‘False economy’ as NHS trusts pay £1.4bn for agency staff

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A hospital staffing crisis saw NHS trusts in England spend more than £1.4bn on agency nurses last year, it has emerged.

The bill was enough to pay the salaries of an estimated 66,000 newly qualified nurses, and more than fill the 38,000 existing vacancies, a report by The Open University claims.

Temporary agency and bank nurses were brought in to plug the gaps in staffing for a total of 79 million hours last year. And they were paid 61 per cent above the hourly rate of a newly qualified nurse.

If all current vacancies were filled permanently, the NHS could save as much as £560m a year, it is estimated.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing (RCN), said the figures exposed the “utter false economy in current NHS staffing”. She added: “Short-sightedness in recent years has left tens of thousands of unfilled nurse jobs, to the severe detriment of patient care.

“Workforce planning has been ineffective and dictated by the state of finances, not the needs of patients. It is further proof that cost-cutting plans saved no money at all and, instead, increased agency costs, recruitment fees and the sickness absence bill through rising stress.

“Ministers should look at these figures and demonstrate they have the political will to fix the shortages.”

Only 146 of the 241 hospital trusts provided agency spend figures in response to a Freedom of Information Request, meaning the total bill is likely to have been far higher.

Jan Draper, professor of nursing at The Open University, said relying on temporary nurses was a “sticking a plaster over the problem”. She said: “We know that poor retention and low recruitment results in inefficiencies and ultimately puts patient care at risk, so it’s vital that we look to a more strategic and sustainable approach.

“Taking advantage of recently introduced degree apprenticeships that offer flexible work-based learning is one solution, making use of funding already ring-fenced to pay for training while opening up new routes into the profession.”

The health service regulator NHS Improvements sets individual limits for the amounts hospitals are allowed to spend on agency staff.

Among organisations which managed to stay within its limit last year was Leeds Teaching Hospitals NHS Trust, which reduced its annual agency spend by £20m compared to three years ago.

The Leeds trust paid out £18m for agency staff in 2017-18 after being set a limit of £26m.

Director of Human Resources Dean Royles said: “We employ nearly 18,000 staff and use a huge range of initiatives to try to ensure we operate clinical rotas and non-clinical duties as efficiently as possible. We have increased our headcount by around 3,000 staff over the last three years or so.” Wakefield-based Mid Yorkshire Hospitals Trust spent £30.4m on agency staff, £7.5m more than its target, according to a report to its last board meeting.

The Open University report was released after an RCN survey found that nearly three quarters of adults believe there are too few nurses to provide adequate care.

A Department of Health and Social Care spokesperson said: “From this year we will train 25 per cent more nurses, are committed to helping them work more flexibly to improve their work-life balance, and have awarded a pay rise of between 6.5 per cent and 29 per cent in a deal backed by the Royal College of Nursing themselves.”