A spending cap that was designed to bring NHS wage bills under control is being constantly breached in Northamptonshire as agencies refuse to bring down their prices, according to a new report.
The nationwide cap means NHS hospitals and mental health trusts have been ordered to gradually reduce agencies’ fees from 150 per cent of the worker’s pay. As of April 1, they can offer them only 55 per cent on top.
But agencies have told Northamptonshire bosses they are unwilling to offer staff lower prices as it “does not give them an effective margin”.
As a result, managers at NHS Northamptonshire Healthcare (NHFT) had to break the spending rules 333 times in one week in February, mostly when hiring nurses. There have been at least 267 breaches per week this year.
NHS Northamptonshire Healthcare predicts even more breaches will take place following the April 1 cap to maintain safe levels of staffing. The alternative would be “shifts remaining unfilled”.
A paper by the NHFT’s Andrew Round, written just before the April 1 cap, says: “Discussions are ongoing with the agencies regarding the April 1 changes and these are proving not to be as positive as [previous, lower caps] with a hardening of the agencies’ positions, with more stating that they will not be able to meet the cap rates.”
As a result, all local NHS trusts have agreed a consistent stance “to avoid the situation where agencies play one trust off against another.”
Other NHS Northampton Healthcare papers reveal that, after a meeting between the trust and a number of agencies last November the “overwhelming feedback” was that the April 1 cap was “unrealistic”. The papers add: “They believe that ultimately the approach to cap rates will affect patient care.”
Despite the agencies’ resistance, NHFT has this year managed to reduced the percentage of its nursing budget spent on agencies to exactly the 10 per cent national target.
But NHFT bosses said they recognise that recruiting more permanent staff is the real solution to reducing the combined bill for agency nurses and doctors, which was about £10 million last year.
But they admit they face fierce competition not only from high-paying agencies, but also St Andrew’s Hospital in Northampton, one of the UK’s biggest mental health facilities.
No-one was available for interview on the issue at NHFT yesterday and none of the agencies approached by the Chron returned calls.