NHS trusts could be banned from using agencies to hire certain temporary entry-level workers in pay bands 2 and 3, such as healthcare assistants and domestic support workers, under new plans by the UK government and NHS England.

The joint plans will be put forward for consultation. The consultation will also include a proposal to stop NHS staff from resigning and then immediately offering their services back to the health service through a recruitment agency.

It comes after a recent article from the Daily Mail reported that the NHS will be banned from hiring agency workers under plans backed by Wes Streeting, the Secretary of State for Health and Social Care of the UK. It also comes after the UK government stated that the understaffed NHS was forced to spend £3 billion on agency staff last year.

Streeting will unveil the package of tough reforms this week to cut ‘wasteful spending in the NHS’.

“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 government stated in a press release.

Health and Social Care Secretary Wes Streeting said, “For too long, desperate hospitals have been forced to pay eye-watering sums of money on temporary staff, costing the taxpayer billions, and pulling experienced staff out of the NHS. We’re not going to let the NHS get ripped off anymore.”

“Last month, the Chancellor made a historic investment in our health service, which must reform or die,” Streeting said. “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.”

Addressing the UK’s health leaders at the NHS Providers Conference today, 13 November, Streeting is expected to announce a series of rigorous measures to make sure the investment announced in the budget delivers shorter waiting times for patients.

Julian Kelly, NHS chief financial officer, said, “The NHS is committed to ensuring every penny of taxpayer money is used wisely to the benefit of patients and to ensure fairness for our permanent staff. While agency spend is at a record low, with trusts on track to save £1 billion over 2 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,” Kelly said.

Recruitment and Employment Confederation (REC) Chief Executive Neil Carberry said in a press release, “There is no doubt that the NHS needs reform to be fit-for-purpose. Improving standards of care, efficiency and effectiveness is about a lot more than money. And getting it right will cut waiting lists, improve lives and support the economy. But as any medic would tell the Secretary of State, you fix a problem with the correct diagnosis. And when it comes to staff issues, Streeting has the wrong one.

“Temporary workforce costs in the NHS are largely the wages and compliance costs of staff. That’s why bank staffing is no cheaper than agency, and why the Secretary of State discovered costs didn’t go down when switching to using overtime. The real failure is in long-term planning for supply, and in squeezing lower cost staffing routes via frameworks – which only drives higher cost emergency care over time,” Carberry added.

“In a dramatic week of leaks and announcements by government on agencies in NHS, the REC has written to the Chief Executive of NHS England,” Carberry said. “The letter asks the NHS to meet and then work in collaboration with stakeholders on staffing issues. The REC writes that a consistent refusal to engage in a meaningful conversation with REC and others, has led the NHS to the situation we face today, with spend on banks almost tripled since 2016.”

In a letter sent earlier this week, Recruitment and Employment Confederation Deputy Chief Executive Kate Shoesmith said a mooted ban on agency workers reported this weekend 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.”  

Shoesmith said, “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 also said banning agency workers would “save pennies in the short term” but would lead to an overall increase in staffing costs in the long run. 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, it added.

Shoesmith said, “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.”

“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,” Shoesmith added.

Tania Bowers, global public policy director at the Association of Professional Staffing Companies (APSCo) also responded to the announcement: “There may be some scope to reduce agency reliance on lower skilled staffing solutions, but this simply can’t be replicated across all temporary resources and we hope that this will not be the case. The NHS needs to view all worker supply holistically as one workforce to increase efficiency.

“The plans to ban those in permanent jobs from resigning and moving into temporary work must also be reviewed with longer-term impacts in mind. This is often a personal choice rather than one driven by staffing businesses, which inadvertently reduces the number of people recruiters can put forward for work. If this option is removed, it risks further damaging recruitment and retention in the sector, and also doesn’t account for the number of permanent professionals that are already supplementing their income through additional temporary work. If this happens, questions will need to be asked as to how the Government will be able to fill new gaps that emerge.”

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.