Healthcare Staffing and Agency Frameworks tender writing

Section 01Service definition

Healthcare staffing is the supply of temporary, fixed-term and permanent workers to organisations that deliver health and social care. The buyer is not commissioning a care service. It is buying access to safe, checked and competent people who work under the buyer's supervision, while the agency remains responsible for their compliance, conduct, pay and replacement.

The setting covers several distinct models, and commissioners expect bidders to understand which one they are bidding for:

• Agency framework: a list of approved agencies that hiring managers call off from, by rotation, ranking, first to supply or mini-competition.
• Dynamic purchasing system: an open list that agencies can apply to join at set rounds throughout its life, rather than once at the start.
• Workforce supply chain: a tiered arrangement where a primary supplier or managed service provider fills roles first and second-tier agencies receive the roles it cannot fill within a set window.
• Staff bank: a pool of flexible workers engaged directly by the buyer or run for it by an outsourced provider, used before agencies are approached.
• Managed service: a single provider manages the whole temporary workforce. A neutral vendor supplies no workers itself and manages a supply chain of agencies; a master vendor supplies workers directly and uses other agencies only where it cannot fill.
• Direct engagement: the buyer engages the worker through its own payroll arrangements, with the agency sourcing and supporting the worker for a fee.
• Temporary to permanent and permanent recruitment: introductions for fixed-term and substantive posts, charged as a placement fee.

Agencies usually act as an employment business when they supply temporary workers and as an employment agency when they introduce people for permanent posts. The two carry different legal duties, and bids are expected to reflect both.

Section 02Typical client cohort

Buyers include NHS trusts and integrated care boards, county, unitary, district and borough councils, children's services and residential children's homes, care homes and home care providers, education providers and not for profit organisations. Councils often open their frameworks to neighbouring authorities and other public bodies through access agreements.

The workers supplied span every staff group the setting relies on:

• Nursing and midwifery, including registered nurses, nursing associates and healthcare assistants.
• Medical and dental staff, including locum doctors.
• Allied health professionals, health science and emergency care staff.
• Adult social care support workers and care workers for residential, day and community services.
• Qualified and registered social care roles, including social workers, senior practitioners, consultant social workers and occupational therapists.
• Children's residential staff, special educational needs roles and educational psychologists.
• Non-clinical roles that keep services running, such as administrative, estates, facilities and ancillary staff.

Demand comes from vacancies, sickness and leave cover, seasonal pressure, new services and urgent same-day gaps.

Section 03Commissioning and procurement context

NHS bodies mostly buy temporary staff through national and regional frameworks and, where they have one, their own staff bank. Councils run agency frameworks, dynamic purchasing systems and worker supply chains, often alongside a managed service provider. Care providers buy agency support directly or through regional arrangements.

• Lots are set by staff group and job type, each with its own role list and price schedule, and often a cap on the number of agencies per lot or per job type.
• Volumes are indicative. Specifications almost always state that there is no guaranteed spend and no exclusivity, so a framework place gives you the right to compete for work, not the work itself.
• Placements are often capped, for example at 12 weeks, before senior approval is needed to extend.
• Terms are typically 2 to 4 years with extension options, and dynamic purchasing systems reopen at regular rounds.
• Evaluation combines pass or fail compliance gates, scored quality questions and a rate card. Many agencies are rejected at the compliance gate before quality is read.
• Agency rates for some roles are held down by price caps and regional agreements between councils, which shape what you can bid.

Section 04Core service requirements

Worker checks before placement

• The six NHS Employers employment check standards for health roles: identity, professional registration and qualifications, employment history and references, right to work, work health assessments and criminal record checks.
• Right to work checks before the first shift, follow-up checks before time-limited permission expires and immediate notification if a worker's status changes.
• References by role type: often one recent reference for roles without a DBS check and at least two covering the last 3 years for roles with children or adults at risk, with a full CV and every gap explained.
• DBS checks at the level the role requires, barred list checks for regulated activity, overseas police checks where relevant, and no worker with an adverse disclosure put forward until a risk assessment is authorised by the buyer.
• Professional registration and revalidation tracking, occupational health clearance, vaccination records and driving checks where the role involves driving.
• No check waived without written consent from the buyer's contract manager.

Training and professional standards

• Mandatory and role-specific training completed before the first assignment and renewed on schedule, mapped to the UK Core Skills Training Framework for health roles.
• Annual appraisal by a more senior practitioner of the same discipline and support for revalidation.
• Photo ID worn at all times and confirmation of each worker's skills and qualifications sent to the buyer before the start date.

