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What is a ‘Framework Agency’?

Nursing Notes



From the 19th October 2015 NHS trusts throughout the UK will be forced to secure agency staff, should they require it, via a pre-approved network of agencies – ‘Framework Agencies’. 

Dubbed ‘Framework Agencies’, they have all subscribed to a framework agreement – a set of rules and guidelines set out by the government. You should seek advise from your agency to see if they have subscribed to the new guidance.

Agencies are being assessed to join the Framework on an individual basis by Monitor and the Trust Development Authority and membership to the framework will be constantly reviewed to ensure high standards and compliance to the criteria.


In 2014/15, NHS providers spent £3.3 billion on temporary staff the primary aim of the framework is to reduce this spend. Monitor / TDA have established maximum agency budgets for each individual trust. The secondary aim of the framework is to bring greater transparency and clearer rules forward in the use of agency or temporary staff.

You can view the new rules regarding the use of agency staff for NHS trusts but the most important points are as follows;

  • Trusts must not exceed the maximum rates of pay which are published in their framework agreements.
  • Hourly price-caps are provisional and unpublished  they will remain under negotiation for the next few months and are expected to be formally set in April of 2016.
  • While maximum rates should not be exceeded, they equally do not have to be paid and trusts should use their resources wisely. Trusts are encouraged to negotiate the best deal they can.
  • Under exceptional circumstances trusts may use non-framework agencies but require prior approval from Monitor / TDA alongside evidence to support their request. They however must still stick to their maximum hourly rate of pay and the following information must be submitted; date, type of nurse, shift, reason for exceptional circumstance, price paid, name of agency and the name of the director who has submitted the request.
  • Trusts must stick to their annual agency spend budget.

It should be noted that these rules are not being enforced upon Foundation Trusts and trusts outside of NHS England – they remain in control of their budget / spend but they are encouraged to comply.

Below is a copy of the criteria set for framework agencies.

The rules for the use of agency staff are complex but have evolved under the framework to ensure a competitive market for NHS trusts. The overall aim of the changes is to provide a better standard of care at a better overall cost.

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Patients are being mislead by unregistered staff using the “Nurse” title

Ian Snug



Leading nurses warn that organisations are employing unregistered care staff with job titles describing them as “nurses”.

A study has that found hundreds of roles which do not require Nursing and Midwifery Council registration used the term “Nurse” in the job title.  This, understandably, has caused concern that patients are being misled and staff could be working beyond their competence.

According to the Health Service Journal, Jane Cummings, Englands’ Chief Nursing Officer, has written to NHS leaders calling for them to ensure staff who use the nurse title are in fact registered nurses.

We found several examples, on the NHS jobs website, of positions which utilise the “Nurse” title but do not require an NMC Registration to apply;

  • Assistant Nurse Practitioner.
  • Enhanced Supervision Nurse.
  • Clinical Support Nurse.
  • Associate Nurse.
  • Complex Support Nurse.
  • Assistant Nurse.
  • Auxilliary Nurse.
  • Nurse Support Worker.

Jackie Smith, the NMC’s Chief Executive and Registrar, has previously said;

“If individuals are calling themselves nurses and they are not on our register, then from a patient perspective that is quite worrying. Employers should not mislead patients into thinking the person in front of them is a registered nurse when they are not. They have a duty to make that clear to patients”.

Janet Davies, Chief Executive and General Secretary, said:

“Support workers play an extremely important role but there must always be a clear distinction between them and trained nurses.

“As the shortage of nurses begins to bite, the NHS is increasingly filling shifts with more unregistered care staff. They do not have the qualifications and training of registered nurses and it is unfair on the all sides, not least patients, when they replace more qualified staff.

“The Government must not allow nursing on the cheap. When the number of registered nurses on shift falls, it is patient outcomes and mortality rates that are adversely affected.”

Presently, only the title “Registered Nurse” is protected but staff are calling for the title “Nurse” to also be protected.

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MP insists nurses are already well paid compared to hairdressers, plumbers or carpenters

James M




An MP has come under fire for saying that nurses are already well paid when compared to hairdressers, plumbers and carpenters in his constituency.

During last weeks debate on scrapping the NHS pay cap, Conservative MP Eddie Hughes said he wanted to ‘bring some context’ to the argument and went on to say that NHS staff already have a good deal when compared to hairdressers, plumbers and carpenters in his Walsall constituency.

But, Hughes has come under fire from NHS staff with nurses reiterating the issue not just about pay. The significant real-terms has also caused many nurses to turn to food banks and caused further issues with staff recruitment and retention as student nurse numbers significantly are affected.

Valerie Vaz, the Labour MP for Walsall South, said his comments ‘echoed the government’s contempt for our NHS workers’ and went on to reiterate that nurses are being forced to use food banks to make ends meet and NHS.

Speaking in Parliament, Eddie Hughes, said;

“I completely welcome the hard work that is done by NHS staff up and down the country, but please let me bring some context to the debate.

“The average income in my constituency is £440 a week, which is approximately £23,000 a year. I intend to advocate on behalf of all my constituents, not just those who work in the public sector. The average salary in my constituency is £23,000, which is about the same as a qualified nurse starts on.

“Many workers in my constituency are employed as hairdressers, plumbers or carpenters, and what pay rise do they get? They have had to work hard every year for their pay, and when we make the comparison using other factors, such as pension schemes, we see that in order to earn the same sort of pension a plumber would need to be putting away 43 per cent of their salary. Yes, we value the public sector in this country, but the Conservatives value all the workers in this country.”

You can view Eddie Hughe’s speech here.

Mike Adams, regional director of the Royal College of Nursing in the West Midlands, said; “They deserve nothing less than fair pay. As it is, we know many nurses work over their hours without pay as a result of staying on after the scheduled end of their shift or working through their breaks to ensure patients are well cared-for”.

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