Caps on spending on agency staff in the NHS in England have been "largely unsuccessful" in luring temporary staff to work in the health service, a new report has found.
In 2015, health officials announced a package of measures to clamp down on agency spending, including caps on the hourly rates, after it emerged that the NHS in England spent more than £3 billion on agency workers in 2014/15.
The health service saved £600 million in the year since the cap was introduced.
One of the intentions of the price caps was to encourage people to return to substantive positions within the NHS, according to the latest report which delves into the use of agency workers in the public sector.
But the authors conclude that efforts to lure agency workers back to the NHS have been largely unsuccessful.
The report, conducted by the National Institute of Economic and Social Research, states that there have been "no noticeable, widespread increase in temp-to-perm transitions" since the cap was introduced.
NHS staff who moved to agency work were less motivated by money and are lured to the work because of a better work-life balance and more flexibility, the authors found.
Ex-NHS staff also said they were motivated to leave to "escape" permanent positions in the health service, reporting experiences of high workload, poor working conditions and short-staffed wards, poor work-life balance and impact on their personal lives.
Report co-author Nathan Hudson-Sharp, a researcher at the National Institute of Economic and Social Research, said: "Current rules around agency spending in the NHS seem to only address the symptoms of the problem.
"What they fail to do is tackle the underlining issue of demand continuing to outstrip supply.
"The future of agency working in the NHS would therefore seem to rest on implementing an approach that is much more comprehensive, and that would enable NHS employers to address underlining issues around staff shortages, training, workforce planning, recruitment and retention."
The research, commissioned by the Office of Manpower Economics, examined problems with staffing in the NHS including geographical difficulties and recruitment and retention issues.
Following interviews with NHS employers, agencies and agency staff, the authors found that employers generally supported the price caps because the caps had enabled them to reduce rates paid to agencies.
But some raised concern about the amount paid to medical locum agencies. The authors estimated that nine in 10 locum doctors were still getting paid above the capped rate.
Some employers described a situation of having to break the cap in order to win a "bidding war" with neighbouring trusts where there was a limited supply of agency staff in the area.
And employers had "mixed views" on the quality of agency staff - with some saying a reliance on such workers was directly to poorer health outcomes.
NHS Improvement said measures to curb excessive agency staff spending are "continuing to have a positive impact".
The organisation said there had been a £505 million improvement in its spending over the past nine months.
Spending on locum and agency staff in December last year was £228 million - 24% lower than in December 2015.
More than two-thirds of NHS trusts have reduced their agency spending since the introduction of the new rules in October 2015.
Dr Mark Porter, chairman of council at the British Medical Association, said: "These figures are further evidence that locum caps do not and will not address the root causes of the growing recruitment and retention problems in the NHS.
"As NHS trusts continue struggling to fill permanent posts, the Government must look at why.
"It is vital that, to improve working conditions and attract doctors to the NHS, we tackle the underlying issues such as an unprecedented workload and dwindling resources, which are causing staff shortages across the health service."
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