Recruiters at recent seminars on the health checks for staff placed in the National Health Service have complained that the rules sometimes lack clarity and pose difficulties for implementation.

The seminars, run by occupational health firm Healthier Business Ltd in Nottingham and Birmingham, were designed to help recruitment agencies comply with the NHS Purchasing and Supply Authority (PASA) regulations.

Many agencies supply staff through NHS Framework agreements (Recruiter, 3 May), and therefore need to investigate candidates' medical histories, including immunisations.

For example, all healthcare staff must be immune to rubella, or German measles. This requires documented proof of vaccination, or a blood test showing immunity. Depending on their level of contact with patients, some candidates may also need to show that they are free from Hepatitis C.

Many recruitment agencies that supply the NHS have their own occupational health advisers — usually a nurse, qualified to degree or diploma level. However, some do not have such specialists. And even those that do often find the requirements of PASA daunting.

One recruiter pointed out that it can be hard for laymen to question data supplied by candidates for positions such as hospital doctors.

And Ian Scott of London-based Dream Medical told Recruiter: "The requirements vary, depending on who you speak to. The goalposts always seem to be changing. We're in the framework, but haven't supplied anybody yet. It seems the bigger firms have a monopoly."

Healthier Business can advise on whether a candidate's documentation is likely to be acceptable by PASA, and individual NHS trusts. More than 20 agencies use its services, including PJ Locums, Mediplacements and Doctors on Call.

Roy McAllister, managing director of Healthier Business, said: "Some [candidates] will chance their arm and use bully boy tactics. We hope you have enough savvy to spot the obvious ones."

A spokesman for PASA said: "Our national team has frequently invited suppliers to contact the team for advice at any stage during the framework. If any supplier needs clarification, our team is available to give advice at any time."

The Recruitment and Employment Confederation has denied claims in the Daily Mirror that the NHS is “wasting” up to £300m on agency staff. External relations director Tom Hadley told Recruiter. “This is a nonsensical figure, and we’d like the Department of Health to be more bullish in challenging it. The agency commission part pf it is small. It’s mostly wages for a frontline service. How is that a waste? Trusts have massively reduced the margins that agencies are charging.”