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Agency caps have saved £600m but spending is still too high, says NHS Improvement

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18 October 2016

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The NHS has saved over £600 million in the first year of measures to curb spending on agency staff, NHS Improvement has said.

Almost three quarters of trusts have successfully reduced their agency spend, and over half of these have reduced spend by more than a quarter.

The measures were brought in after the NHS spent over £3 billion on agency staff in 2014/15, with some trusts requesting help negotiating with agencies and bringing staff back into the NHS.

However, despite monthly spend now being around 20% less than it was at the same time last year, the sector is still spending £250 million a month on agencies.

Therefore, NHS Improvement is bringing in a new raft of measures to further reduce spending, including the publication of league tables of agency spend on best and worst performing trusts.

NHS Improvement will also collect data on shifts that cost over £120 an hour and introduce an approval process for the appointment of any interim very senior managers who charge over £750 per day.

Jim Mackey, chief executive of NHS Improvement, said the progress made is “promising”, however, “there’s much more to be done”.

“Over a third of the agency bill is spent on medical agency fees, so we need to ensure agencies and doctors do their bit to make sure they’re not overcharging,” he said. “We need everybody to pile in, and patients deserve that effort from us to make sure they’re getting the right care, from the right staff, at the right time.”

However, Dr Anthea Mowat, chair of the BMA’s representative body, said the new measures are “nothing really but a sticking plaster”.

She said: “Simply naming and shaming trusts or individuals will not address the underlying issues causing an overreliance on agency workers.

“Increasingly, locums are employed because hospitals can’t attract staff to take up full-time posts.

“Caps do not address the root causes of the recruitment and retention problems in many parts of the NHS, especially emergency medicine.

“The government must tackle these issues with alternative interventions such as improving working conditions, better rota management and flexible shift patterns to help bring down agency costs.”

NHS Improvement analysis suggests that if the rate paid for each shift above the wage cap is reduced by just £10 per hour, the sector could save a further £102 million in a year.