Daily Insight: Return of the agency crackdown

As the row over the health service’s delayed planning guidance for 2024-25 (set to start just under seven weeks away) drags on, NHS England has decided to issue some draft documents in an attempt to give local leaders something to plan on.

This is not the full-fat planning guidance, which will contain key details over the asks on emergency and elective care, and is presumably still being argued over between NHSE and the government.

But the draft revenue and contracting guidance seen by HSJ warns of a further crackdown on agency spending.

In the years running up to the pandemic, the service got a grip on expensive temporary staff and pushed spending below £2.5bn.

During covid-19 when money was no issue it surged again and trusts have since struggled to get the genie back in the bottle.

Now NHSE is warning that trusts in deficit will get additional controls on agency spending, according to the leaked guidance. In these cases, NHSE “reserves the right” to demand an extra 10 per cent cut in expenditure on top of any existing planned reductions.

It’s yet another way of forcing trusts into line when they set their financial plans for 2024-25.

Something to chew on

As you would probably hope, most NHS trusts have five-star ratings for food hygiene. But there are a minority who have failed to get the top mark in recent inspections. 

HSJ has looked at Food Standards Agency ratings – published online – to work out which NHS hospitals have the lowest food scores.

Only a couple had two out of five stars, which means improvements are necessary. These were Colchester Hospital in Essex and William Harvey Hospital in Kent. 

Both of their trusts said they were disappointed with their scores and had already carried out improvements in response.

A further six received three out of five stars. This includes Watford General for its ward kitchens, which was a recent improvement from its previous one-star.

This looked at official scores for whole hospital sites, their main catering operations and ward or hospital kitchens.

There were some individual units or wards that received even lower scores. This includes a zero-star rating at a London older adult mental health unit. 

An independent review into NHS food had higher hopes for food hygiene. It said all hospitals should have a minimum of four stars for food hygiene, described as “good”, and aim for five stars. 

Trusts with ratings below five stars said they had carried out improvements since inspections or were in the process of doing so.