Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential impact of firms providing agency labour to the NHS on (a) the amount of profit generated by those agencies, (b) trends in the level of health staff leaving NHS employment and joining those agencies and (c) dependence of the NHS on agency labour.

The Department does not collect data on the amount of profit generated by agencies supplying staff to the National Health Service nor the number of health staff leaving NHS employment to work for agencies. Data on agency staff is held by the employing agency and is not shared with NHS England. NHS England holds data for agency shifts in the NHS, including hours worked and cost.

The deployment of a temporary workforce is an important element of efficiently running the NHS, allowing the NHS to meet demand fluctuations without the need to increase capacity above that which would be required on a sustained basis. Staff can be drawn from internal staff banks or external agencies.

Our policy is to reduce the use of agency staff and to prioritise the use of in-house staff banks over agency use.  The introduction of the Agency Rules in 2016 helped to reduce agency spend by around £1.2 billion, from a peak of £3.6 billion in 2015/16 to £2.4 billion at the end of 2020/21. Total agency spend as a percentage of total wage bill decreased from 7.9% in 2015/16 to 3.7% in 2020/21. Reducing the use of agency staff must be balanced with providing safe care to patients. Trusts are able to use temporary staffing to respond to situations where they do not have sufficient staff numbers. NHS England has re-established measures in September 2022 to control agency expenditure, including a system agency expenditure limit.