Chesterfield Royal spends more than £15 million on agency doctors and nurses - double the cost of 2011, special investigation reveals

Spending on temporary staff at Chesterfield Royal Hospital has almost doubled in the past five years, information obtained by the Derbyshire Times has revealed.
Chesterfield Royal HospitalChesterfield Royal Hospital
Chesterfield Royal Hospital

The trust spent more than £15 million on bank and agency doctors and nurses during 2014-15, compared with £8 million during 2010-11, a Freedom of Information made to the hospital trust has revealed.

Information for the current 2015-16 financial year was only partly available, but figures between April and November 2015 showed that Chesterfield Royal has already spent £13.1 million on temporary nurses and medics.

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This would lead to a predicted yearly spend of £17.4 million to April 2016 - an increase of more than £2 million on 2014-15.

The news comes after NHS regulators accused medical staff of exploiting a recruitment crisis in the sector by working for ‘rip-off’ agencies, which are adding increasing financial pressure to our hospitals.

But trust bosses say they are working to bring spending down, and are recruiting actively to fill vacant roles for both doctors and nurses.

The hospital is also recruiting from overseas, with nurses hired from Italy, Spain and Romania to combat the national nursing shortage.

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Meanwhile, the hospital is also increasing its ‘bank staff provision’ - which is a cheaper option than hiring in staff through recruitment agencies.

Lynn Andrews, Director of Nursing and Patient Care at Chesterfield Royal, said hospitals had historically relied too heavily on nursing agencies, and the hospital had been actively trying to reduce agency spend since early 2014.

But she said it is unlikely that figures will drop down to the 2010-11 levels again.

She said: “You get a far greater sense of team working if you have staff employed directly by the trust, and that gives a better service and provides greater care for the patients.

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“It’s really important that we employ our own staff and not simply rely on agencies.

“But it is also important to have a flexible workforce.

“You are always going to have staff sickness and absences to accommodate, so you need to be able to flex up and flex down to meet demand.

“We have had significant success with our recruitment drive overseas and a lot of doctors want to come and fork for us.

“We often find that people who come to Chesterfield Royal on a placement from medical school apply to come and work here when they have qualified because they enjoyed it so much.”

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Overall agency, bank and locum spend at Chesterfield Royal increased by £66,000 in 2014-15 on the previous financial year, but between April and November last year, it had already spent £14.9 million.

This could suggest an overall spend of £19.9 million by the end of the 2015-16 financial year - a possible increase of £2.6 million on the previous financial year.

The trust has seen a year-on-year reduction in expenditure in allied health and support services since 2013.

Meanwhile, agency expenditure for administrators and healthcare scientists has continued to increase over the same period.

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In the financial year 2013-14, Chesterfield Royal spent £746,000 on temporary administrators, rising to £891,000 in 2014-15.

Between April and November last year, the trust had spent £635,000 of temporary administrators - meaning a likely spend of £844,500 by the end of the financial year.

Ms Andrews said that in terms of hiring temporary doctors and nurses, a deliberate shift has been implemented away from agencies in favour of staffing banks.

This allows staff to take extra shifts without the additional costs charged by private agencies to individual foundation trusts.

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“What was required was an increase in staffing levels and there has been further investment in nursing numbers,” she said.

“Our overall aim is to reduce our agency spending and to bring in the right type of workforce to offer the best possible service.

“With that in mind, I think it is unlikely that we will see expenditure falling back to 2011 levels as there is every likelihood that we will be looking at creating more advanced practitioner posts - it is about spending the money on the right staff.”

Earlier this month, health regulators claimed that locum doctors and nurses had been exploiting the NHS staffing crisis by charging extortionate rates to cover shifts.

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New regulator NHS Improvement, said medical professionals had been charging extortionate rates to trusts, until new pay restrictions were brought in on February 1.

Junior doctors can now only receive double pay for covering an agency shift, while other medical staff, including nurses, could claim 75 per cent above their basic pay while providing agency cover.

A spokesman for the regulator said: “It can’t be fair that a doctor or nurse working for an agency is being paid significantly more than a colleague doing the same job but working for the NHS.

“We’ve put in place measures which will tackle rip-off agencies whose use has pushed the NHS into deficit and taken money away from treating patients.”

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Official figures released in November revealed NHS trusts spent £1.86 billion on agency staff in the first six months of the financial year.

It cited: ‘Agency nurses and locum doctors, employed to meet unplanned activity, inefficient use of permanent staff and a shortfall in the permanent workforce due to recruitment difficulties’ for the overspend.

The regulators acknowledged that agency and locum staff can be ‘vital’ for the NHS, although their over-use was unaffordable.

‘We are tackling this issue, including encouraging staff to come back into substantive roles in the NHS rather than rely purely on agency work,’ the spokesman said.

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