90% of NHS Trusts Regularly Use ‘Off-Framework’ Agencies

Just 4% of NHS trusts are fully compliant with the Trust Development Agency and Monitor guidelines that say they can only use staff from pre-approved ‘framework’ agencies. 

Research, released by the research group MSI, demonstrated that 90% of NHS Trusts in England are regularly using ‘off-framework’ agencies to ensure adequate staffing coverage. The figures also reveal that just 4% of NHS trusts are fully compliant with the capping guidelines.


Finally the research claimed that 45% of the 288 agencies supplying the sector “do not operate within any of the government approved frameworks”. However, it noted that this was a “positive if slight shift towards compliance” as last year it found that 60% of agencies were “off-framework”.

MSI Group’s CEO Nick Simpson said: “This research highlights the extent to which NHS Trusts are being forced to break Monitor guidelines in an effort to protect patient safety.

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Overall the numbers demonstrated a very slight move towards “more affordable” agency fees. Monitor and the NHS Trust Development Agency recently updated its guidance on the use of agency staff.