Government policy is forcing NHS trusts in England to breach guidelines around the use of agency staff to protect patient safety, according to research by a healthcare recruitment agency.
Just 4% of NHS trusts are fully compliant with Monitor guidelines that they can only recruit from agencies that are on one or more NHS approved frameworks.
Research by the MSI Group found that trusts are repeatedly using a clause which allows them to breach guidelines if patient safety is compromised and there is no alternative.
The research showed that more than 70,000 shifts were filled by agency staff since the caps were introduced in November 2015.
Researchers sent Freedom of Information requests to every acute and mental health NHS trust in England.
They found that 79% of trusts recruit staff outside of the approved frameworks.
It also revealed that 90% had also exceeded the new agency pay caps.
According to the rules trusts are barred from paying locums more than 55% above substantive pay rates.
The MSI Group said unregulated “off-framework” agencies can set their own rates and are not subject to the same compliance audits that “on-framework” agencies have to undertake.
It claimed that 45% of the 288 agencies supplying the sector “do not operate within any of the government approved frameworks”. However, it noted that this was a “positive if slight shift towards compliance” as last year it found that 60% of agencies were “off-framework”.
MSI Group’s CEO Nick Simpson said: “This research highlights the extent to which NHS Trusts are being forced to break Monitor guidelines in an effort to protect patient safety.”
He added: “The sector had been experiencing positive progress towards sustainable pay rates when initial guidelines – barring off framework expenditure – were introduced in October 2015. However they were not given enough of a chance to prove their worth before new caps were hastily rushed in shortly after.”
Monitor and the NHS Trust Development Authority said that overuse of agency staff is “unaffordable”.
The health bodies added: “We want to encourage staff to come back into the NHS. We also want trusts to be able to rely on a more stable supply of staff, paid on standard NHS terms and conditions and not the rip-off rates charged by agencies in recent years.”
They said it was early days for the new programme but it was having a “positive impact.” Trusts had requested its introduction and it was “helping them regain control over their spending on staff.
Monitor and the NHS Trust Development Agency recently updated its guidance on the use of agency staff.
