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Working with care providers across England

Resources · Money

Getting out of agency dependency.

Nobody chooses it. It arrives one shift at a time, each individually justified, until a large share of the rota is bought at a premium from people who do not know the service.

It is a symptom, and treating it as a cost problem fails

Agency use is what happens when a service cannot recruit or cannot retain. Capping the spend without fixing either of those simply moves the failure onto the rota.

The usual sequence is familiar. Someone leaves and is not replaced quickly. The remaining team absorbs it, then tires. Sickness rises. Agency covers the gap. Permanent staff notice they are working alongside people earning more for less responsibility, and morale falls. Another person leaves.

Every step in that loop makes the next one more likely. Which is why an instruction to reduce agency spend, issued on its own, almost never works — it removes the relief without removing the cause, and the service either breaks or quietly ignores the instruction.

The way out is unglamorous and slower than anybody wants: fix recruitment speed and retention first, and let agency use fall as a consequence. Cutting it directly only works once there is something to cut back to.

Know what it is costing you

The margin check shows the weekly position with agency in it. Most providers underestimate how much of the gap is this one line.

What is left, per week?

Three causes worth checking first

In our experience these account for most of it.

Recruitment takes too long

Weeks between an application and a start date, with candidates lost at every stage. In a market where good people have several options, speed matters more than the advert. Measure your own time-to-start before changing anything else.

The first eight weeks

A large share of leavers go early, and usually for reasons nobody asked about: a rota that did not match what was discussed, shadowing that did not happen, a manager they never really met. Early leavers are the cheapest turnover to fix.

The rota nobody can live with

Late notice, unpredictable patterns, and a pattern of asking the same reliable people to cover. Those people leave eventually, and they are the hardest to replace.

A sequence that actually reduces it

Four steps, in order. Skipping to the last one is what most services do.

Measure two numbers weekly. Time from application to start, and leavers within their first three months. These predict agency use better than agency use itself does.

Compress the recruitment pipeline. Fewer steps, faster responses, checks started earlier. Most services find days of avoidable delay in a process nobody has looked at end to end.

Fix the first month. A real induction, shadowing that happens, a named person who checks in, and a rota that matches what was promised at interview. This is the highest-return work available in most services.

Then reduce agency deliberately. With a target, a date, and a named owner — once there is a permanent team capable of absorbing it. Not before.

Be careful about paying permanent staff less than the agency workers standing next to them and expecting nobody to notice. They always notice, and it is one of the most reliable ways to lose the people you were relying on to end the dependency.

The commercial terms are yours to check

Agency rates, notice periods, temp-to-perm fees and any restrictions in your supply agreements vary and are negotiable more often than providers assume. Read your own contracts before assuming a constraint is fixed.

This guide is about the underlying cause. The contractual side is worth a separate look, and worth taking advice on where a transfer fee or a restrictive term is involved.

Ring us before it is urgent. It is a much shorter conversation.

Thirty minutes, no charge, no obligation. If agency is eating the margin and you have already tried capping it, the fix is usually further upstream.

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