REC response to agency reforms announced by the Health and Social Care Secretary

Responding to reforms announced by the Health and Social Care Secretary Wes Streeting this morning that include a possible ban on agency use for some roles, Recruitment and Employment Confederation (REC) Chief Executive Neil Carberry said:

“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.

“No ban will solve this – the NHS must meaningfully address the varying needs of staff, who want to work in different ways and many of whom will have been demoralised by the approach taken this morning. We have always said that the Department of Health putting workforce first means getting unions, staffing partners and trusts together to build an approach that attracts and retains a strong core of substantive staff and complements this with a stable and good value approach to temporary staffing. This is the diagnosis that is staring NHS England in the face – and has been for years – yet it is being ignored. Let’s change that now, rather than heading off down the same road that has failed so often before.”

Neil Carberry added:

"Banning trusts from hiring temporary workers when they need them is a serious mistake and shows a clear misunderstanding of where the real problems are. Agency workers are essential to maintaining safe staffing levels and ensuring services run smoothly. These workers provide the flexibility that the NHS desperately needs, and many choose this route because it offers a better work-life balance. Removing this option would only put more strain on an already under-resourced system and make staffing shortages even worse as staff lose patience with poor NHS management."

Simply banning some agency workers does not resolve this issue, and instead shifts the burden of staffing costs to other temporary supplies such as NHS banks. The rates for temporary and agency workers were set in 2016 and have not been revised since, leaving it increasingly difficult for agencies to supply workers at these rates and driving more provision to equally skilled but much more expensive models, including staff banks and emergency off-framework rates.

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. 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.

The REC letter opposes today’s proposal and says the ‘policy uses agency staff as a convenient scapegoat for inefficient procurement process, rather than tackling the core issue. Reforming and reviewing how we recruit and procure staff to the NHS would be a more practical long-term solution to strike the balance between sustainable and safe staffing and value for money. The REC as ever wants to discuss the importance of the agency market with you [NHS] in more detail’.

Notes to editors

Temporary workers, locums and interims play a big part in keeping the NHS on its feet, whilst it tries to stem a crisis of care caused by growing demand and chronic staffing shortages. But the current pay cap imposed by NHS England for the cost of these workers has not changed since 2016. They are an important contributor to the workforce – and yet are regularly left out of bonus rounds, and little to no attention is paid to why people choose to work this way in the first place, argues REC. 

Approximately 500 REC member businesses work in Health and Social Care. REC’s membership also includes hundreds of SMEs who provide clinical and non-clinical professionals to NHS Trusts and local authorities, as well as to the private sector. REC members supply valuable permanent and flexible workers across all bands and services. 

The REC has also written to Health and Social Care Secretary Wes Streeting to seek urgent reassurance about the future of agency workers in the NHS given their vital contribution to patient care: 'Plans to ban agency workers would save pennies in the short term but would lead to an overall increase in staffing the NHS in the long run’, 11 November 2024.

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The REC is the voice of the recruitment industry, speaking up for great recruiters. We drive standards and empower recruitment businesses to build better futures for great candidates and themselves. We are champions of an industry which is fundamental to the strength of the UK economy.

Find out more about the Recruitment & Employment Confederation at www.rec.uk.com.