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College criticises rising NHS financial burden of agency nurses


Short-term workforce planning means the NHS will spend almost £1bn on agency nurses in the 2014-15 financial year, according to the Royal College of Nursing.

A report published today by the RCN warns of a projected spend of at least £980m on agency nursing staff by the end of this financial year if action is not taken – an average of £4.2m per trust. 

“It is now time for serious workforce investment and sensible, long-term workforce planning”

Peter Carter

The report also claims that the cost to the health service of agency nurses has increased by 150% since 2012-13, sparked by a recruitment surge in the wake of several high profile reports – most notably the Mid Staffordshire NHS Foundation Trust public inquiry – demonstrating links between staffing levels and patient safety.

The college’s figures are based on Freedom of Information requests to trusts in England. Requests were sent to all 231 acute, community and mental health and specialist trusts at the end of October, of which 168 responded.

The RCN argues that the money used for agency nurses could have been better spent on recruiting permanent staff to help solve the problem of vacant nursing posts across the country.

It calculated that £980m was enough to pay for 28,155 permanent nursing staff, including senior nurses, and with a mix of different bands.

Peter Carter, chief executive and general secretary of the RCN, said: “This report shows the true financial cost of a health service which takes a ‘payday loans’ attitude towards workforce planning, leaving itself at the mercy of agencies because it refused to invest sensibly in the past.

Royal College of Nursing

Peter Carter

“The NHS is under immense pressure and it is now time for serious workforce investment and sensible, long-term workforce planning,” he said. “Anything less will be selling future generations severely short.”

The RCN’s report follows other evidence on NHS agency spend, revealed earlier in the week.

The Commons’ public accounts committee criticised the Department of Health for failing to make the most of cost-saving opportunities in the way agency staff were used by the NHS.

In a report on the parlous state of the health service’s finances, it highlighted the increasing high costs of hiring temporary medical and nursing staff, which cost the NHS £2.6bn in 2013-14, compared to £2.1bn in 2012-13.

Meanwhile, data revealed by the Welsh Liberal Democrats showed spending on agency nurses nearly doubled in 12 months in Wales and that £60m was used in this way over the last four years.

Freedom of Information responses from health boards showed that in 2013, £12m was spent on agency nurses, but a year later this figure had jumped to £23m.


Readers' comments (20)

  • I wonder if the government know what will happen to this figure if they decide to stop paying us for unsocial hours?

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  • This is one of the reasons there was strike action by several unions (NOT the RCN). The minimal 1% recommended by the pay review body was ignored by the govt. The strike action was effective.

    This information is not news (even though the details might be), so the RCN cannot claim any credit for highlighting it.

    Working conditions, probably more than pay, are a major factor in retaining staff. Enough staff are trained to fill several hospitals, but they will not work full-time, or at all.

    The unions should be much more closely involved with the working conditions of their members, and focus on actions to take to improve them. It's not good enough for the unions to opt out of strike action because it would be "unprofessional", "uncaring" or whatever other excuses the unions use for inaction.

    Their have always been agency workers (don't know about outside the cities) and they will continue for the foreseeable future.

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  • There is a need to long term planning and investment, as it has been for the last 15 years; however, bank and agency nurse will always be part of the NHS workforce, and so they should be. Like politician, the RCN seem to jump on the bandwagon of cheap headlines. Surely agency workers are not represented by the RCN and they still don't understand the need of a temporary workforce otherwise the report would read different.

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  • It's not just poor work force planning..It's also to do with managers who don't care ergo demoralising staff so they leave and this stupid idea of all degree many excellent care assistants cannot train now....
    You don't need a degree to need a degree to glad I am close to retirement...I have a degree I achieved it 30 years after I qualified as an SRN

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  • agencies pay nurses more and? nonoe complains about bankers bonuses funded by taxpayers- all we ever here of is the bankers will go abroad if we don't pay them a lot, but society wants cheap labour from nurses

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  • Do not panic! Do not panic! I'm sure Mr Hunt knows what he is doing!

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  • Having attended the Avon & Wiltshire Mental Health Partnership NHS Trust board meeting on 28 01 2015 where they were discussing the need to approach multiple numbers of agencies to fill staff vacancies and for increasing sickness levels, it concerns me but is no surprise they failed to respond to this FOIA requests for the survey.
    It was mentioned that staff sickness is up due to stress, anxiety and depression , and that for a Sunday shift the highest agency spend for a single doctor for one shift was £1,000 !
    It also concerns me to see that only 70% of the trusts that received a Freedom of Information request actually responded to the requests - despite Legislation stating they MUST ?
    What is happening to our NHS ?

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  • Question for Volker Kellerman.

    The Agency Nurses I know pay their subscriptions to the RCN.

    What did you mean by "surely agency nurses are not represented by the RCN??"

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  • I think looking at why so many nurses are actually ON agency as opposed to anything else is rather "miraculously" ignored....I earn just under £13 an hour basic....if I went into agency work, I would earn a basic of a minimum of TRIPLE this for what I do, though I would not be expected to do half of what I currently do..trusts for example will not allow many agency nurses to cannulate or perform venepuncture. Agency nurses in the most part can choose where and when they work and as has often been said to me, "I just come in, do it and leave the politics at the door", if I had a pound for every time I have heard "I was starting to hate my job, the effect it was having on MY health and my I joined the agency and now I love it" I would be able to give up the job! So there will be knee jerk reactions and trusts will stop employing agency, until they realise they cannot fill the posts and staffing levels are not maintainable, I have seen it happen! Just as I have seen happen the trusts own bank offering shifts at double pay, then stopping it, then realising no one is picking up shifts and re-introducing it. All seems VERY simple yet no one is talking about it!

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  • It's not agency nurses or locum doctors fault that they're paid to cover shortages caused by various factors. It's the market forces and lack of qualified staff which drives up costs. This shows that regular staff are very much under paid, with terms + conditions being eroded.
    Agency staff are only called in when their bank staff are not able to fill the vacant post. If left vacant, compounds the stresses to staff present + increases risks to all patients, both leading to even more costs to an organisation.
    It annoyed me a bit, on the news, inference that agency staff aren't good quality staff. Most probably are, just like everyone, including bank + newly recruited staff, requires appropriate orientation + support. Also some agency staff work to top up their substantive job to make ends meet. Why work bank when agency pays more appropriately. Also there's a reluctance to pay overtime rates when they can ask staff to work on bank to cover extra shifts and staff often work extra without claiming it back.
    Agency nurses could be a member of RCN, Unison, Unite, etc or none - interesting to hear if agency members of striking unions worked on strike days.

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