NHS still wasting £480m a year on temporary staffing from private agencies, watchdog says

Trusts have made significant reductions in agency staff bill but say government workforce planning is major stumbling block

Caps on agency spending have seen the bill fall by a third (PA)

NHS hospital and ambulance trusts in England are wasting £480m a year filling temporary vacancies with staff from private agencies, according to figures released by the NHS financial watchdog.

NHS Improvement data released on Friday shows trusts spent more than £2m on the five highest paid “locum” staff doctors last year, with some agencies charging £480 an hour for one consultant.

The health service is in the middle of a drive to crack down on costly locum doctors, nurses and other staff who sell their services back to the NHS through private agencies but do the same role as their employed peers.

Hospitals are being encouraged to build up banks of employed staff who want to work flexibly instead. These staff cost on average 20 per cent less than the locum route and this money could then be spent on other services.

Trusts said that they have made great strides in cutting locum spending, reducing it by a third since caps were introduced in 2015.

But they stress that bank or locum staff are “sticking plaster” for the 100,000 NHS vacancies that are advertised across the health service in England and which will grow without proper workforce planning and reforms.

While the figures show charges up to £480 per hour for consultants – with a deal of £200 per hour for the next five – the trust would expect to pay £76.10 for senior doctors from their own bank

At least 150 locum doctors have been in these temporary roles at the same trust for more than two years – 14 have been at the same trust for over five years.

Almost 340 nurses have been reported as having worked over two years at trusts.

Improvements to rostering IT systems and new options of flexible working hours have meant fewer staff feel the need to join agencies.

Last year spending on bank staff was higher than for agencies for the first time in several years, leading to a £528m reduction in agency spending for the NHS.

But it is still targeting further savings and has set all trusts in England a target of reducing agency costs by 17 per cent for 2018-19.

NHS Improvement chief executive Ian Dalton said: “Trusts have made fantastic progress in reducing spending on expensive private agency staff over the last three years.

“These savings mean more money for other vital NHS services and ensure every penny the NHS spends counts.

“But there is further progress to be made… an over-reliance on high-cost private agencies when there are other options available is not good for patients or for the NHS’s finances.”

The price cap introduced by NHS Improvement means providers should not spend more than 55 per cent above the basic rate for a staff member.

Any agency shift which costs more than £100 an hour must be signed off by the trust’s chief executive and reported to NHS Improvement.

Deputy director of policy and strategy at NHS Providers, Miriam Deakin, said: “The reliance on agencies across the health and care system is a sticking plaster solution for the growing number of vacancies across the NHS and the increase in demand for services.

“Although temporary staff continue to play an important role in the NHS staffing mix, we urgently need a long-term approach to staffing that is underpinned by a comprehensive workforce strategy.”