Booking and fill

• Response times tiered by urgency, typically an hour or two for shifts starting within 24 hours and several working days for planned roles.
• A booking platform available 24 hours a day, 365 days a year, a staffed out-of-hours telephone line and no premium-rate numbers.
• Limits on CVs per role, written permission from each candidate before you represent them, and minimum notice periods to protect continuity, often longer for child and family social workers.
• Fill rate, time to submit, time to fill and turn-up rate defined and reported.

Managing workers on assignment

• Replacement and no charge for no-shows and unsuitable workers, charges and replacements for late cancellations, and do-not-rebook requests honoured.
• Investigation of safeguarding allegations made by or against your workers, outcomes shared with the buyer and referrals made to the DBS and professional regulators.
• Candidate care: feedback to every applicant, regular contact with workers on site and timely offboarding.

Pay, charging, timesheets and invoicing

• Charge rates broken into worker pay, holiday pay, employer National Insurance, employer pension, the apprenticeship levy where it applies, and the supplier fee, with separate structures for PAYE, inside-IR35 limited company and umbrella workers.
• Pre and post 12-week rates, pay caps, tenure discounts, rebates, transfer fees and temp to perm rules set out in the price schedule.
• Electronic timesheets approved by the buyer, consolidated weekly invoices with every cost shown as a line item, and integration with the buyer's vendor management or purchase-to-pay system.

Contract management and reporting

• A named account manager, monthly performance meetings and key performance indicators.
• Management information on fill rates, spend by worker category and service, assignment dates and extensions, pay and charge rates, expenses, cancellations, starters and leavers, and Agency Workers Regulations and IR35 positions.
• Compliance audits of your process and a sample of worker files, a named compliance lead, responsibility for any subcontracted agencies, and a business continuity plan that protects worker pay above all.

Section 05Regulatory and compliance framework

• Employment Agencies Act 1973 and the Conduct of Employment Agencies and Employment Businesses Regulations 2003, including the rules on transfer fees.
• Agency Workers Regulations 2010, giving equal treatment on pay and conditions after 12 weeks in the same role.
• Off-payroll working rules (IR35), status determination statements and due diligence on umbrella companies, including checking that the key information document matches the payslips.
• National Minimum Wage and National Living Wage, working time rules and holiday pay.
• Right to work and illegal working legislation, the Immigration, Asylum and Nationality Act 2006 and the Immigration Act 2016.
• Safeguarding Vulnerable Groups Act 2006 and DBS barring referral duties, and the Children's Homes (England) Regulations 2015 for workers in children's homes.
• Professional regulation by the NMC, GMC, GDC, HCPC and Social Work England, and indemnity requirements for regulated professionals.
• UK GDPR and the Data Protection Act 2018, with agencies usually acting as an independent controller for candidate data.
• Equality Act 2010 and the buyer's Public Sector Equality Duty, and WCAG 2.2 AA accessibility for worker-facing systems.
• Workers must meet the expectations of the regulator for the setting they work in, such as the CQC or Ofsted.

Section 06Key operational challenges

• Filling hard-to-recruit roles quickly while competing with other agencies for the same workers.
• Keeping every worker file audit-ready when checks, registrations, visas and training all expire on different dates.
• Pricing within rate caps and regional agreements while covering every on-cost and staying viable.
• Managing IR35, umbrella company and Agency Workers Regulations risk across a mixed workforce.
• Last-minute cancellations, no-shows and replacement at short notice, out of hours and at weekends.
• Winning work when you sit behind a managed service provider or a staff bank in the order of supply.
• Integrating with each buyer's booking, timesheet and invoicing systems.

Section 07How we approach this setting

We read the specification, lots, price schedule, call-off terms and every returnable in full, then confirm which lots and job types you can genuinely supply and evidence. Every answer is built from your own compliance procedures, booking systems, audit results and fill data, and mapped to the published scoring criteria. We test your rate card against the caps and the commitments in your method statements, so the bid you submit is one you can deliver.

Section 08Typical starting points we handle

Agencies bidding for their first public sector framework, agencies joining a council dynamic purchasing system at a new round, established agencies adding lots, staff groups or regions, agencies moving from second-tier supply towards a primary role, and agencies whose compliance evidence is strong in practice but not yet packaged for evaluators.

Section 09Outcomes we work towards

Framework and dynamic purchasing system places across the lots that suit your workforce, compliance submissions that pass the gate first time, rate cards that are competitive and workable, and a supply model you can mobilise within the buyer's timescale.

Section 10Where this applies

NHS temporary and permanent staffing, council agency frameworks and worker supply chains, staff bank and managed service arrangements, children's and adult social care staffing, and staffing call-offs from care providers and other public bodies.