Nurses hired at £1,600 a day to cover shortages

By Laura Donnelly and Melanie Mulhern

Read the NAO report here

NHS HOSPITALS are hiring agency nurses at rates of up to £1,600 a day in an attempt to cope with rising staff shortages, a Sunday Telegraph investigation found.

The number of shifts filled by temporary workers has risen by more than half in a year, with private agencies receiving more than seven times the rate paid to nurses on the payroll.

Experts said the disclosures showed how attempts to improve hospital efficiency had backfired, with jobs being cut, only for temporary staff to be hired at inflated rates.

The scale of job losses is disputed, with unions claiming that thousands of front-line posts have gone since 2009 while ministers say that fewer than 500 posts lost involve nurses.

The number of nurses from overseas who have registered to work in Britain has also soared by 70 per cent in two years, new figures show.

Disclosures under the Freedom of Information Act showed that since 2009 private agencies have been paid up to £1,600 per shift to provide the health service with specialist nurses, compared with an average rate of about £212 a day for those on the NHS payroll.

Our investigation found:

• The Derby Hospitals Foundation Trust paid £1,632 for a specialist nurse to work a 12-hour shift in its accident and emergency unit - a rate equivalent to an annual salary of £229,500. The NHS pays between £25,528 and £34,189 for the same role. The same trust spent £1,399 on a 13-hour shift for a nurse;
• Princess Alexandra Hospital Trust in Essex paid £1,356 for a specialist nurse to work 12.5 hours in April 2010. Last year the trust announced plans to cut 250 staff posts to find savings;
• The Mid-Staffordshire Foundation Trust paid £1,303 for a specialist nurse to work 10½ hours in December, and £1,061 for a general nurse;

Figures from NHS Professionals, which supplies a pool of staff to hospitals, showed that in 12 months, the number of nursing shifts filled by agency workers had risen by 51 per cent.

Previous investigations by this newspaper found doctors were being hired at rates of £20,000 a week to cover hospital staff shortages caused by European rules.

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 £20billion by 2015 to ensure there are sufficient funds to cope with the rising demands of an ageing population.

Experts said many hospitals that made cuts to their workforce found they were short-staffed and were forced to pay higher rates to bring in workers at short notice.

Research from 39 trusts - about one quarter of those in England - showed that 21,000 shifts were filled by agency staff during March, a rise from about 14,000 a year earlier.

Experts said the figures were likely to be more than four times as high, because the sample was made up of trusts that used NHS Professionals before turning to costly private agencies.

Figures for the group of trusts showed temporary cover was sought for 155,000 shifts in March. Of those, 90,000 posts were filled by "bank"nurses and about 21,000 by agency staff . More than 40,000 shifts were left unfilled.

Dr Peter Carter, of the Royal College of Nursing, said the figures demonstrated lamentable planning by the NHS. He said: "Now the hospitals have made such drastic cuts the agencies have got them over a barrel and can charge what they like."

The Royal College of Nursing said more than 26,000 front line posts were lost in the first year of the Coalition. Ministers did not recognise the figure and said the number of qualified nursing staff had fallen by 450 since 2009.

The report by NHS Professionals said much of the demand for temporary staff in the past six months was unforeseen by hospital trusts.

The quango said it struggled to recruit staff because private agencies were able to offer "almost guaranteed work" at much higher rates.

Shortages were worst in the North, where demand for shifts rose by 24 per cent.

Experts said agency staff figures represented at least 100,000 shifts being filled each month, often on rates of more than £100 an hour.

Julia Manning, of the think-tank 2020health, said: "The figures are astonishing and demonstrate such appalling short-sightedness on the part of NHS trusts.
"It really concerns me that hospitals are drawing up plans which are based on wishful thinking, rather than reality, only to end up paying so much over the odds."

The payments included agency commission.

Last year, an investigation by The Sunday Telegraph disclosed that hospitals recruited doctors and nurses abroad, despite local posts being earmarked for cuts and pledges by David Cameron to cap immigration.

Thirty-four hospital trusts responded to requests for information about the highest rates paid for medical or nursing shifts since April 2009. Of those, 28 admitted to spending more than £1,000 a shift.

A Department of Health spokesman said figures from NHS Professionals did not reflect the national picture. He added that the NHS had saved £128million on agency staff in 2010-11.

£1,400 agency rate for a general nurse, compared with a £188 NHS rate

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