NHS Bill For Agency Nurses Tops £1bn

The NHS is still spending too much on stand-in nurses to cover absences, with the 2005 bill topping £1bn, MPs say. The House of Commons Public Accounts Committee pointed out this was 9% of the total nursing budget.

Chairman Edward Leigh said reliance on agency staff could compromise patient safety, a claim which angered the body which represents temporary NHS workers.

The Nurses Agencies Association said temporary staff have the right skills, and are good value. The number of nurses employed permanently by the NHS rose by 55,000 between 2000 and 2005, the period covered by the report. However, hospitals continued to pay their own staff to work extra shifts, or to take temporary staff from either an NHS-run body or independent agencies. The amount spent across England rose by almost 40% during this time.

The committee’s report said it was significantly more expensive for the NHS to bring in an agency nurse compared with the standard rate of pay for an equivalent permanent nurse. It said the NHS was not planning properly to minimise the use of agency staff.

Edward Leigh said: “Too many trusts are relying on temporary nurses to mask their inability to manage their permanent staff properly. This is not simply a point about wasting money. The use of temporary nurses might be compromising patient safety. At least 39% of temporary staff are not receiving supposedly mandatory basic life support training.”

However, since 2005, the emergence of severe financial deficits in the NHS has prompted many trusts to introduce severe restrictions on the use of agency staff. In many cases, wards cannot book staff to cover illness or holidays without the direct authorisation of a trust director. In most areas, a single agency has been selected to supply nurses to trusts after a tendering process to drive down prices.

Steven Rubel, from the Nurses Agencies Association, which represents private agencies, said it was “nonsense” to suggest that patient safety was put at greater risk through agency staff. He said: “At least 80% of nurses signed up to private agencies are actually working in the NHS at the same time – so if they don’t have the required training, that’s a real indictment of the NHS in general, not nursing agencies.

He also denied that using agency staff was a more costly alternative. “At the moment the commercial relationship between agencies and the NHS is murderous. There’s no respect.”

Conservative Shadow Health Minister John Baron said: “It is deeply concerning that NHS trusts are spending so much on temporary staff when vacancies for permanent staff are being frozen as a result of financial deficits. Newly qualified nurses are leaving training unable to find their first proper job while excessive use is being made of temporary staff.”

Health Minister Lord Hunt said that spending on agency staff had now fallen to 3% of the total nursing expenditure in the NHS. He said: “The NHS has made real progress in driving down the cost and the use of agency staff. Patient safety is paramount and it is the responsibility of both the NHS trust and the supplying agency to ensure that all nurses receive and place on their record mandatory health and safety training.”