Published: 15/08/2002, Volume III, No. 5818 Page 8 9

Expensive or unscrupulous nursing agencies will effectively be banned from working with the NHS across London by an unprecedented deal to drive costs down and standards up, a new project has promised.

The staffing crisis in the capital, which has left up to one in four nursing posts empty, means temporary cover has to be found for around 200,000 shifts a month.

According to the project, the annual bill for agency nurses runs to around£150m.

Martin Else, project director of the London Agency Project (LAP) and Royal Free Hampstead trust chief executive, said the first phase of the scheme should save trusts between£50,000 and£250,000 each. Launched in September 2001, it covers accident and emergency departments, operating theatres and intensive care across 29 trusts.

The London directorate of health and social care believes that under the first phase of the scheme, a small district general hospital should save about£80,000. A global figure for savings for the 29 acute trusts involved has not yet been calculated because not all of them joined at the start of the scheme.

But only one shift has had to be covered by an agency outside the LAP framework since the project began.

From next April, all agency nurses used across the capital, in all specialties, will be hired from an approved list of agencies which have passed rigorous tests on quality and cost.

Under the project, 77 acute, primary care and mental health trusts will enter into an agreement to use only approved agencies - with a guaranteed ceiling charge for each grade and specialty.

In April, the London directorate advertised for agencies to bid for the second phase of the project, which will set up framework agreements covering all aspects of nursing. More than 100 agencies applied and 89 have been shortlisted and will now go through a complex tendering process, including checks on their ability to provide staff, charges and training and development.

The successful agencies will be announced in December and from next April those agencies which failed to meet cost and quality standards will no longer be used by the NHS in London.

The Federation of Independent Nursing Agencies has warned that the 'onerous' tendering process and increased insurance premiums for agencies may rule some out of the process.

But London nursing director Christine Beasley told HSJ: 'The approach We have taken is, if You have got an agency that really wants to do business of quality and at a reasonable price, then There is nothing within the framework that will drive them out.'

No target has been set on the reduction of the annual spend, but it should make a significant dent in the current£150m bill, Mr Else said.

'It will ensure that the NHS in London continues to improve the quality of the agency workers supplied, introduces new quality standards and achieves value for money, ' he stated. 'What we can say categorically is we will be making savings overall, but it is a balance between savings and quality.'