According to research from the Recruitment and Employment Confederation (REC), centrally-imposed restrictions on the amount that NHS trusts can pay for temporary doctors and nurses risks understaffed wards and patient safety.

Responding to a survey conducted in March, 63% of healthcare recruitment agencies said they expect locum doctors and agency nurses on their books to focus on the private sector in response to the latest pay cap, which came into effect on 1 April. Moreover, 31% said that candidates will leave the profession altogether. Just 3% said they expect candidates to take up permanent roles in the NHS.

“Everyone knows that efficiencies have to be made in the NHS, but rather than a considered plan to improve staffing we’ve seen a policy which is myopic and ill-conceived,” Kevin Green, REC chief executive said. “At a time when demand for temporary staff to fill gaps is increasing, locum doctors and agency nurses who have provided a lifeline to the NHS are having their pay cut to such an extent they are choosing to work outside of the public sector or leave the profession altogether.”

Demand for temporary staff from NHS trusts has increased since the caps were imposed. In June 2015, 33% said they received more than 100 requests for staff per week from each NHS trust they work with. The latest data shows that 47% of healthcare recruitment firms are now receiving more than 100 requests to fill shifts every week from each NHS trust they supply.   

According to the study, 87% said that since the first cap was enforced in November 2015 they have found it more difficult to fill temporary NHS vacancies.

“All the evidence suggests the cap is exacerbating the skills shortage crisis rather than alleviating it, and NHS Improvement has so far failed to produce evidence to the contrary,” Green said. “We believe that shifts are going unfilled in hospitals across England as the Department of Health instructs hospitals to put finance before patient safety.”

Meanwhile, 79% of healthcare recruitment agencies said they work with NHS trusts which are routinely breaching the caps.

“How many doctors and nurses have left agency work in favour of permanent roles? Are there fewer staff on wards since November? What has the impact of the cap been on performance within the NHS? These are questions that NHS Improvement needs to answer,” Green said.

NHS spend on agency staff accounted for 2.9% of the NHS's overall annual expenditure in 2014/15.

In March 2016, the House of Commons Committee of Public Accounts found that “the NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.”