Call for a rational approach to NHS staffing

John O'Hanlon
- Leadership - Apr 13, 2015

Recent reports that the NHS spends up to £2.5 billion a year on agency staff have sparked outrage throughout the media and amongst the general public. Concern was fuelled by the discovery that one NHS hospital had paid an agency nurse £2,200 to work a single twelve hour shift, and by a report from cross-party thinktank Civitas that called for a broader pool of permanent staff to enhance workforce stability and patient safety.

The Civitas report said that agency nurses cost from £24 to £29 an hour, equivalent to between £47,000 and £56,000 a year, while the salary for an NHS band 5 nurse is between £21,478 and £27,901. At senior levels it reported that, since the salary of an NHS consultant is between £75,249 and £101,451, four consultants could be employed by the NHS for the price of one agency consultant, which typically works out at £459,000 a year. It recommends that the NHS should train more staff rather than employing locum doctors and agency nurses

However, while the complex circumstances which have led to this headline figure are often simplified in mainstream media, the benefits of contract staff to the public sector are often overlooked cautions Nick Simpson, the CEO of healthcare recruitment group MSI. Putting political agendas aside, these are his top five reasons why the NHS needs agency staff:

1. Fluctuations in requirements – Agency staff plug gaps across the NHS so that it is able to provide optimum levels of care, irrespective of peaks in demand surrounding viral epidemics or seasonal admissions.

2. Global market – Professionals from overseas make an important contribution to the NHS and help to redress the balance of UK trained professionals travelling abroad for work.

3. Avoidance of permanent headcount costs – Investing in agency staff sporadically is an efficient way for Trusts to ensure front line services are consistently maintained, without the overheads associated with permanent recruitment. Agency staff can be drafted in to cover staff absences on short notice, freeing the NHS from unnecessary permanent headcount costs.

4. No room for error – Quality of service is absolutely vital, and contract staff are subject to the same stringent criteria that permanent staff must adhere to. Agency and locum staff remove the risk of reduced care quality and patient safety issues. The availability of contractors ensures that nurse to patient ratios need never be compromised.

5. Necessity – Agencies offer a valuable service that much of the NHS would struggle without. According to the Royal College of Nursing, over a third of district nurses are over 50, yet cuts to nurse degree training places in the UK mean we are not pipelining sufficient home grown talent. Until these issues are resolved, there are simply not enough permanent staff. It’s a simple case of supply and demand.

“An ageing population, retirement cliffs and insufficient talent pipelining have all contributed to an acute shortage of permanent healthcare professionals,” says Simpson. “While it is imperative that these issues are addressed long-term, we cannot escape the fact that agency nurses and locum doctors provide a valuable service that, for the imminent future, the NHS simply cannot do without.”

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