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AGENCY STAFFING – TOWARDS A BETTER ALTERNATIVE The current government clampdown on agency staff has prompted an urgent need to seek out new ways of working to protect high quality patient care, argues Alexander Chilvers of 18 Week Support
Agency staff spending has contributed significantly to the NHS deficit. Such costs have risen more than tenfold in the last two years to £3.3 billion. The use of temporary staff can be beneficial, providing Trusts with flexibility to meet increased demand quickly and ensure adequate staffing levels are in place without risk to patient safety. However, an over-reliance on agency staff has become commonplace at a huge cost to the NHS – up to £3,500 per locum consultant per shift – and is simply unsustainable in the long term. This has led NHS England to introduce a cap on agency staff, and to impose ‘expenditure ceilings’ on the use of such staff from April 2016. These strict new rules are designed to ensure that no temporary staff are paid more than permanent employees. During the last Select Committee hearing (May 2016), Jeremy Hunt appeared positive: “The Agency Bill is beginning to level out. We saved £290 million since October compared to the trajectory of agency spend at that time. Two thirds of Trusts are saying they are making savings.” However, the latest figures suggest that the Bill is being grossly underestimated – with nine out of ten NHS Trust’s breaching the cap, and spending on agency staff continuing to rise. The requirement to make continuing savings is placing trusts under enormous strain, and inherently this impacts adversely
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HEALTH BUSINESS MAGAZINE | Volume 16.3
upon workforce productivity (as evidenced by recent marked reductions in trust productivity metrics). It is therefore imperative that trusts embrace a new way of working in order to meet waiting time targets and to deliver a health service fit for purpose. Furthermore, a National Audit Office report concluded that the rise in spending was mainly a direct result of Trusts’ increasing need for agency staff, often to cover unfilled vacancies. Its findings suggest that 75 per cent of the increased spending occurred from greater use of agency staff and higher average hourly pay rather than from an increase in fees. THE SOLUTION 18 Week Support has been working with NHS Trusts to deliver clinical solutions designed to help them meet their waiting time targets. Its services are delivered below the national tariff, which means that, in many cases, NHS Trusts generate a surplus when utilising this solution. Dr Conal Perrett, CEO and founder of 18 Week Support, said: “All of our clinical staff work within the NHS. Our clinical leads in each speciality all hold substantive senior NHS consultant posts within London Teaching Hospitals and are recognised leaders in their respective disciplines. “We manage every aspect of the patient journey from referral to discharge, reducing
new to follow up ratios in contrast to an agency solution. 18 Week Support prides itself on working seamlessly with existing clinical teams to provide high quality patient care.” Alex Chilvers, co-founder and operations director of 18 Week Support, said: “Working with an accredited in-sourcing provider, a Trust can increase its throughput of patients by utilising spare capacity out of hours, evenings and weekends. “Working with an experienced provider that can cope with larger volumes as a result of injecting the required staffing levels means that patients that otherwise would not be seen can be treated, and Trusts can generate income from commissioners. “It also neatly offers potential to meet the seven-day working agenda by exploiting spare capacity within the hospital facilities.” CONCLUSION NHS trusts have become dependent on agency staffing in order to provide short term, flexible clinical solutions. However, with spiralling costs, this ‘quick fix’ has been a major driver of the NHS deficit. Furthermore, the introduction of tighter rules on how Trusts work with agencies will only add to their workforce crisis. Using an in-sourcing provider is therefore a logical and effective solution to facilitate Trusts in the management of their ongoing staffing issues, to meet waiting time targets and deliver a better standard and quality of patient care, as well as to comply with the recent new ‘rules of the game’. 18 Week Support is a CQC registered in-sourcing provider, working to deliver additional capacity to NHS Trusts. Through its strategic provision of outpatient and surgical services to clear existing backlogs across multiple clinical specialties, 18 Week Support is well placed to assist Trusts in achieving their waiting time targets. ! FURTHER INFORMATION Contact Alexander Chilvers by emailing: achilvers@18weeksupport.com or visit the website at: www.18weeksupport.com