Ministers are facing calls to tackle the chronic understaffing in the NHS as figures show the bill for hiring temporary frontline workers has risen to more than £10 billion a year.
Hospitals and GP practices in the UK are paying a record £4.6 billion for agency staff and a further £5.8 billion for doctors and nurses to do extra ‘banking shifts’ to fill gaps in rosters.
Widespread staff shortages have increasingly forced the agency in all four home countries to hand over colossal sums to employment agencies to hire substitute workers. In England alone, the bill for agency workers, particularly nurses and GPs, has risen from £3 billion to £3.5 billion in the past year – an increase of 16%.
Wes Streeting, the shadow health secretary, said years of neglect of the growing NHS staffing crisis by Conservative governments have forced “desperate” hospitals to spend “huge” sums on agency staff, including doctors who can cost more than £5,000 to work in to take service. single service.
The Royal College of Nursing said spending on agencies was “staggering”. It would be cheaper to hire more nurses rather than have tens of thousands of vacancies, general secretary Pat Cullen said. The NHS in England currently has 42,306 vacant nursing posts.
NHS spending on bank staff – who work extra shifts in their own hospital or a nearby hospital to earn extra money – has risen even more sharply than agency spending. In England this has more than tripled from £1.8 billion in 2015/2016 to £5.8 billion in 2022/2023, according to a report by specialist healthcare data analyst LaingBuisson.
Spending on agency workers in general – agency workers and bank staff – has “skyrocketed” in recent years as Covid has led to an already understaffed NHS coming under greater pressure due to increased demand for care and political pressure to eliminate the backlog, LaingBuisson discovered.
Many parts of healthcare – including emergency departments, maternity services, GP practices and intensive care units – are struggling to overcome severe and long-term staff shortages. Lack of staff is forcing hospitals to cancel surgeries, postpone treatments and even delay induced births of babies.
“The sums of money spent by the NHS on temporary staff have exploded in recent years,” says Tim Read, director of research and content at LaingBuisson.
A tougher approach by the NHS in England in 2015/16 to the use of agency staff led to health trusts reducing the amount they spent on them from £3.63 billion that year to £2.38 billion in 2019/20 . But interest rates have since crept back up and reached £3.46 billion in 2022/2023, the company found.
“Our analysis shows that expenditure on temporary staff is skyrocketing. The amount of money spent on temporary staff through recruitment agencies has grown enormously over the past two years,” Read said.
“If you take into account the amount of money also spent on bank staff, NHS spending on non-permanent staff will reach over £10 billion in 2022/2023.”
Trusts in England are paying up to £5,234 to hire an agency doctor and up to £2,140 for an agency midwife to work a single shift, Labor research has found. The Northern Care Alliance trust in Greater Manchester spent £21 million on agency doctors in 2021/22 and £16.7 million in 2022/23 on midwives it hired through agencies.
“These amounts going to agency staff are truly staggering when there are tens of thousands of vacant posts. It’s just not right,” Cullen said. It would be more cost-effective to increase the NHS’s recruitment and retention of nurses by paying them better, she added.
Employment agencies such as Acacium Group and Medacs Healthcare have seen their incomes rise sharply in recent years as a direct result of the NHS’s growing reliance on healthcare staff they supply, the Health Service Journal reported in October 2022.
NHS England said health funds are now spending less on agency staff than before and also less as a percentage of the service’s total expenditure this year. But it provided no figures to support either claim.
However, LaingBuisson figures show that the NHS in England spent £3.46 billion on agency workers in 2022/2023 – £471 million more than the £2.99 billion the year before. The percentage of the total annual spend of £9.3 billion on temporary staff used to hire temporary staff increased slightly over the period.
An NHS England spokesperson said: “Despite record pressure and unprecedented periods of industrial action, the NHS has reduced the amount of money spent on agency staff, both in absolute terms and as a percentage of expenditure this financial year.
“The NHS will continue to reduce agency dependency over the coming years by training more NHS staff domestically and retaining more existing staff, as part of the NHS Long Term Workforce Plan.”
But Read said the NHS cannot take for granted that the plan would deliver the huge increase in homegrown staff it envisages by 2038. Politicians will have to invest large amounts of money and “demonstrate commitment over several election cycles,” he said.
NHS bosses blame the huge bill for temporary staff partly on industrial action by NHS staff.
“High demand for services, overstretched budgets and staff shortages mean that the NHS too often has to rely on staff from agencies and banks to plug workforce gaps,” said Saffron Cordery, deputy chief executive of NHS Providers, which manages the healthcare trust. represents in England.
“Trusts are doing everything they can to get a handle on agency spending and expensive overtime pay, but on top of existing challenges, wave after wave of industrial action is making it harder to ensure staff wage costs don’t rise significantly,” she says. said.
Furthermore, trusts’ efforts to deliver on Rishi Sunak’s pledge to reduce NHS waiting lists mean they are working “at full capacity” and this “may involve the creation of additional shifts that need to be staffed” , she added.