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Foundation trusts overspend on agency staff

The foundation trust sector massively overspent on contract and agency staff in the final three months of last year, data from the regulator Monitor shows.

The sector planned to spend £397m on such staff over the quarter ending on 31 December but it actually spent £977m – an overspend of 146%.

All types of trusts overspent on contract and agency costs, but the problem was most pronounced in the acute sector – where there was a 152% overspend – and among mental health trusts, which overspent by 141%.

According to review by Monitor, the variance was partly explained by “labour market factors”, such as difficulties recruiting nurses and middle grade doctors.

However, the regulator said the size of the overspend also suggested “poor workforce planning”.

It added that some trusts had highlighted increased staffing in response to the Francis and Keoth reviews – both critical of clinical understaffing – to explain the variance compared to planned costs.

The overspend on contract and agency staff is part of a wider picture of deteriorating financial performance among foundation trusts, although the sector seems to be maintaining operational performance despite this.

Of 147 foundation trusts, 39 are in deficit; more than the 24 which had planned to be in deficit and almost double the level at the same period last year (21).

The combined deficit of these trusts was £180m – £12m higher than the £168m expected. Monitor said 60% of the overall deficit could be attributed to five organisations, all of which are subject to regulatory action.

The most challenged region is the Midlands and East.

Readers' comments (5)

  • full time nursing job, slow career progression, more responsibility or pick your shifts for double the money and reduced workload and responsibility = no brainer!

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  • I am one of the agency nurses that foundation trusts are overspending on(have been full time in the past)....without us lots of departments couldn't open/run & it would be dangerous, & sometimes we give better care than the full-timers.

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  • Anonymous | 5-Mar-2014 6:50 am

    I am sure you are perfectly correct but it should be the exception rather than the rule. sometimes it cannot be avoided but if it is a common and regular occurrence obviously it is far too costly and staffing levels should be looked at. experienced agency staff returning to their own hospital and area of work they are familiar with can be of great benefit but this is often not the case.

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  • Anonymous | 5-Mar-2014 7:18 am

    It is a regular, common occurence and I agree staffing should be looked at because there isn't enough nurses period from what I can see. Wards/departments quite often keep booking the same agency staff because they know them, how they work etc and sometimes you feel like (and get treated like) you're permanent staff. And this is usually a good thing because both sides know how the other works & it's a theorectical win win all round. Though sometimes I look around and realise that 70-85% of the staff I'm working with on a particular day is agency and then I think 'oh this isn't good...'

    Yet I know sometimes ag staff only look at the hours worked and not WHERE they'll be working, which I think is just as important, yet maybe doesn't happen a lot of the time. Either way, unless Trusts and their hospitals sort out the chronic understaffing (& bad communication....but that's another issue) that is rife & also dangerous to both patients and staff, Foundation trusts will continue to overspend on agency staff. End of story.

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  • Hi anonymous 6.50am - you may be correct in your assertion that you provide good care, I don't think there is any argument about that fact, however as a taxpayer, I believe that the NHS (which I fund) should ensure value for money. Therefore to pay exorbitant prices for a registered nurse from an agency is not a good use of finite resources. Agency nurses should be remunerated at the same rate as those who are employed in the NHS........to do otherwise sends the wrong message to the NHS workforce!

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