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Public sector agency workers - flexible asset or expensive liability?

The use of temporary workers in the NHS and social care could be costing money and compromising quality and safety, according to a new report published by a team of researchers.

The research, led by Leeds University Business School's Centre for Employment Relations Innovation and Change (CERIC) and funded by the Economic and Social Research Council, looked at the growing use of professional agency staff in health and social care and the implications for management practice and the delivery of services. It found that while employing temporary agency staff is often unavoidable to maintain services, it remains costlier than using full-time employees. This is despite recent evidence that fees paid to agencies have fallen.

Problems were also identified with the quality, competency and performance of some agency workers due to poor training. Further problems related to some agency workers' lack of knowledge about the organisation and limited commitment to the employer.

The report also found that employing agency workers can have a damaging effect on staff morale. For example, in hospital trusts agency workers were typically assigned easier tasks, leaving the permanent staff to deal with more difficult cases. Problems relating to agency workers' skills and competency levels raised concerns over quality of service, safety and continuity of care.

Professor Kirkpatrick, deputy director of CERIC said: "Agency staff play an important role in providing flexibility and the ability to bring in specialists as required. However, there are some significant risks, both in making sure the right people are recruited and that support systems for those people, once in post, are effective."

The report found that the response of management in the public sector to these issues has been mixed. In both NHS trusts and social care, some progress has been made in reducing the demand for agency work. In the NHS, this has been achieved by increasing the flexibility of existing staff, using nurse banks, or introducing multi-skilled 'pools' of nurses able to provide emergency cover. In social care, more attention is being paid to the recruitment and retention of permanent social workers. This however has been difficult due to continued shortages of professionally qualified staff, especially in London.

The research found that improvements have been made to the methods public organisations use to procure agency workers. In social care, for example, Vendor Managed Services (VMS) have been introduced to replace previous haphazard methods. Under this new system, local authorities outsource the procurement of all of their agency workers to the VMS provider, which in turn seeks to use local authorities' purchasing power to cut costs and enforce standards.

However, Professor Kim Hoque, of Nottingham University Business School pointed out that "While these new systems have helped to reduce the fees paid to agencies, they have not addressed the 'softer' aspects of placement matching and the achievement of 'person-organisation fit'. Looking ahead, organisations need to address the management of agency workers once in post and balance this with the often intense pressure to cut costs."

For further information:

Please contact the University of Leeds Press Office on +44 (0)113 343 4031 or email

Notes to editors:

1.     The report, "Professional Agency Working in Nursing and Social Work: Drivers, Consequences and Management Responses" by Professor Ian Kirkpatrick of Leeds University Business School's Centre for Employment Relations Innovation and Change (CERIC), Professor Kim Hoque of Nottingham University Business School, Dr. Alex De Ruyter (University of the West of Scotland Business School) and Dr. Chris Lonsdale (Birmingham Business School) is available on request.

2.     Centre for Employment Relations Innovation and Change (CERIC)

The Centre for Employment Relations Innovation and Change (CERIC) draws from the expertise of internationally renowned scholars at Leeds University Business School and the Faculty of Social Sciences to create a vibrant research environment. Its work contributes to contemporary, national and international debates on the changing dynamic and the future of work, employment and labour markets.

A distinctive element of the work of the Centre is the understanding of employment processes and outcomes within a broader regulatory and structural context. The Centre's research is broadly concerned with examining the modernisation of employment relations, and how processes of organisational restructuring and innovation shape patterns of continuity and change in employment relations. It evaluates the consequences of change for different stakeholders and is committed to developing new strategic and policy relevant visions.

3.     Leeds University Business School

Leeds University Business School is among the leading UK university-based business schools with a high reputation for research and a history of successful partnerships with industry and commerce at local, national and international levels.

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