The much-publicised NHS staffing crisis means NHS organisations must look to recruitment agencies to fill gaps in their rotas. While in an ideal situation they would be able to take advantage of a flexible workforce supplied by agencies that fit into a regulated framework, the reality is they are left with little choice but to go further afield.

Going off-framework has a number of drawbacks, the biggest being that the cost of agency staff can spiral out of control. It’s not a sustainable solution, but NHS organisations must continue to prioritise patient care and safety, meaning they are having to fall back on agency provision.

At the end of 2021, there was a 5.8 per cent vacancy rate among medical staff, data from NHS England shows. This was up from 5.1 per cent the previous year, demonstrating how the issue is only being exacerbated over time.

With NHS Trusts in England spending £6.2 billion on agency and bank staff in 2019/2020, and the use of agency staff a necessity to enable the NHS to deliver a flexible workforce that helps them to plug gaps during peak demand periods, they need to find a sustainable process.

Issues with off-framework agencies

Liaising directly with an off-framework recruitment agency can present a number of issues. While they plug the staffing gap in the short term, they can leave NHS temporary staffing teams with problems further down the line.

Lack of compliance

The NHS framework is in place to ensure temporary staff are recruited via a compliant method. Stepping outside of these regulated agency professionals means you don’t have the same peace of mind. Having not applied through the open tender process, off-framework agencies are not required to provide as much information on their practices as approved agencies.

No transparency with costs

Off-framework agencies don’t have to abide by pre-agreed pay scales and often charge three or four times the framework rate. On top of this, they have been known to charge trusts for mileage for staff to travel to work. Agencies can send medical workers from a wide area, meaning travel costs are high, while NHS employees fund their own journeys.

Efforts to reduce off-framework spending have had some impact, taking it from £3.6 billion a year to £2.4 billion, but this is still a long way from the goal to eliminate it by 2022. This aim was set out in an open letter by the former care minister Helen Whately in December 2020.

Inability to be neutral

Neutrality is a casualty of off-framework agencies working directly with NHS organisations. They work to their own agenda without the checks and balances implemented by the pre-agreed framework, leaving the health service with little choice but to meet their demands to ensure continuity of care. This is why a vendor-neutral workforce service with full visibility of the entire supply chain can act as an effective bridge between the parties.

Best ways to approach agency staffing

While using agency staff is unavoidable, there are ways of approaching the solution that help to mitigate some of the downsides. Any cost savings resulting from taking these steps can be channelled back into the NHS.

Use an agency within the framework

The first call and best option should always be to use a regulated agency that sits within the NHS framework. The benefits of this include agreed pricing levels and cost visibility, but unfortunately, this is not always possible.

Use a framework-approved supplier

Instead of immediately going off-framework, it’s worth working with a supplier that offers full visibility of its end-to-end process. With transparent costs and regulated practices, you can benefit from a neutral supplier while securing the staff you need.

The PlusUs WorkForce Manager platform

This is where our WorkForce Manager platform comes in. Use this technology to enjoy greater visibility and control of your temporary workforce to ensure all shifts are filled, there are no issues with compliance and your costs don’t spiral out of control.