NHS spending on agency and locum staff up 20% in last year hitting £3 billion in England
A lack of doctors and nurses in the NHS is forcing bosses to pay high rates for agency staff, new analysis shows.
Dr Sarah Clarke, president of the Royal College of Physicians, said there is a “significant cost” to paying agency workers to fill rota gaps but the move is needed to keep patients safe.
Figures from the BBC show spending on agency staff rose 20% last year to hit £3 billion in England.
It said that, for many shifts, bosses have been so short-staffed they have been willing to breach Government pay caps for agency workers, most of whom are doctors and nurses.
Separate data supplied by Labour shows some NHS trusts have paid as much as £2,500 to nurses to fill shifts. There are currently almost 47,000 nursing vacancies in the NHS.
Dr Clarke, a cardiologist, told BBC Breakfast: “Staff shortages have meant that we’ve had to dip into the public spending and pay for agency and locum staff and this of course comes at a significant cost.”
She said some staff want to work as locums as it pays more, gives more flexibility and “takes them away from some of the terms and conditions that are unpopular”.
One fix for the issue would be to employ more doctors, she said.
She added that doubling the number of medical students to 15,000 would cost £1.8 billion per year – cheaper than the cost of agency staff.
Asked about agency staff making much more money than regular NHS workers, she said: “Unfortunately, they are employed by agencies so the agency sets the fees.
“If we are short-staffed, we have to go and get more staff because this is about patient safety. We have to have people there to care for our patients.
“But (in) the longer term, it is fixing the workforce issue.”
She said using agency staff is a short-term fix but the Government needs to produce a workforce plan on how it intends to staff the NHS long term.
NHS leaders, charities and think tanks have been repeatedly calling on the Government to publish a workforce plan.
One cancer doctor told the BBC he was offered £130 an hour – well above the cap for his role – and described the fees available as “astonishing” and a reflection of “desperation by management”.
The BBC also reported evidence of aggressive marketing by agencies, which take a cut of the shift pay, with one boasting it is the “best” time to try it, because the fees that can be commanded are increasing.
Agency pay rates are capped at 55% above what a normal employee would receive.
But for nearly nine in 10 agency shifts for doctors and dentists, and four in 10 for nurses, the caps were exceeded last year.
NHS bosses can only do this if there is a significant risk to patient safety.
Siva Anandaciva, chief analyst at the King’s Fund think tank, told the BBC the NHS is caught in a “vicious cycle”.
He said a combination of staff shortages, Covid sickness absences and rising demands is driving the increase in reliance on agency workers.
Shadow health secretary Wes Streeting called it an “infuriating” use of money.
“Taxpayers are picking up the bill for the Conservatives’ failure to train enough doctors and nurses,” he said.
A Department of Health and Social Care spokesman said: “We have a clear policy to reduce agency spend through capping the hourly pay of agency and temporary staff, ensuring they are only hired through approved NHS agreements to ensure value for money and prioritising NHS staff rather than external agency staff where extra shifts need filling.
“These measures have seen agency spend fall by a third overall between 2016 and 2021.
“We have also commissioned the NHS to develop a long-term workforce plan to help recruit and support NHS staff and we have given over one million NHS workers a pay rise of at least £1,400 this year.”
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