Liverpool, Streeting will propose measures that may include banning trusts from using agencies to cover gaps in entry-level positions and banning agencies from re-introducing NHS workers that leave permanent jobs. The plans are aimed at cutting the £3bn spent on agency staff last year.

Under joint plans to be put forward for consultation, NHS trusts could be banned from using agencies to hire temporary entry-level workers, such as healthcare assistants and domestic support workers.

The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency, the government said.

“The proposed measures could save the NHS significant sums, improve quality of care and enhance patient safety, as reducing reliance on agency staff has been shown to decrease clinical incidents,” the government said in a statement. 

The Recruitment & Employment Confederation (REC) has written to the health and social care secretary to seek urgent reassurance about the future of agency workers in the NHS.

In a letter sent yesterday [11 November 2024], REC deputy CEO Kate Shoesmith said the mooted ban on agency workers is a “short-sighted and ill-informed” move. Shoesmith also expressed alarm at the timing of the potential announcement while a major consultation on NHS remains open, and without engaging in any consultation from stakeholders. “It betrays the government’s repeated claims that they want to work collaboratively with business,” she said in the letter.

“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 people the choice they want to work in a more balanced, flexible way.”

The REC argues that simply banning agency workers does not resolve this issue, and instead shifts the burden of staffing costs to NHS banks. Banks are not subject to the same pricing controls as agencies. Banning agency workers would save pennies in the short term but would lead to an overall increase in staffing costs in the long run, Shoesmith said. A ban would also increase shortages in the NHS as many agency staff would not move into permanent roles, they would just leave the sector, the letter contended.

Streeting said: “Last month the chancellor [Rachel Reeves] made an historic investment in our health service, which must reform or die. I am determined to make sure the money is well spent and delivers for patients.

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

“Recruitment agencies have charged NHS trusts up to £2k for a single nursing shift, thanks to the 113,000 staffing vacancies across the service.

“Costs of this kind were driven up further thanks to periods of strike action. The move, announced this week, will form part of government efforts to reform and improve efficiency in the NHS – with more action planned in the future to cut reliance on short-term agency staffing.

“The proposals will also provide greater fairness in the workplace by ensuring staff carrying out the same roles are not paid significantly different sums.”

The REC’s Shoesmith added: “The staffing frameworks are unfit for purpose having not been revised in the eight years since they were introduced, and this has driven NHS trusts to use more expensive off-framework provision. Working with the recruitment industry, the government could completely redesign public sector procurement frameworks to provide the best value for patient safety and the taxpayer but our consistent calls for partnership remain ignored.”

She went on to say that the REC would like to work with Streeting “to deliver a fundamental review into framework and off-framework practices, to develop a modernised strategy that will help support the wider reforms the system needs”.

Julian Kelly, NHS CFO, said: “While agency spend is at a record low, with trusts on track to save £1bn over two years, we want to go further still.

“That’s why the NHS, working alongside the government and providers, will launch a consultation with a view to stop using agencies to fill entry-level posts, building on the approach we have successfully imposed for administrative and estates staff.”

Addressing the nation’s health leaders at the NHS Providers Conference in Liverpool on Wednesday, he is expected to announce a series of rigorous measures to make sure the investment announced in the Budget delivers shorter waiting times for patients.

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

Shoesmith concluded: “The staffing frameworks are unfit for purpose having not been revised in the eight years since they were introduced, and this has driven NHS trusts to use more expensive off-framework provision. Working with the recruitment industry, the government could completely redesign public sector procurement frameworks to provide the best value for patient safety and the taxpayer but our consistent calls for partnership remain ignored.

“The REC would like to work with Wes Streeting to deliver a fundamental review into framework and off-framework practices, to develop a modernised strategy that will help support the wider reforms the system needs.”

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