ghp October 2015 | 19 regulation & policy This article will example the common areas healthcare recruiter businesses have gone wrong when it comes to accreditation, spot-check audits and the right PR to manage criticism. It will provide a best practice guide to surviving audits and the issues around this. Healthcare recruitment compliance expert, Duncan Kennedy, of Audit Ready explains: Introduction NHS organisations have always needed to have a flex- ible workforce to manage fluctuations in activity and to cover vacancies and short term absences. Cover has traditionally been provided by in-house banks or commercial recruitment agencies. As reported the Government and senior leaders of the NHS are having to address a budget requiring £22bn in efficiency savings and a predicted funding shortfall of £8bn. In 2014/15 NHS providers spent £3.3bn on temporary staff. It clear to understand why the amount spent on agencies is high profile. In the early noughties there was significant concern about the over reliance on agencies, the amount spent and the impact on the quality of care. One of the strategies for managing agencies was the introduction of framework agreements for nursing. Since that time frameworks have evolved covering all staff groups: the difference then was the use of frameworks was advised rather than mandatory. Following the Francis Report there has been a height- ened sense of priority across the whole service to ensure safe staffing levels are achieved and maintained; which for some Trusts has made it very hard to avoid increased agency use. As such a seismic shift has taken place in the Governments attitude towards controlling costs and raising quality. In September, Monitor and the TDA published mandatory rules for using agency nurses form “approved” framework agreements; subsequently a further announcement has confirmed a new hourly price cap will now be introduced for all types of agency staff. Framework Agreements A framework agreement is an ‘umbrella agreement’ that sets out the terms (particularly in relation to price, quality and quantity) under which individual contracts (call-offs) can be made throughout the period of the agreement. For the NHS, the framework agreements for the sup- ply of temporary healthcare workers were introduced to manage cost and to ensure NHS quality standards relating to pre-employment checks and personnel vetting were performed by awarded agencies. There are several health framework agreements in place across the country, which are managed by a number of different procurement organisations, the main ones being, the Crown Commercial Service (CCS), Healthtrust Europe (HTE), the London Pro- curement Partnership (LPP) and NHS Commercial Alliance. Compliance NHS organisations are required to demonstrate they are compliant with the checks outlined within the NHS Employment Check Standards, as failure to comply could potentially put the safety, and even the lives, of patients, staff and public at risk. When NHS organi- sation use agencies they are obliged to demonstrate that agencies are performing the required pre-employ- ment screening checks, therefore the requirement to demonstrate compliance is also embedded within the framework agreements and audits are performed by the framework owners to ensure compliance with the NHS quality standards. Where have agencies gone wrong? Recently the focus has been on agencies charging “extortionate, excessive and unreasonable” prices to the NHS for the supply of temporary workers i.e. holding the NHS to ransom. These agencies would argue it is a case of simple economics – supply and demand. However, I would argue corporate ambition has been chosen over corporate responsibility. They have decided to take the pound for short term gain rather than work as a responsible supplier, providing a service that is valued rather than despised. Although a relatively small number of agencies, the reputational damage to the sector has been significant and has contributed majorly to the Governments hardened attitude. The relationship between healthcare recruiters, the NHS, Gov- ernment and public has never been more fragile. There have been a number of public scandals linking to agency staff getting paid seemingly high fees for emergency shifts. This has led to scrutiny of healthcare recruiters and the NHS. A number of healthcare recruitment companies have come under fire be- cause of these numerous scandals because they have not all have been prepared.