The NHS Staffing Crisis: Bill for Temporary Workers Surpasses £10 Billion Annually

Ministers are under increasing pressure to address the chronic shortage of staff within the National Health Service (NHS) as recent figures reveal a staggering annual bill exceeding £10 billion for hiring temporary frontline workers.

Hospitals and GP surgeries across the UK are grappling with a record expenditure of £4.6 billion on agency personnel, coupled with an additional £5.8 billion for doctors and nurses undertaking extra shifts to cover rota gaps.

The dire situation of short staffing has compelled healthcare facilities in all four UK nations to allocate substantial sums to employment agencies for stand-in workers. England alone has witnessed a 16 per cent increase in the bill for agency staff, particularly nurses and GPs, escalating from £3 billion to £3.5 billion over the past year.

Shadow Health Secretary Wes Streeting attributed this surge to years of neglect by Conservative governments, forcing desperate hospitals to allocate enormous budgets for agency staff, some of whom cost over £5,000 for a single shift.

The Royal College of Nursing described the levels of agency spending as "staggering", saying that it would be more cost-effective for the NHS to hire permanent nursing staff rather than relying on temporary solutions. With 42,306 vacant nursing posts in England alone, the need for a comprehensive staffing strategy is imperative.

The expenditure on bank staff, those who take on extra shifts at their own or nearby hospitals for additional income, has witnessed an even more pronounced increase. In England, spending on bank staff has more than tripled from £1.8 billion in 2015/16 to a substantial £5.8 billion in 2022/23, according to healthcare data analysts LaingBuisson.

The report suggests that the overall spending on temporary workers, including both agency and bank staff, has skyrocketed due to the combined impact of the ongoing COVID-19 pandemic, existing understaffing and political pressure to reduce the backlog.

The repercussions of severe and longstanding staff shortages are being felt across various healthcare services, including A&E departments, maternity services, GP practices and intensive care units. Hospitals are compelled to cancel operations, delay treatments and, in some cases, induce births prematurely due to insufficient personnel.

Tim Read, LaingBuisson's Director of Research and Content, underscores the alarming escalation in NHS spending on temporary staff, attributing it to the heightened demand for care during the pandemic.

"The sums of money that the NHS is spending on temporary staff have exploded in recent years... When you take into account the amount of money that is also spent on bank staff, this takes NHS spending on non-permanent staff to more than £10bn in 2022/23," he said.

While a clampdown in 2015/16 led to a temporary reduction in agency staff spending from £3.63 billion to £2.38 billion in 2019/20, the figures have crept back up, reaching £3.46 billion in 2022/23. LaingBuisson's analysis indicates a substantial increase in spending on agency staff through recruitment agencies, with the combined expenditure on non-permanent staff exceeding £10 billion in 2022/23.

Labour research highlights that trusts in England are paying exorbitant fees, such as £5,234 for hiring an agency doctor and £2,140 for an agency midwife for a single shift. The Northern Care Alliance trust in Greater Manchester, for instance, spent £21 million in 2021/22 on agency doctors and £16.7 million in 2022/23 on midwives sourced through agencies.

The Royal College of Nursing argues that investing in recruiting and retaining more nurses through better pay would be a more cost-effective solution than relying on agency staff. Employment agencies, including Acacium Group and Medacs Healthcare, have seen a sharp increase in income due to the NHS's growing dependence on the personnel they supply.

The long-term financial implications of the current reliance on temporary staff raise concerns about the sustainability of the current approach.

NHS England contends that health trusts are spending less on agency staff both in absolute terms and as a proportion of the overall budget in the current year.

However, LaingBuisson's figures paint a different picture, revealing that NHS spending on agency workers in England reached £3.46 billion in 2022/23, an increase of £471 million from the previous year. The proportion of the overall £9.3 billion annual outlay on temporary staff that was utilised for hiring agency personnel slightly rose during this period.

Despite the claims of decreased spending, concerns persist about the effectiveness of the NHS Long Term Workforce Plan in addressing the staffing crisis. Tim Read warned against taking the plan for granted, asserting that significant investments and commitment across several election cycles will be necessary to achieve the ambitious targets by 2038.

NHS bosses attribute the escalating bill for temporary personnel to various factors, including high demand for services, overstretched budgets, staff shortages and recurrent industrial action by NHS staff.

Saffron Cordery, Deputy Chief Executive of NHS Providers, accentuated that trusts are struggling to control agency spending and overtime payments, particularly in the face of ongoing industrial action.

"Trusts are doing all they can get to get a grip on agency spend and expensive overtime payments, but on top of existing challenges, wave after wave of industrial action is making it harder to ensure staff pay costs don't rise significantly," she said.

The relentless efforts to meet Prime Minister Rishi Sunak's promise of reducing NHS waiting lists have further strained healthcare facilities, leading to the creation of additional shifts that need to be staffed.