NHS hospitals are hiring agency nurses at rates of up £1,800 a day in a bid to plug dangerous staff shortages, an investigation has found.
Private agencies have been paid up to £1,794 per shift to provide the health service with specialist nurses Photo: Alamy
The bill for temporary workers has risen by more than 20 per cent in just one
year, with private agencies receiving more than seven times the rate paid to
nurses on the pay roll.
Experts said the disclosures show how cost-cutting efforts have backfired,
with thousands of frontline posts being cut - only for agency nurses to be
hired at vastly inflated rates, when wards became short-staffed.
The use of temporary staff has become endemic in the NHS, with almost every
trust in the country now relying on private agencies to plug gaps in
staffing.
Hospital trusts with soaring bills for agency workers include nine which were
identified last week as having dangerously low staffing levels, according to
rulings by the official safety watchdog.
An investigation has found since 2010, private agencies have been paid up to
£1,794 per shift to provide the health service with specialist nurses -
compared with an average rate of around £212 a day for those on the NHS pay
roll.
The nurses do not receive all the money, with agencies taking a fee of at
least 20 per cent of the total.
Our investigation found:
• The total bill for temporary nurses is set to reach £450 million by the end of this financial year - a 21 per cent rise on 2011/12;
• Mid Staffordshire Hospitals Foundation trust paid £1,794 for a specialist nurse to work 13.5 hours in Accident & Emergency (A&E) unit in December 2011 - the equivalent to an annual salary of £230,000. The NHS pays between £25,528 and £34,189 for the same role;
• University Hospital Southampton Foundation trust paid £1,591 for a 12 hour A&E shift the previous December;
• In April 2011, a 12-hour nursing shift cost North Lincolnshire and Goole trust £1,572;
• Derby Hospitals Foundation trust spent £1,489 on an 11-hour shift in A&E in January 2011;
Research from 106 NHS trusts - two thirds of those in England - shows that in 2011/12, they spent £238 million on temporary nurses.
The same trusts are facing a bill of £287m by the end of the current financial year - equivalent to £450 million, when extrapolated to all NHS trusts.
Just 15 organisations agreed to supply figures about the highest rate paid for a shift. Of those, several admitted to paying rates of more than £1,000 a day for short-term staff.
In most cases, nurses were provided by private agencies, which normally take a commission of at least 20 per cent.
Such agencies usually pay nurses rates of between £25 and £40 an hour, but pay more for bank holidays, specialist nurses and to meet surges in demand.
All hospitals rely on some temporary staff, to cover sickness absence. However, experts are concerned by the scale of spending identified in our investigation, and the sharp rise in it, indicating that agency nurses are increasingly being used routinely, to fill gaps in the permanent workforce.
The Royal College of Nursing (RCN) says the firms have been able to vastly increase their rates - and the percentage they take in commission - because many hospitals are desperately short of nurses after cutting thousands of frontline posts.
Official figures show there are 6,000 fewer nurses working in the NHS since May 2010.
The payment by Mid Staffordshire Hospitals Foundation trust for £1,794 shift was made to Thornbury Nursing Services, one of the largest agencies in the UK.
The firm pays specialist nurses up to £93.25 an hour to work bank holidays - which is £1,119 for a 12-hour shift.
In its marketing materials, potential recruits that they can earn twice as much as a full-time NHS nurse if they can take on shifts at short notice.
The firm was founded by former nurse Moira Sloss and her husband John in 1983, and became part of Independent Clinical Services Limited which they sold for £66 million in 2002.
The couple personally made £45 million on the deal.
The company, which declared pre-tax profits of £7.5 million on a turnover of £36.6 million in its latest accounts, is now owned by US private equity giant Blackstone, which owns a string of businesses, including Hilton Hotels and tourist attractions such as Madame Tussauds.
There are now more than 60 private firms providing nursing and medical staff to NHS trusts in the UK.
Other major companies include Medacs Healthcare, which advertises 300 shifts for nurses every day, and declared an operating profit of £5.9 million on an annual turnover of £172 million in its latest accounts.
Guy's and St Thomas' Foundation trust had the highest total bill, and is on course to spend £19 million by the end of March.
Dr Peter Carter, General Secretary of the RCN said: "We frankly despair about what we are seeing going on across the country.
Even the most hard-nosed accountant would think it is bizarre that the NHS should lose thousands of frontline posts, and then end up at the mercy of agencies, who can charge hospitals what they like."
He said that when NHS managers became desperate to fill shifts, agencies were able to increase the percentage of commission they took, as well as the overall rate paid.
Last week The Sunday Telegraph disclosed that 17 hospitals have been warned of dangerously low staffing levels following their latest inspections from regulators Care Quality Commission.
Ten of the trusts who received the warning responded to this newspaper's FOI request about agency spending and at nine, bills for temporary workers are soaring amid the staffing crises.
Although the NHS has been protected from cuts by being guaranteed a rise in annual spending in line with inflation, the service is attempting to save £20 billion by 2015, to ensure there are sufficient funds to cope with the rising demands of an ageing population.
Experts said the disclosures reflected their concern that too many cuts had been made on over-stretched wards, instead of in the bureaucracy running the health service.
Colin Ovington, Director of Nursing & Midwifery at Mid Staffordshire Foundation Trust said the trust sometimes had to employ agency staff, and that on such occasions patient safety was given a higher priority than cost.
He said: "This means that we have to pay the going rate for those staff who are available to cover, sometimes at short notice – these costs are often extremely high, due to the agencies' fees."
He said the two payments identified were for specialist nurses working on a bank holiday weekend, and included travel expenses.
