Agency nurses used by the NHS in England must be ‘high quality and up to the job’


Helen Goldsmith, Lead Clinical Nurse at Local Care Force logo-local-care-forceHelen Goldsmith is Clinical Lead Nurse for leading Nursing, Social and Homecare agency, Local Care Force. Here, she comments on the new initiative to ensure agency nurses are ‘fit and proper’ and how this is handled by her agency.

Last month a national initiative was launched by the LPP to try and ensure agency nurses used by the NHS in England are ‘high quality and up to the job’ – as a Clinical Lead for a nursing agency, this is a subject that I feel very strongly about indeed. Agency nurses are often great nurses, with all levels of experience who choose work of this nature for a number of reasons. When supported and developed as a permanent nurse would be, there should be no question whatsoever over their abilities and it is without a doubt the supplying agency’s responsibility to always ensure that their staff are trained, confident and proficient to work within any specialist nursing setting.

As an experienced practitioner and previous agency nurse, I know firsthand how isolating and daunting it can be to work in different environments, with different systems, patients, residents, service users and unfamiliar staff. Often the biggest challenge is the poor medication management, the different medication systems, badly completed MAR charts and out-of-date ID photographs for service users, but the lack of clinical support is what used to worry me the most.

So how does our agency prepare nurses for this? For starters, as Clinical Lead Nurse, I am on hand to support our nurses when on shift and to call for clinical advice. Part of my role is to establish their clinical knowledge on specialism’s before placing them, to ensure the right fit for both parties. I also work ‘troubleshooting’ shifts myself at more complex client sites and support the nurses through any investigations or safeguarding incidents they may be involved in.

At Local Care Force, we place high value on working in partnership with our customers. For us, it is essential. Our customers are not always prepared nor realise the measures they should take to support agency nurses and so we are happy to work with them directly to ensure that the correct procedures are put in place.

However, this is not always an industry standard and can sometimes result in hospitals and nursing homes being unprepared, unfit and not set up with the correct processes to employ staff provided by agencies. Frustratingly, in these instances, any blame or criticism often falls on the shoulders of the agency nurse, which is extremely unfair and is why it is vital that proper policies are put in place.

So whilst an agency should only supply competent staff, it doesn’t stop there, employers are also accountable for providing full and proper handovers. They need to ensure that up to date care plans are available along with photos of service users, and must present clearly written medication cards with additional instructions on specifics, such as ways to support certain individuals And, it is also essential that out-of-hours contact details for management are easy to find in an emergency to support staff should they need it. It all sounds quite simple but in practice is often handled in this way very differently.

So what does make us different and how do we make it easier for those taking on agency nurses? At Local Care Force, it is standard practice for to visit all client sites prior to any placement. We do this so we can ensure that the skills required by the unit or ward always match the nurse we place. It allows us to feel confident that a full and detailed briefing on each placement is received including the medication systems in use, staffing and patient levels, the needs of the client group and any additional specialist training requirements. This always results in a more confident nurse working in a safer environment and ensures that the quality of our agency nurses is never in question and that the hospital or care home is also supported.

However, despite all this preparation and support, there is also still a long way to go because of longstanding pre-conceptions about the quality of those who choose to work as an agency nurse. We frequently see regular staff attitudes towards agency staff vary, which is something that needs to be addressed. Agency nurses are often seen as a hindrance, incompetent, lazy or an unnecessary waste of money. But the reality is they are competent clinicians, often with years of experience under their belts. Agency staff should be viewed as an extension of the team and given more support from the organisations employing them and staff working with them. They can be a real asset adding experience and a safe pair of hands to help ensure that most importantly; the highest possible standard of care for patients is delivered.

Our nurses are always of the highest standard and are treated and developed as permanent nurse would be.  We arrange staff supervisions and appraisals, a rigorous mandatory classroom based training programme, regular professional discussions and a new innovative course called ‘Nurses: Protect yourselves’. In addition to this, we also hold regular team meetings to ensure that our workforce don’t feel isolated and provide a blog which is not only informative, but also ensures all our nurses have ’a voice’.

It goes without saying that all agencies should expect and demand high standards, employing only high quality clinicians. Without a doubt, an agency nurse should be proficient, capable, experienced, have a full understanding of accountability and be an up-to-date clinician. We have a rigorous recruitment progress where candidates are thoroughly interviewed, questioned and challenged on clinical scenarios linked to their specialism and stringently vetted, in terms of a referenced employment history. We have to evidence a valid pin which is checked quarterly, an enhanced DBS, an up to date training record and additionally complete our training along with multiple other checks before they can even commit to their first placement.

Finally, our main point of difference is that we offer a Clinical Lead Nurse who is always on hand to support, guide and develop and working in partnership with our training arm of the business so that we can offer a variety of specialist training to ensure the best from those who work with us. So, are agency nurses fit and proper? Absolutely, and at Local Care Force they are much, much more.

For more information please visit or call Local Care Force on 0330 6600644,


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