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Monitor and the NHS Trust Development Authority

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19 Nov 2015
Monitor and the NHS Trust Development Authority (TDA) have published the proposed rules and a consultation on the introduction of caps on the total amount trusts can pay per hour for all types of agency staff.

The information published sets out in detail the proposed price cap rules and launches a consultation on the principle and detail of the rules 

Under the proposed rules, from 1 April 2016, trusts would not be able to pay more than 55 per cent above the relevant national pay rates for an agency worker, employed either via an agency or direct engagement. The 55 per cent uplift would account for:

  • Employment on-costs including employer pension contribution
  • Employer national insurance
  • Holiday pay to the worker
  • A modest administration fee/agency charge.
The aim is to introduce the proposed price caps on the 23 November 2015 and then, subject to monitoring, reduce them in two further stages so that by 1 April 2016 capped agency rates would be equivalent to national NHS pay rates for substantive staff.

Full details, including tables setting out the maximum total rates for each staff group, can be accessed via the GOV.UK website.  The consultation runs until 5pm on 13 November 2015 and all interested parties and stakeholders are invited to respond to the consultation.

The rules have been developed with the support of clinical and financial leaders across Monitor, TDA, the Care Quality Commission, NHS England and the Department of Health. The objective is to bring agency workers' pay in line with substantive workers' pay by 1 April 2016

After having a read of this report, I'm unsure as to what it is attempting to achieve other than create further problems in the future.

The reason why Monitor are trying to do this is to cut back on the amount of agency workers, and  to move them into substantive roles, but I feel that if they are trying to achieve this through lowering contract rates towards current banding levels, it simply won't work. I also feel that giving themselves 10 days between the 13th and 23rd November is unacceptable and there is no way that responses can be properly gathered and evaluated in a 10 day timescale, and I imagine they have already made their mind up.

I think that Monitor need to have a hard real think about what they are trying to propose as I personally feel that the percentage level is far too adventurous and unrealistic. Setting targets such as these will only further reduce the chances of success and lead to future problems. 

My thoughts are that if Monitor is successful with their plans, NHS contractors will not reduce the rate to what has been suggested, but simply move into the private sector where they can earn more money. This will result in Trusts not getting the right people in, or anyone in at all, resulting in more deficit, and lots more pressure on substantive staff.

It is going to be an interesting next couple of weeks and I would love to hear your thoughts on this matter.

Please contact me to discuss this further or leave your thoughts in the comments below... 
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