Health Minister Robin Swann has announced measures to reduce expenditure on agency staffing within health and social care and to eliminate the use of off-contract agencies.
The use of off-contract agencies has contributed significantly to an increase in agency staff expenditure over the last decade. Off-contract agencies are typically more expensive than their on-contract counterparts. They are not covered by formal relationships with the health service and are therefore able to charge above contractually set prices. From 2018/19 to 2021/22; expenditure on off-contract agency nursing staffing rose from £27.0m to £101m, accounting for 72.5% of all agency spend for this grouping.
The drive to reduce agency spend will run in parallel with ongoing initiatives to build the health service workforce. These include maintaining nursing/midwifery university places at their highest ever level and additional investment to expand the number of places for Allied Health Professions and undergraduate and post-graduate medical training.
The Minister said: “The severe financial pressures on our health and social care system are well documented. While I will continue to relentlessly make the case for additional funding, I also have to ensure the monies we do have are used efficiently and effectively.
“Ending the use of off contract agencies has been a major priority for me in that regard. Equally as important is the need to address the impact that large-scale agency use can have on the morale of our health service staff. Overreliance on agency use has a negative impact on our workforce, placing additional pressures on them to support agency staff who are unfamiliar with systems and wards. This creates another pressure on the provision of safe and quality care.
“I fully recognise that the increase in agency use has been driven by service and staffing pressures, particularly during the Covid-19 pandemic.
“Obviously due consideration will have to be given to continuity and quality of service and of course patient safety. Some degree of agency use will always be required, as variation in demand means additional ad hoc resources will be needed at times.
“Ending off-contract agency use and reducing overall agency spend will not happen overnight nor will it be a pain free option. But it has to happen.”
Setting out how the elimination off contract agency use will be achieved, the Minister continued: “A new health service procurement process will be launched in the coming days for agencies who wish to provide nursing and midwifery agency staff to HSC. Agencies who have remained outside contractual frameworks now have a clear choice. I would encourage them to work with us on a contractual footing – or face an end to their income from the health service and taxpayers.
“I look forward to moving forward collegiately with those agencies who opt in to the new contract.”
The new public procurement process for agencies providing nursing and midwifery staff will be launched by the HSC’s Business Services Organisation (BSO). The expectation is that those agencies who are successful in securing a place on the framework will start providing services to HSC in February 2023.
Procurements are also planned for the supply of medical and dental locum staff. There will be further work to bring to an end the use of Social Workers employed by recruitment agencies in Trusts by June 2023.
The sustained drive to reduce agency costs will be accompanied by reform of the HSC Trusts’ Staff Banks to make them a more attractive option for staff wishing to work additional hours.
The Minister added: “I want a health service that instils a sense of pride in those that work for it and I want to encourage more health care professionals back into our workforce.
“The benefits of working for the HSC system include job security, a good pension scheme, paid annual and sick leave, life insurance, maternity leave and organisational support for training and career development and progression.”
Notes to editors:
1. The full Ministerial statement is available on the Department of Health website.
- 1,335 new undergraduates have commenced their Nursing degree at QUB, UU or the Open University this academic year.
- £8m funding in 22/23 to support the recruitment of international nurses which will allow the recruitment of 600 new nurses this financial year.
- Allied Health Professional undergraduate places expanded by 41 places this year.
- Primary medical degree places available each year in NI has increased to 306
- The number of places available on the medical foundation programme and on medical speciality training programmes in 2022/23 has increased. This increased investment will support priority service commitments including additional Clinical Oncology, Medical Oncology, Radiology, Paediatric Cardiology, Vascular Surgery, Transplant Surgery, Palliative Medicine and Dermatology training places as well 10 additional places on the GP training programme.
- A Regional Retention Report sets out a full suite of actions that will be taken to support nursing and midwifery workforce and to retain highly skilled, experienced staff.
- The Agency Reduction Working Group has identified that reform of the Trusts’ Staff Banks and how they operate is necessary to support the move away from Agency usage. This will include consideration of introducing or adopting a new regional nursing bank.
- Reforms would include examining the rates paid for undertaking bank shifts and the frequency of payment following completion of a bank shift.
- It is recognised that it should also be made easier (through a digital solution) for a member of the bank to book a shift. This will support regional transparency on filling of shifts and help to maximise effectiveness of Bank. This Action should be led by a project team from across HSC with support from the Department and NHS colleagues.
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