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Exclusive: agency nurse use rockets in wake of staffing cuts


Use of agency nurses by the NHS has jumped by 50% in a year and is quickly rising, Nursing Times has learnt, calling into question widespread cuts being made to posts in order to save money. 

The number of acute and community shifts filled by agency staff in England rose from around 14,000 during January to March 2011 to roughly 21,000 during the same three months in 2012, suggests a report seen by Nursing Times.  

The document also reveals burgeoning demand across the NHS for temporary shift work. Requests for both bank and agency shifts during January to March 2012 were up 18% to 155,000, compared to the same period 12 months before.

The report was compiled by NHS Professionals, which provides much of the health service with bank staff. It was based on data from 70 trusts across England and covers nursing bands 2 to 6.

Worst affected was the North where temporary shift demand was up 24% in January to March 2012 compared to the same three months in 2011. The South of England saw demand jump 12% and in London demand rose by 13%.

The findings appears to contradict many trusts’ claims they are looking to reduce spend on agency staff due to the higher associated cost, and increased risks to quality and safety created by reductions in continuity of care.

The report said: “After reducing for two consecutive years, shift demand has increased steadily from summer 2011, and greatly accelerated from January through to March 2012.

“Much of the additional demand seen in the last six months was unforeseen, with many trusts actually forecasting reduced shift demand. This raises the question of the root cause of the unexpected increase in demand for additional staff and how long it might be sustained.”

NHS Professionals suggested a number of potential causes, including underestimation of referral numbers and delayed discharge of patients as well as recruitment freezes and post cuts. 

Peter Griffiths, chair of health services research at Southampton University, said the increases were surprising. It could either mean demand was outstripping supply, or that trusts were cutting back on workforce and relying on temporary staff to fill shifts, he said.

“Agency staff are a very expensive option,” he said. “It is difficult to see how this is good value for money. You are employing someone who is less effective and costing more.”

Professor Griffiths warned that increasing agency use might lead to bank staff moving to agencies, because the rates of pay were often better. This would exacerbate the problem, as trusts would be forced to turn to use agencies due to falling bank capacity.

However, the report was seized on by unions as evidence that austerity measures were leaving parts of the NHS understaffed.

Royal College of Nursing chief executive and general secretary Peter Carter told Nursing Times: “You can’t take out hundreds of nursing posts and expect life to just carry on. It’s a false economy.

“The agency mark-up will be phenomenal. This is an ill-conceived way of trying to go about saving money.”

Unison head of health Christina McAnea echoed this view, saying the increase in temporary staff use showed the impact government cuts were having.

She said: “This huge dependence on agency staff is a clear indication that staffing levels are inadequate, and scuppers the hard work that has been done over the last 10 years to reduce agency spend across the NHS.

“The enormous staffing pressures facing nurses in hospitals needs to be addressed urgently, and plugging the gaps with agency staff is not a viable or cost effective solution to the problem.”

She added: “It will cost hospital trusts far more in the long run – financially and in terms of the valuable experience permanent staff develop over time.”

Philippa Slinger, chief executive of Heatherwood and Wexham Park Hospitals Trust, successfully reduced agency spend from £1.5m in September to £800,000 at present, by employing 300 permanent staff.

She said the report revealed a “surprising” trend given the current economic climate. “Every chief executive knows agency costs a lot of money and can compromise your quality,” she said.

NHS Professionals refused to release to Nursing Times the precise numbers behind the percentages highlighted in its report.

In a statement it said the trend was “disappointing”. “This increase in demand is representative of trusts struggling to maintain the right staffing levels to meet real changes in their needs,” it added.

However, a Department of Health spokesman claimed the report did not “reflect the national picture” and said the DH was confident the NHS would hit its £300m savings target for agency spend by the end of 2013-14.

He said: “We are reducing our spending on agency staff by re-negotiating contracts nationally to get the best possible staff at the best possible price, and hope all NHS organisations will use the new contracts. Since most agency staff are used to cover sickness absence, we are working with hospitals to improve staff health and wellbeing.

“Local healthcare organisations are best placed to decide how many doctors, nurses and other health professionals they need to care for their patients,” he added. “Where there are changes to the size and shape of the workforce senior doctors and nurses must be involved at all stages and the quality of patients’ care must be maintained or improved.”



Readers' comments (47)

  • This is hardly an exclusive. It's common knowledge. It's also hardly shocking, its yet another example of the moronic and inept management and leadership decisions we have to put up with.

    "We have to save a load of money, I know, we'll get rid of a load of nurses!"
    "Great idea! Oh crap, there's no staff left and everyone is dying!"
    "Quick! Get a load of bank and agency staff in at more expense!!!"

    f****** muppets!

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  • anybody out there who did not see this coming ???

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  • It has happened before and proved a very costly exercise and a false economy as well as a threat to stability in ward teams affecting continuity of care and thus impacting on the quality of nursing.

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  • totally agree with anon 7.35am

    managers eh what a load of ****heads

    couldnt run a bath!!!!

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  • Florence

    I would like to see the actual figures to prove that most Agency staff usage is due to sickness/ maternity cover ect.
    When will our management and more importantly our Government learn ???

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  • michael stone

    'Much of the additional demand seen in the last six months was unforeseen, with many trusts actually forecasting reduced shift demand.'

    Ah, forecasts which turn out to be wrong - where have I come across that before !

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  • DH Agent - as if ! | 12-Jun-2012 11:47 am

    why don't you just go back on your holidays.

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  • teresa chinn | 12-Jun-2012 8:00 am, yeah, the managers and chief execs!

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  • The trust that I work at has stopped using bank staff to save money.What do they do Give staff a 50 hour week when needed and give them their hours back within 3 months They also cancel your shifts if ward is quiet and bring you in at a later date. You dont have any social life anymore Its horrendous especially when you have a family. The staff are knackered doing all these hours so eventually therell be more complaints. The ward manager doesnt do these long hours just gives them to the staff. Its disgusting Im coming up to retirement and find these long hours so tiring Cant wait to get out of the place

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  • Anonymous | 12-Jun-2012 3:33 pm

    sounds like you need to manage your managers better. there are laws to protect workers which dictate how many hours they can work without breaks.

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