Clampdown on NHS cash hived off by agencies for locum staff

LOCUM agencies are facing restrictions on the amounts that they can cream off fees paid by the NHS for temporary staff.

New rules will be announced this week to alter the rates charged by firms that supply doctors and nurses to hospitals, following a Telegraph investigation last month that exposed how some were quietly pocketing up to half of the sums paid by the health service.

The move comes as this newspaper reveals how most trusts spend sums running into millions of pounds on temporary staff without knowing how much agencies take.

The new rules are intended to restrict these fees and ensure transparency.

The “cut” taken by agencies is effectively a finder’s fee, and in some cases includes money that will go on “employer costs” such as national insurance contributions.

But senior figures in the NHS and its regulator, NHS Improvement, fear that some firms are charging “extortionate” rates.

A source said that under the new rules, introduced by NHS Improvement, agencies would effectively have to “compete on their commission”, leading to a “fairer deal for the NHS”.

The rules are the latest in a series of changes intended to tackle the “crippling” pressure of agency bills.

Last night, Jim Mackey, chief executive of NHS Improvement, who is expected to announce the move at the Commons public accounts committee tomorrow, warned that the locums industry “is still a seller’s market, with the NHS on the losing side”.

He is also poised to pledge a clampdown on the practice of agency workers being paid through personal services companies, allowing them to avoid paying tax.

Mr Mackey said: “Staff who work through agencies or as locums need to realise that the market is shifting. In future, they will be better off seeking substantive employment within the NHS and picking up extra shifts through staffing banks than relying on the high rates paid by agencies.”

In 2014-15, the NHS spent £3.3 billion on agency nurses and doctors.

Now, a Freedom of Information request to all NHS trusts has shown that most have been paying locum agency bills without knowing how the cash is split between company and worker.

Of 54 NHS trusts that responded to the Telegraph request, only six could provide such a breakdown for agencies that they were paying more than £10,000 per year. The remaining 48 failed to reveal the information, most saying they did not hold it.

One of the largest agencies, Independent Clinical Services (ICS), charged a trust £63.95 for a nurse to work evenings or Saturdays. The nurse received £32.50, and the firm took £31.45 – 49 per cent. ICS said this was likely to have been the result of “a last-minute request” that represented a very small proportion of its work.