Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the prevalence in the use of off-framework agency staff by NHS providers; and if he will make an assessment of the potential impact of using these staff on NHS finances.

The National Health Service is now operating at the lowest levels of off-framework on record, since a peak in month four of 2022/23, with the highest compliance on capped rates since the introduction of the Agency Rules in 2016.

The Government is committed to reducing off-framework agency use, the cost of which is at a premium above the agreed framework rates. Additionally, staff hired through off-framework agencies are not subject to the same pre-employment checks as those carried out by on-framework agencies. Off-framework use is actively monitored through NHS England’s governance mechanisms, with additional oversight applied to trusts with recurring non-compliance.

The 2025/26 NHS priorities and operational planning guidance aims to improve procurement, contract management, and work to accept operating models that meet commercial standards. The NHS Planning Guidance states that trusts should reduce their agency spend by a minimum of 30%, and the accompanying Revenue Finance and Contracting Guidance sets the ambition that agency spend should be eliminated in the coming years.