Guy's and St Thomas' Foundation trust said it was one of the largest and busiest trusts in the country and that the rise in staff was primarily a result of the organisation taking over community services.
A spokesman for the Department of Health said hospitals should publish their staffing levels twice a year.
He said agency staff should be used to cover sickness if necessary, but that hospitals which saved money did so by cutting back on such spending, and instead filling their permanent posts.
The most costly nursing shifts:
• The total bill for temporary nurses is set to reach £450 million by the end of this financial year - a 21 per cent rise on 2011/12;
• Mid Staffordshire Hospitals Foundation trust paid £1,794 for a specialist nurse to work 13.5 hours in Accident & Emergency (A&E) unit in December 2011 - the equivalent to an annual salary of £230,000. The NHS pays between £25,528 and £34,189 for the same role;
• University Hospital Southampton Foundation trust paid £1,591 for a 12 hour A&E shift the previous December;
• In April 2011, a 12-hour nursing shift cost North Lincolnshire and Goole trust £1,572;
• Derby Hospitals Foundation trust spent £1,489 on an 11-hour shift in A&E in January 2011;
Research from 106 NHS trusts - two thirds of those in England - shows that in 2011/12, they spent £238 million on temporary nurses.
The same trusts are facing a bill of £287m by the end of the current financial year - equivalent to £450 million, when extrapolated to all NHS trusts.
Just 15 organisations agreed to supply figures about the highest rate paid for a shift. Of those, several admitted to paying rates of more than £1,000 a day for short-term staff.
In most cases, nurses were provided by private agencies, which normally take a commission of at least 20 per cent.
Such agencies usually pay nurses rates of between £25 and £40 an hour, but pay more for bank holidays, specialist nurses and to meet surges in demand.
All hospitals rely on some temporary staff, to cover sickness absence. However, experts are concerned by the scale of spending identified in our investigation, and the sharp rise in it, indicating that agency nurses are increasingly being used routinely, to fill gaps in the permanent workforce.
The Royal College of Nursing (RCN) says the firms have been able to vastly increase their rates - and the percentage they take in commission - because many hospitals are desperately short of nurses after cutting thousands of frontline posts.
Official figures show there are 6,000 fewer nurses working in the NHS since May 2010.
The payment by Mid Staffordshire Hospitals Foundation trust for £1,794 shift was made to Thornbury Nursing Services, one of the largest agencies in the UK.
The firm pays specialist nurses up to £93.25 an hour to work bank holidays - which is £1,119 for a 12-hour shift.
In its marketing materials, potential recruits that they can earn twice as much as a full-time NHS nurse if they can take on shifts at short notice.
The firm was founded by former nurse Moira Sloss and her husband John in 1983, and became part of Independent Clinical Services Limited which they sold for £66 million in 2002.
The couple personally made £45 million on the deal.
The company, which declared pre-tax profits of £7.5 million on a turnover of £36.6 million in its latest accounts, is now owned by US private equity giant Blackstone, which owns a string of businesses, including Hilton Hotels and tourist attractions such as Madame Tussauds.
There are now more than 60 private firms providing nursing and medical staff to NHS trusts in the UK.
Other major companies include Medacs Healthcare, which advertises 300 shifts for nurses every day, and declared an operating profit of £5.9 million on an annual turnover of £172 million in its latest accounts.
Guy's and St Thomas' Foundation trust had the highest total bill, and is on course to spend £19 million by the end of March.
Dr Peter Carter, General Secretary of the RCN said: "We frankly despair about what we are seeing going on across the country.
Even the most hard-nosed accountant would think it is bizarre that the NHS should lose thousands of frontline posts, and then end up at the mercy of agencies, who can charge hospitals what they like."
He said that when NHS managers became desperate to fill shifts, agencies were able to increase the percentage of commission they took, as well as the overall rate paid.
Last week The Sunday Telegraph disclosed that 17 hospitals have been warned of dangerously low staffing levels following their latest inspections from regulators Care Quality Commission.
Ten of the trusts who received the warning responded to this newspaper's FOI request about agency spending and at nine, bills for temporary workers are soaring amid the staffing crises.
Although the NHS has been protected from cuts by being guaranteed a rise in annual spending in line with inflation, the service is attempting to save £20 billion by 2015, to ensure there are sufficient funds to cope with the rising demands of an ageing population.
Experts said the disclosures reflected their concern that too many cuts had been made on over-stretched wards, instead of in the bureaucracy running the health service.
Colin Ovington, Director of Nursing & Midwifery at Mid Staffordshire Foundation Trust said the trust sometimes had to employ agency staff, and that on such occasions patient safety was given a higher priority than cost.
He said: "This means that we have to pay the going rate for those staff who are available to cover, sometimes at short notice – these costs are often extremely high, due to the agencies' fees."
He said the two payments identified were for specialist nurses working on a bank holiday weekend, and included travel expenses.
Guy's and St Thomas' Foundation trust said it was one of the largest and busiest trusts in the country and that the rise in staff was primarily a result of the organisation taking over community services.
A spokesman for the Department of Health said hospitals should publish their staffing levels twice a year.
He said agency staff should be used to cover sickness if necessary, but that hospitals which saved money did so by cutting back on such spending, and instead filling their permanent posts.
The most costly nursing shifts:
- Mid Staffordshire Hospitals, 13.5 hours, A&E, £1,794, December 2011
- University Hospital Southampton, 12 hours, A&E, £1,591, December 2010
- North Lincolnshire and Goole, 12 hours, speciality unknown, £1,572, April 2011
- Derby Hospitals, 11 hours, A&E, £1,489, January 2011
- Mid Staffordshire Hospitals, 13.5 hours, A&E, £1,475, December 2011
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