According to new research from UK-based healthcare recruitment agency MSI Group, 96% of NHS Trusts are forced to breach agency staffing pay caps to ensure patient safety with only 4% of NHS trusts being fully compliant with government guidelines on agency staff use.

The research, which was obtained from Freedom of Information requests sent to every Acute and Mental Health NHS Trust in England, revealed that 79% of NHS Acute and Mental Health Trusts currently recruit staff outside of NHS approved staffing frameworks. It also revealed that 90% of Trusts have been forced to exceed the recently introduced agency pay caps.

This comes at a time when staffing agencies have already been blamed for pushing the NHS into deficit.

Monitor guidelines stipulate that Trusts can only recruit from agencies that have been awarded a place on one or more NHS approved frameworks. They also specify that Trusts cannot pay locums more than 55% above substantive pay rates. 

This new research indicates that Trusts repeatedly have to use a clause which allows them to breach guidelines when patient safety is compromised, and there is no alternative. Over 70,000 shifts have been filled under this clause since the caps were introduced on 23 November 2015.

“This research highlights the extent to which NHS Trusts are being forced to break Monitor guidelines in an effort to protect patient safety,” Nick Simpson, CEO of MSI Group said. “The sector had been experiencing positive progress towards sustainable pay rates when initial guidelines - barring off framework expenditure - were introduced in October 2015. However they were not given enough of a chance to prove their worth before new pay caps were hastily rushed in shortly after.”

Unregulated ‘off-framework’ agencies are free to set their own hourly and commission rates and are not subject to the rigorous compliance audits that ‘on-framework’ agencies undertake to retain their approved status. Of the 288 agencies currently supplying the sector, 45% do not operate within any of the government-approved frameworks. This represents a positive, if slight, shift towards compliance in the sector, with previous research conducted by MSI Group last year indicating that 60% of agencies were operating ‘off-framework’. 

“Strategic workforce planning is a vital tool for coping with a staffing crisis that looks set to continue for some time to come,” Simpson said. “Agency staff are a vital asset for managing times of increased need and don’t have to be associated with the crippling costs charged by ‘off-framework’ agencies.”

“Any professional working within the healthcare arena will recognise that the staffing crisis is a sizable problem in the NHS,” Simpson said. “But what’s become increasingly clear is that these issues have been compounded rather than alleviated by new guidelines introduced by Jeremy Hunt.”