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Last minute NHS u-turn on agency ban saves nurses thousands

NHS England has axed its plans to bring in a ban on health service nurses taking agency shifts in other parts of the NHS the day before the rule was to come into force.

NHS England has axed its plans to bring in a ban on health service nurses taking agency shifts in other parts of the NHS the day before the rule was to come into force.


The u-turn was announced by Jim Mackey, chief executive of NHS Improvement, in a letter this morning (31 March) which followed a campaign to overturn the decision by the Royal College of Nursing (RCN) and its members.

The plans will now be on hold until further notice.

In his letter to RCN chief executive and general secretary, Janet Davies, Mackey said: ‘The instruction has caused uncertainty for providers, and created challenges for some of your members. This was not my intention and I can confirm that NHS Improvement is pausing until further notice

‘To be clear, this pause means that trusts will not be expected to follow this instruction from 1 April.’

The NHSI chief executive has invited the RCN to participate in the drafting of new rules around the use of staffing agencies.

‘Agency ban’

In a letter to NHS trusts on 27 February, NHS Improvement had said: ‘From 1 April 2017 trusts should not be using agencies to employ individuals who are substantively employed elsewhere in the NHS.

‘Trusts subject to the agency staff rules will only be able to engage substantive NHS staff working additional hours through staff banks, and/or overtime, and deduct PAYE as appropriate.’

Change of direction

Jim Mackey said: ‘Trusts have taken great strides on cutting back agency costs, saving over £700m this year alone.

‘We know that the nursing workforce has contributed the lion’s share of the savings made, and we are grateful for these efforts, on top of the excellent care and commitment they offer patients day in day out.

‘We have listened and responded to the feedback from nurses about the latest agency rules on substantive staff. We’re committed to getting it right for nurses and doctors alike and making sure the system and the way staff can work is fair and equal, which is why we’re taking more time to work with the sector.’

Cuts to income

The RCN warned that the change would have forced NHS nursing staff into the private sector or see their earnings drop by £1,150 per year on average from tomorrow (1 April), especially in light of the continued pay freeze on nurses.

Prior to the decision change, NHS trusts had informed nurses they would need to join in-house staffing ‘banks’. However, NHS banks pay at least 20% less per hour than an agency for the same shifts.

Analysis by the RCN showed that a nurse who works an average of five extra hours each week through an agency would have been £1,100 worse off over the year before tax.

The RCN had sought legal advice on the change and advised its members they were not obliged to join an NHS bank.

‘Unfair, punitive and damaging’

Janet Davies today said: ‘This was an ill-conceived plan by NHS Improvement and today’s u-turn will be welcomed by nursing staff across the country. It is right to withdraw it and we will be seeking urgent meetings before any further plans are drawn up.

‘For many NHS nurses, the only way to ensure a decent level of income is to undertake additional work through an agency. They would not have to do this if NHS pay had kept pace with inflation in recent years.

‘The voice of RCN members forced NHS Improvement to recognise the instructions were unfair, punitive and damaging to high-quality patient care. We are pleased that NHS Improvement has agreed to work with the RCN to get this right.’