Dear all,

We would like to thank you for all that you have done to reduce agency spending in recent years. The introduction of the agency rules and your actions have had a significant impact. For example, off-framework agency use is at an all-time low.

It is our mission to ensure that every pound we spend in the NHS brings as much value as possible. We are clear that there is no room for waste in the NHS and every organisation within the health service must play its part. It is simply not right that the taxpayer should foot the bill for billions of pounds of spend on agency staff. In most cases, agency margins are an unnecessary cost to the service, when other models allow access to the same flexible workforce.

We are writing to you to reiterate the message on temporary staffing set out in the NHS Planning Guidance, which makes clear that trusts must reduce their spend on agency staffing by at least 30% in the next financial year. It is our ambition that we need to collectively be more ambitious and eliminate agency use altogether by the end of this government’s term of office.

We all know that bank work offers the best benefits to our staff through flexibility and the ability to work in familiar settings. We want to ensure that working through a staff bank is staff’s first choice when they want to take on an extra shift.

Therefore, DHSC and NHS England will be taking decisive action to ensure that trusts meet the temporary staffing target set out in Planning Guidance and have comprehensive migration plans in place. To ensure we all keep a determined focus on this objective, we are establishing a delivery group, across DHSC and NHS England, to monitor progress and ensure that trusts are taking robust action to comply. If we do not feel that sufficient progress is being made by the autumn, we will consider what further legislative steps we should take to ensure that use of agency staff is brought to an end.

It is also imperative that bank rates are competitive but do not exceed those paid by agencies directly to the worker. We expect you to be evaluating your bank rates against the local market to ensure they are not more than the average equivalent agency rate.

Many of you will already be working with NHS Professionals to manage your agency costs. We would encourage trusts that are not already working with them to consider whether use of their national bank offer would help to transition agency expenditure to bank more effectively. NHS Professionals has also recently written to chairs and CEOs who don’t currently work with them to illustrate the size of financial opportunity available in that transition.

We know that you are working hard to help us fix our NHS and thank you for your continued support. This is an important issue for us and if we collectively respond, this will release around £1 billion over the next 5 years to be invested back into patient care.

Yours sincerely,

Publication reference: PRN02016