AGENCY NURSING is on the increase as the widespread shortage of qualified nurses drives hospitals to go out-of-house to solve their staffing problems. From the nurse's point of view, agency work can have attractive benefits such as flexible work and better pay, But there is a growing feeling that the NHS is being held to ransom through hefty agency commission fees, and that the quality of patient care is being compromised.
The London Agency Project (LAP) framework has been designed to address these problems. Recruitment agencies that want to supply nursing staff to the NHS in London must now go through a rigorous tendering process to gain LAP status. NHS Purchasing and Supply (PASA), which organises this process, then provides NHS trusts in London with a preferred shortlist of nursing recruitment agencies.
The LAP is divided into two phases. LAP1 started in September 2001 and lists 29 preferred agencies for the supply of temporary theatre, critical care, ITU and emergency nursing staff. The second phase of the project, LAP2, starts next month. This lists 72 preferred agencies for the supply of temporary general medical, surgical and paediatric nursing staff.
The intention is that through the project, agencies and the NHS will work in partnership, solving staff shortages cost-effectively while ensuring that quality care is maintained. From the NHS perspective, this will mean better value for money and an assurance that agencies on the list will not demand excessive commission fees for the placement of temporary staff.
In addition to addressing costs, the LAP framework is designed to promote key values of NHS recruitment and retention policy. Preferred agencies will provide a recruitment service that helps strengthen the NHS commitment to improving working conditions for its staff. In the past, not only was the NHS wasting money on fees, but agency nurses were missing out on the training and support necessary for career development because they were not working as permanent employees. And, as more nurses sought agency work, trusts felt they were funding an increasingly underskilled workforce.
LAP listed agencies must not only adhere to a regulated pricing structure when dealing with NHS trusts, but must also provide many of the training and development opportunities for nurses on their books that would usually be provided by a permanent employer. Listed agencies must also provide regular staff appraisals and induction training, staff handbooks and health and safety training. The tendering process tested agencies on their ability to meet these pledges. Those that did not provide satisfactory evidence of this did not make it onto the list.
Quality of care
From the nurse's perspective, there is a strong case for working with an LAP-listed agency. The benefits include flexible working and the provision of training and skills development.
NHS trusts benefit from this agreement because they know the temporary nursing staff they receive have been fully vetted for their qualifications and regulatory compliance. Although the cohesion of clinical teams may still be threatened by the placement of temporary staff, the LAP pledges will go a long way to ensuring that quality of patient care is maintained.
Nurses wishing to register with an LAP-listed agency will need to prepare for the vetting process. Proof of identification, immunisation records and Criminal Records Bureau checks will be more rigorously enforced. Agency nurses are unlikely to be allowed to begin working in the NHS if they cannot provide the relevant evidence. Those who are already registered with LAP-listed agencies should expect their records to be re-checked during their agency employment. Contract nurses should consider registering with an LAP-listed agency to take advantage of the improved working opportunities.
Paul Bromwich is managing director of Bluecare Recruitment
Bluecare's nursing division supports and has been approved by the LAP2 framework
For more information on the LAP and a list of agencies appointed to the framework, visit www.london.nhs.uk/ modernising/londonagency.htm
