The NHS will struggle to stay in the black this year unless ‘decisive action’ is taken to reduce the cost of temporary staffing, the NHS England chief executive has warned.

  • NHS risks failure to stay within funding allocation due to rising temporary staff spending
  • Simon Stevens says system has “no choice” but to act “collectively”
  • Calls for “complementary” action from ministers on overseas recruitment
  • NHS England predicts deteriorating financial position

The call comes as NHS England admitted that it was expecting finance data to show deterioration in the financial position of commissioners.

At NHS England’s board meeting today, Simon Stevens said: “There is now a wide understanding that [without] decisive action on temporary staffing in the next several weeks it will be very hard for the NHS overall to deliver its side of the funding bargain for 2015-16.

“We have no choice now but to act, and the clear expectation is that collectively we will do so.”

Mr Stevens’ chief executive’s report, published ahead of the meeting, said providers’ temporary staffing spending had increased in the first quarter of 2015-16 “at precisely the time when [trusts] planned the opposite”.

Simon Stevens

Source: Peter Searle

‘We have no choice now but to act’, Simon Stevens said

This “points to the need for much more rigorous collective and immediate employer action to cap rates and convert agency spending into flexible permanent jobs”, his report added.

It is likely that collective action on agency spending will take the form of a cap on the price paid per shift for clinical staff. A cap for the hourly rates payable for nursing shifts is due to come into force around the end of this year. HSJ understands that trust chief executives have also asked arm’s length bodies to impose a cap for medical locums.

Mr Stevens joined the call for ministers to relax the rules on overseas recruitment for NHS employers. In order to reduce temporary staffing bills, the report said: “Complementary action is also needed by government in respect of international recruitment and new career ladders between care assistant and graduate nursing roles. These are expected shortly.”

NHS England chief finance director Paul Baumann told the board that the latest published finance data, from July, shows NHS commissioners are forecasting a small overspend of £85m in 2015-16 – less than 0.1 per cent of their total resource allocation. However, these numbers were out of date, he said. Mr Baumann said he would receive August data tomorrow.

He said: “I am slightly concerned that this may be showing, in particular around [clinical commissioning groups] and some of our direct commissioning teams, a more favourable picture than we will be looking at when I see the numbers tomorrow morning.”

A “major stock take” identifying the mitigating actions needed to “bring things back into line” would begin after the August data has been received.

Mr Stevens said one “small ray of sunshine” was that demand for emergency care was growing at a slower rate than budgeted for.

Following instructions from NHS England, CCGs are planning for accident and emergency admissions growth of 2.3 per cent. However the first four months of 2015-16 saw growth of 0.7 per cent.