Recurring concern
Unsafe reliance on agency staff for clinical staffing
Pin
Get email alerts
Request correctionFirst reported 6 Mar 2014•Latest report 8 Feb 2026
What this concern includes
Includes material deficiencies in the use, deployment, competence assurance, induction, supervision or continuity of agency clinical staff where the report directly connects them to reliance on agency staffing as the shared unsafe condition.
Not included
- Excludes permanent-staff shortages or general workforce problems not materially involving agency staffing.
- Excludes isolated individual performance failures unless the report links them to agency staffing or the resulting reliance on agency workers.
- Excludes unrelated reliance on external providers, untrained people, patients, families, questionnaires or other non-staffing controls.
- Reports
- 22
- Individual concerns
- 32
- Date range
- 2014–2026
- Stated actions
- 62
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
-
Concerns raised1
Inexperienced ward staffing for detained children
This report raised 30 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
-
Action
Implement staffing controls requiring appropriately skilled and inducted bank and agency staff, supported by rota review and competency oversight.
Stated by Essex Partnership University NHS Foundation Trust -
Action
Implement enhanced escalation and local induction processes when CAMHS roster requirements or staff competencies are insufficient.
Stated by Essex Partnership University NHS Foundation Trust -
Action
Increase CAMHS staffing capacity and strengthen leadership through additional shift staff, retention premiums, new management and preceptor-support roles, and activity coordinators.
Stated by Essex Partnership University NHS Foundation Trust
-
Action
Continue developing CAMHS preceptorship and workforce planning, and use the Mental Health Optimal Staffing Tool across the Trust.
Stated by Essex Partnership University NHS Foundation Trust
-
Concerns raised1
Lack of evidenced training requirements for agency nurses
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
Action
Reduce reliance on agency nursing staff through workforce measures.
Stated by Malhotra Care Homes Ltd -
Action
Require agencies to provide evidence of mandatory training compliance before nurses work at the Home.
Stated by Malhotra Care Homes Ltd
-
Concerns raised1
Failure of agency staff to communicate effectively in English with residents and colleagues
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
-
Action
Seek evidence that providers using agency staff have verified their training, skills and command of English.
Stated by Care Quality Commission -
Action
Publish guidance for social care providers on international recruitment and assessing care workers’ English-language competence.
Stated by Department of Health and Social Care -
Action
Implement more robust contract monitoring processes and quality visits across care homes.
Stated by Tameside Borough Council
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Position
The care provider is responsible for assessing agency staff’s English proficiency and ensuring their suitability for the role.
Stated by Department of Health and Social Care
-
Concerns raised1
Lack of home-specific training for agency staff
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
Action
Update agency-worker induction with falls protocols, the I STUMBLE tool and post-fall decision-making tool.
Stated by Hermes Care Ltd -
Action
Support new agency staff before shifts and complete existing agency staff attendance at the company’s training sessions.
Stated by Hermes Care Ltd
-
Concerns raised1
Failure to train agency healthcare staff in the ACCT process and the threshold for opening an ACCT
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
-
Action
Write to Health and Justice regional teams sharing concerns and requesting action to ensure agency and bank staff access necessary joint training, including ACCT training.
Stated by NHS England -
Action
Take the report’s findings to the NHS England Health and Justice Delivery Oversight Group for oversight of the proposed training-access action.
Stated by NHS England -
Action
Require regional teams to provide assurance at the planned Health and Justice Delivery Oversight Group meeting that agency and bank staff have timely access to ACCT training.
Stated by NHS England
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
-
Position
HMPPS is responsible for overseeing effective ACCT training delivery at prison establishments, including ACCT case manager and assessor training.
Stated by NHS England
-
Position
NHS England is responding to concerns about prison healthcare staff training in the ACCT process.
Stated by Home Office
-
Concerns raised2
Failure to assure agency nurses’ competence, induction and handover
Reliance on agencies to assess the competence of supplied clinical staff
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
Action
Share and discuss RCA findings with the nursing agency and implement a competency checklist signed by agency staff and the supplier.
Stated by Spire Healthcare Limited -
Action
Provide deteriorating-patient training to agency staff through the supplier competency process.
Stated by Spire Healthcare Limited
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Position
The RMO’s agency was considered best placed to assess whether the incident was isolated or required wider performance action or GMC escalation.
Stated by Spire Healthcare Limited
-
Concerns raised5
Failure to require nursing agencies to supply professionally qualified staff
Failure to require nursing agencies to supply staff who have undergone appropriate ED induction
Failure to require nursing agencies to supply staff with current training to specified standards
Failure to provide a suitable induction system for bank and agency staff to become familiar with the crash call system
Lack of audits and spot checks verifying bank and agency nurses’ familiarity with crash call procedures
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
-
Action
Check for new temporary staff at every shift start and complete a signed first-shift induction covering emergency and resuscitation procedures, equipment locations and reporting processes.
Stated by Leeds Teaching Hospitals NHS Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Position
Existing qualification, training, induction, audit and spot-check arrangements are considered sufficient to ensure temporary ED staff understand emergency procedures.
Stated by Leeds Teaching Hospitals NHS Trust
-
Concerns raised1
Reliance on agency nursing staff
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
-
Action
Continue targeted and general recruitment campaigns to increase the substantive nursing workforce.
Stated by Frimley Health NHS Foundation Trust -
Action
Provide trainee nursing associate and degree apprenticeship routes to develop nursing staff.
Stated by Frimley Health NHS Foundation Trust -
Action
Continue international nurse recruitment and provide recruited nurses with examination preparation, registration support and preceptorship.
Stated by Frimley Health NHS Foundation Trust
-
Action
Encourage substantive and former permanent staff to undertake shifts through the Trust’s staff bank.
Stated by Frimley Health NHS Foundation Trust
-
Concerns raised1
Reliance on agency nurses
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
-
Action
Develop a stable, experienced ward nursing team through recruitment and training to reduce agency-staff reliance.
Stated by Medway NHS Foundation Trust
-
Concerns raised2
Lack of clear protocols integrating agency district nurses into the organisation
High proportion of district nursing care provided by agency nurses
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
-
Action
Revise daily handovers to include temporary staff and a specific pressure-ulcer management item, with regular senior-nurse monitoring.
Stated by Whittington Health NHS Trust -
Action
Recruit substantive and bank district-nursing staff through local and international recruitment.
Stated by Whittington Health NHS Trust -
Action
Work with regular agency staff to support their transition into permanent employment through flexible options.
Stated by Whittington Health NHS Trust
Data last updated 7 September 2026