New figures obtained under the Freedom of Information Act by health watchdog Monitor (part of NHS Improvement) reveal that UK hospitals were forced to breach pay caps on NHS agency staff more than 50,000 times a week in order to prevent patient-endangering staff shortages.
The pay caps were imposed on temporary agency staff by the government in November 2015, amid charges by Health Secretary Jeremy Hunt that staffing agencies had taken advantage of the NHS by charging exorbitant hourly rates.
The policy was roundly condemned by the Recruitment and Employment Confederation as short-sighted and unworkable.
Pay rates for locum doctors were initially capped at 150 per cent above standard pay for junior medics and at 100 per cent for temporary non-clinical staff and nurses, many of whom are contracting in the NHS via Umbrella Companies. The cap was then progressively reduced to 55 per cent across the board from 1st April this year.
NHS bosses are permitted to breach the cap under a “break glass clause” if they consider that there is a “significant risk” to the safety of patients. In the first week of the cap, 228 hospitals used the clause 35,662 times between them.
By the end of December 2015, this had fallen to 21,277 times, but the number has risen steadily since, hitting 54,419 uses during the week commencing 4th April 2016.
The figures strongly suggest that, as the limit has been lowered, more staff have been affected.
According to Chief Executive of NHS England, Simon Stephens, hospitals began putting more nurses on wards in the aftermath of the Stafford Hospital scandal. The official inquiry into Mid Staffordshire Foundation Trust identified a lack of nurses as a key reason for unsatisfactory care (data for Stafford Hospital had revealed that there were between 400 and 1,200 more deaths occurring than expected).
But blaming “rip off” agencies, as Mr Stevens also did last year, is a misrepresentation of the real causes of the rise in temporary/contracting staff in the NHS. According to the Chief Executive of the Royal College of Nursing, Jane Davies: “Agency cap breaches are a barometer of the scale of the NHS’s workforce problem, and it shows clearly that the problem is getting worse.
“NHS Trusts are unable to recruit nurses and are rightly prioritising patient safety over sticking to the cap.
“This is a workforce planning issue. The number of nurses being trained in the UK has been reduced, for short-term financial reasons.”
When the caps were introduced, the Recruitment and Employment Confederation warned that they were illogical and would worsen NHS staff shortages, driving health professionals to desert the NHS for private alternatives.