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Agency waste would fund 3,300 full-time midwives


Last year the NHS spent over £72m on agency, overtime and bank midwives, which is enough to solve the midwife shortage if it was spent on recruiting permanent staff, according to a union.

The money would pay for around 3,318 whole-time equivalent midwives, according to a report published today by the Royal College of Midwives ahead of its annual conference next week.

“Women’s outcomes improve when they see the same team of midwives”

John Skewes

The report – titled Agency, Bank and Overtime spending in maternity units in England in 2015 – is based on a Freedom of Information request to all 123 NHS trusts in England with maternity services.

The FOI, which asked how much they had spent on agency and bank staff and overtime each month in 2015, was responded to by 91.5% of the trusts.

Along with a number of spending patterns, it revealed that the total cost of agency maternity staff in the NHS during 2015 was £24,950,157.

Meanwhile, the average spends per hour on agency staff was £41.25 and the highest average monthly spend was in December 2015, when spending peaked at £50.58 per hour.

In addition, the RCM calculated that the NHS spent £4,522,440 on overtime for midwives in 2015 and £43,225,603 on bank midwives. The average spend per hour for bank staff was £25.63 per hour.

In total, NHS organisations spent £72,698,200 on agency, overtime and bank midwives, according to the college, which believes England is currently short of around 3,500 midwives.

It calculated that £72,698,200 was enough to pay for 2,063 full-time, experienced midwives – paid at the top of band 6 at £35,255 a year – or 3,318 full time, newly qualified midwives with a starting salary of £21,909.

Perhaps unsurprisingly, the RCM found 12 of the highest 20 spenders on bank, agency and overtime were London trusts (see list below). The FOI revealed that 23 trusts spent over £1m pounds on agency staff alone.

Royal College of Midwives

Unions attack ‘ill-informed’ bursary reform plans

Jon Skewes

Jon Skewes, director for policy, employment relations and communications at the RCM, said: “An over reliance on temporary staff is clearly more expensive than employing the correct number of permanent staff and needs to be corrected sooner rather than later.

“For the £72m that the NHS spent on temporary midwives, it could have employed enough midwives to have stemmed the shortage in 2015. Indeed, it could solve the midwife shortage,” he said.

He added: “Women deserve high quality and safe care and evidence shows that women’s outcomes improve when they see the same team of midwives.

“The way for trusts to provide this is to ensure their units are staffed correctly with the right numbers of permanent midwives rather than relying on temporary staff,” said Mr Skewes.

Labour shadow health minister Justin Madders said: “These figures show a shocking increase in reliance on agency midwives.

“They are symptomatic of a growing staffing crisis in our NHS,” he said. “The rocketing reliance on agency midwives is totally unsustainable and is a legacy of six years of Tory under investment.

“There has been a total failure to recognise that it is the NHS staff who keep the health service going and they need to be respected and motivated properly,” he added.

The RCM’s annual conference will take place on 19-20 October in Harrogate.

Top 20 trusts with highest total midwifery agency, bank and overtime spend in England during 2015

  • King’s College Hospital NHS Foundation Trust
  • Barts Health NHS Trust
  • Chelsea and Westminster Hospital NHS Foundation Trust
  • West Hertfordshire Hospitals NHS Trust
  • Lewisham and Greenwich NHS Trust
  • Royal Free London NHS Foundation Trust
  • Southend University Hospital NHS Foundation Trust
  • London North West Healthcare NHS Trust
  • St George’s Healthcare NHS Trust
  • Guy’s and St Thomas’ NHS Foundation Trust
  • University Hospitals Of Morecambe Bay NHS Foundation Trust
  • Croydon Health Services NHS Trust
  • University College London Hospitals NHS Foundation Trust
  • Homerton University Hospital NHS Foundation Trust
  • Barking, Havering and Redbridge University Hospitals NHS Trust
  • Mid Essex Hospital Services NHS Trust
  • Maidstone and Tunbridge Wells NHS Trust
  • Central Manchester University Hospitals NHS Foundation Trust
  • Heart of England NHS Foundation Trust
  • Peterborough and Stamford Hospitals NHS Foundation Trust

Readers' comments (5)

  • Until work conditions and standard of work colleagues improves in the NHS then many people like myself will choose to work for agencies. Yes the money could be spent on recruiting new staff but a big problem is retention, especially with the NMC trying it's best to get people to leave the profession!!

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  • Our unit don't use agency midwives just leave us short - 2 -5 mw down each day 😳

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  • Well I agree with the first comment and if agency staff aren't used and we are dangerously short more of us will end up st the nmc !

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  • It's rather misleading as its pre capped rates and so both pay and charge rates will of dropped dramatically this year.
    Agencies are a very easy target to cover the many failings of the NHS.

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  • Where are you going to get 3,318 Midwives....there is an Obvious Shortage and difficulty in retaining Nurses.

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