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Nursing staff shortages costing NHS trusts £1.5bn a year in agency and bank fees


Trusts in England are spending £1.46bn a year on agency and bank nurse shifts in order to plug gaps in permanent nursing staff, according to a report published today by academics.

The bill for temporary staff would be enough to pay the salaries of 66,000 newly qualified registered nurses – more than filling the 38,000 existing vacancies, according to the Open University.

“The real figure could be as high as £2.4bn if extrapolated to cover all trusts”

Open University report

The university has based its estimates on data collected under the Freedom of Information Act, which it has published today in a report titled Tackling the Nursing Shortage.

The data from the 146 trusts that responded revealed that, collectively, they spent at least £1.46bn on temporary nursing staff, either from the bank or from external agencies.

“But the real figure could be as high as £2.4bn if extrapolated to cover all trusts,” warned the report. “Temporary nursing staff is expensive,” it added.

Put another way, the trusts paid for an additional 79 million hours of registered nurses’ time at a premium rate – 61% above the hourly rate of a newly qualified nurses in full-time employment.

Based on the difference in cost, the university calculated that the NHS could save as much as £560m a year if current vacancies were filled permanently.

“Relying on temporary nurses to plug gaps is just sticking a plaster over the problem”

Jan Draper

Meanwhile, a survey of 500 nurses and healthcare support workers also commissioned by the university for the report revealed that 76% of registered nurses expected the shortage to worsen in the next 12 months and 61% believe even more temporary staff will be needed.

The university highlighted that poor retention was a problem in the NHS, with issues around pay, workload, organisational culture and access to continued professional development all driving nurses to others sector or out of the profession altogether.

As previously reported by Nursing Times, the university noted that Brexit had also seen a 28% rise in European Union nurses quitting the UK, which could further exacerbate the staffing problems.

In addition, the survey found that 34% of registered nurses were unhappy in their current role and 35% were thinking of leaving their job if things do not improve.

The university noted that retention was particularly problematic at the beginning of nurses’ careers, as well as highlighting the recent fall in course applications in the wake of the move to scrap bursaries.

Providing alternative ways to study to become a registered nurse is one suggestion for tackling the shortage, according to the university.

“These figures expose the utter false economy in current NHS staffing”

Janet Davies

In its survey, 63% of registered nurses believed offering flexible distance learning would help to recruit nursing students from more remote areas and keep nurses in these areas after they qualify.

In addition, 71% believed that apprenticeships could help to attract new student nurses to the profession and 60% believed that it offered a good alternative to the recently removed bursaries.

The government has recently introduced plans for both degree-level nurse apprenticeships and the new nursing associate role, which it also envisages people being trained for via apprenticeships.

The university’s report concluded that an increased focus on work-based training and apprenticeships could, therefore, offer a more stable long-term approach to education.

Jan Draper, professor of nursing at the Open University, said: “The sector is facing challenging times. Relying on temporary nurses to plug gaps is just sticking a plaster over the problem, and costs considerably more than if vacancies were filled permanently.

Open University

Jan Draper

Jan Draper

“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,” she said.

“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,” said Mr Draper.

She added: “Not only can this approach inspire and motivate the workforce, it can also increase future nursing supply and reduce retention issues in local communities, helping to reduce the strain on the sector.”

Commenting on the cost of temporary staff, Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “These figures expose the utter false economy in current NHS staffing.

Royal College of Nursing

Pay rise above 1% ‘needed to ease nurse crisis’

Janet Davies

“Short-sightedness in recent years has left tens of thousands of unfilled nurse jobs, to the severe detriment of patient care,” she said. “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,” said Ms Davies.

She added: “It is a failure of politicians and policymakers to recognise the value of nursing. Ministers should look at these figures and demonstrate they have the political will to fix the shortages.”


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Readers' comments (5)

  • Bank staff should not be aligned with agency staff. The former are usually paid band 5 or band 6 rates and are generally showing support for the NHS.

    Agency staff are paid far more, often seem less engaged and lets face it are taking advantage of an NHS in staffing crisis.

    It is appalling that Bank staff who regularly work for one Trust are not allowed to complete a staff survey.

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  • I am a Sister. Yes, previous comment is correct. We also need to consider how hard our HCA's work. They are the front line of nursing. They deserve a qualified nurse working with them for observation, supporting safety, to understand issues and guide. There again, we are not in the 80's or 90's. Nurses are now virtually pharmacy. Bank nurses should be recognised more. Nurses should be able to be nurses more.

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  • I really think that if all NHS Nurses and Allied Professionals were Agency paid it would save our healthcare a fortune as hospital would not need to submit to pension schemes, Holiday pay will not be required, sickness would decline. Which would give the NHS more stability. But ask yourself why do healthcare workers leave the NHS and join the agency?

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  • Non-EU nurses fail their paces for minor reasons at Northampton and Oxford universities at a great cost to trusts and companies.

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  • Fail their Osce exam

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