Trusts in the South West face uncertainty over their procurement of agency nurses as their plans have still not been approved by regulators.

From 19 October, trusts will be barred from using agencies not on approved “framework agreements” unless they obtain specific approval.

Four frameworks have been approved, but many agencies that operate in Cornwall, Devon, Somerset and Dorset are not in these national schemes.

To secure a place on a framework, agencies must agree to greater transparency and cost controls.

Trusts in the region have been working with Peninsula Purchasing and Supply Alliance, a procurement body that represents 14 providers in the region, to urgently try and secure an interim agreement with regulators by the end of next week.

The 14 providers

  • Cornwall Partnership Foundation Trust
  • Devon Partnership Trust
  • Dorset County Hospital FT
  • Northern Devon Healthcare Trust
  • Peninsula Community Health
  • Plymouth Community Healthcare
  • Plymouth Hospitals Trust
  • Royal Cornwall Hospitals Trust
  • Royal Devon and Exeter FT
  • Salisbury FT*
  • Somerset Partnership FT
  • Torbay and South Devon FT
  • Taunton and Somerset FT
  • Yeovil District Hospital FT

* Salisbury FT said it has a contract with a different provider, whose framework for agency nursing has been approved.

If this is unsuccessful they will be forced to seek individual approval of their arrangements for procuring agency staff.

In a notice published last month, Monitor said: “Monitor is currently working with PPSA towards a possible future approval of its supplier arrangement.

“Trusts wanting to use unapproved framework agreements or off-framework arrangements, including PPSA, will need to apply to Monitor/[NHS Trust Development Authority] for approval… demonstrating how their arrangements provide superior quality and value for money over existing approved framework agreements.”

The notice said a number of applications had so far been rejected for not demonstrating appropriate value for money, such as “high rates comparative to agenda for change pay”.

Mark Gronow, director of procurement for the alliance, said its “agency relationship agreements” were set up last year due to “significant use of non-framework agencies within the South West”.

He added: “Given the increased challenges concerning the use of agency staff in light of the agency rules, the PPSA are working with Monitor to ensure that the agreements receive their approval.

“In doing so, the need for individual trusts to apply for approval of arrangements that fall outside approved frameworks will be alleviated. This is the first step in developing a collective [South West] agency solution which will secure improved quality, governance and financial savings for the NHS.”

Another aspect to the new rules came into effect on 1 October. Trusts were given individual “ceilings” for the proportion of nursing expenditure they can spend on temporary staffing agencies.

However, regulators have not yet set a firm date on which they will impose the most controversial aspect of the rules, price caps on the hourly rates trusts can pay for agency nurses.