The current shortage of nursing staff willing to take up an NHS contract has firmly shifted the balance of power away from trusts and towards the agencies, contributing to the rapid increase in agency costs since the mid-1990s. But one company claims it can reverse this trend.

It has set up an Internet-based system that it claims will allow trusts to manage their nurse banks more efficiently, fill more lastminute vacancies, and give managers more information about the use of temporary nursing staff.

John Sloss of says each subscriber trust can manage the system according to its needs. Temporary staffing needs can be entered on to a secure website which can be accessed in the trust's own bank office. If the bank is unable to fill the post, the vacancy could then be shown to the hospital's preferred agency. It could then be passed on to other nominated agencies if the preferred provider could not meet the requirement.

'The NHS sets the rules at all times by stipulating the lead and secondary agencies and how long the bank and preferred agency has to fill the shift, 'Mr Sloss says.

'We see it as a means of getting a grip on not only the performance of the agencies but also their own banks, how well they respond and how much it is costing them. You might see that a particular ward gives the bank so little notice that the vacancy has to go out to agencies, and you can gather information on why a ward is calling for these staff. '

Mr Sloss is coy about the cost of using the system, which is currently being piloted in a number of trusts across the country, saying the fees are calculated on the basis of how often it is used and the potential savings it could make for the individual trust.

'In general we would expect determined use of the system to bring agency commission down from the standard 20 per cent to about 10 per cent. And the trust should get a better service, 'he adds.

Eventually, the site hopes to cut out the agencies and have trusts talking directly to their own bank nurses or pool of accredited nurses.