Agencies supplying temporary staff to the NHS have said the NHS has increased the rate it pays for its bank shifts, cancelling out some of the gains from switching provision inhouse.
NHS Improvement has leant heavily on provider trusts over recent years to reduce spend on agency staff, introduced price caps and encouraged them to expand their own bank arrangements, which pay a lower rate and tend to use trust staff on overtime to fill shifts.
However, agencies have told HSJ they have seen evidence of trust banks increasing rates above those which agencies are allowed to offer.
In a letter to NHS Improvement, Recruitment and Employment Confederation policy director Tom Hadley said this could be “anticompetitive”.
NHS Improvement has been monitoring rates paid by banks since October and believes they are not increasing across the board, although it acknowledges there were some instances of rate inflation.
The news comes as NHS Improvement’s quarter three performance report for the provider sector showed spending for the year so far on bank staff hitting £2.2bn, up from £1.8bn at the same point last year. Agency spend fell from £2.2bn at quarter three last year to £1.8bn at the same point this year.
The predicted spend for 2017-18 on bank staff is £2.8bn, £843m worse than planned. The predicted total agency spend of £2.4bn is better than planned by £137m.
NHS Improvement said this reflected “increased demands, high levels of vacancies, sickness absence and staff turnover”.
In his letter Mr Hadley said: “We are now seeing strong evidence that bank pay has been escalated considerably as a means of attracting agency staff onto the bank. As well as potentially being anticompetitive, this flies in the face of the overall aim of saving money to the taxpayer and is contradictory to the objective that NHSI originally set in encouraging parity between substantive and agency/bank staff.
“We have seen strong evidence that this disparity is actually increasing as a result of banks offering rates far exceeding those previously offered by agencies.
“We understand that NHSI are already looking into this and would welcome a confirmation that the price caps will now apply to banks and specific details on timescales.”
The REC represents 600 specialist healthcare agencies.
One agency boss told HSJ: “I do not believe that any real savings have been delivered at all. It is also important to note that bank staff attract additional costs associated to pensions, holiday entitlement, and the costs associated with running the banks.”
He added: “The lack of compliance undertaken by the banks is concerning. Banks do not appear to be undertaking any ongoing compliance checks of bank workers. With the amount of staff now working via banks this is a real cause for concern for public and patient safety.”
NHS Improvement said staff sourced through a bank were safer as they were more likely to be trust staff and familiar with the organisation’s protocols.
An NHS Improvement spokesman said: “A key priority of our agency programme is to move trusts’ spending on agency workers onto bank and substantive staff; and we’ve have had some excellent success at this in recent years.
“Moving staff from agency to bank is better for patients, fairer for staff and cheaper for taxpayers. Providing patients with safe care is the responsibility of trusts regardless of the type of worker who is delivering it. So, we expect trust boards to assure themselves around this by the use of robust internal audit and the implementation of strong management and governance systems.”
information obtained by HSJ