Agency staffing

COVID-19 sources of external staffing

Advice from NHS England and NHS Improvement on the use of agency staff during the current outbreak can be found in the staff terms and conditions section of this guidance. The advice recognises the value of deploying agency staff where clinically needed.

In a letter dated 23 March 2020, Helen Whately, minister of state with the lead for the health and care workforce, encouraged NHS trusts to work collaboratively in the use of agency staff and highlighted that agency workers follow the COVID-19 guidance on NHS England and NHS Improvement's website, for staff working in a health and care environment.

The NHS provides guidance on procuring agency staff and the maximum rates to be paid so that trusts secure value for money. However, under Section 9 of the agency rules, price caps can be exceeded on exceptional patient safety grounds. It is up to local organisations to decide when they need to pay above price cap for exceptional patient safety reasons, based on clinical judgements.

During this period trusts should ensure that, even where they have exceeded price caps on exceptional patient safety grounds, agency resource is procured via NHS England and NHS Improvement approved frameworks, so that appropriate compliance checks are completed.

Where trusts experience issues with particular agencies on these frameworks, for example around rates or instances of agency staff not arriving for shifts, they should continue to raise these in the first instance with the relevant procurement framework. Where issues need to be escalated, please contact NHS England and NHS Improvement supplying all the relevant details to

In addition, as stated in Keith Willett’s letter of 2 March 2020, trusts should review their mutual aid agreements with staffing agencies, in accordance with their individual critical incident policies.

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