Rising Costs of Temporary Nursing Staff in Northern Ireland
Northern Ireland health trusts have spent more than £160 million on private agency nursing staff in a single year, reflecting a tripling of these costs over the past six years. This expenditure is in addition to the £1.1 billion spent on permanent NHS nursing and midwifery staff, according to a report from the auditor general.
The report highlights a significant reliance on agency nurses within the region's health services, contributing to the increased financial burden on health trusts.
Dorinnia Carville, the auditor general, emphasized the need for additional nursing staff to maintain safe and effective care. She stated that Northern Ireland requires an extra 2,195 nurses to meet these standards.
Department of Health Response and Workforce Planning
The Department of Health (DoH) explained that costs associated with agency staff are necessary to ensure that health services remain "safe and effective." They noted the establishment of a planning group focused on reducing unsustainable spending on agency and locum staff across health and social care (HSC).
In their statement, the DoH also reported that agency use in social work has been "entirely eliminated" and that "significant progress has been made in recent years to stabilise and grow" the HSC workforce.
Factors Contributing to High Agency Staff Usage
The auditor general's report identified several reasons for the continued high use of temporary nursing staff. These include staff absences, unfilled vacancies, increased population demand, and inadequate workforce planning.
A 2023 initiative aimed at eliminating the use of off-contract agencies, which previously had the ability to set payment rates for health trusts, was deemed successful. However, the report noted that "agencies had developed a strong market hold" with rates significantly higher than those in England.
Disparities in Pay Rates for Agency Nurses
The report revealed that some agency nurses in Northern Ireland were paid up to 64% more than their counterparts in England. Additionally, agency staff earned an average of £11 more per hour compared to temporary nurses hired directly by health trusts, known as bank nurses.
The auditor general indicated that if agency staff had been compensated at the same rates as bank nurses, Northern Ireland could have saved £186 million over the past four years.
Recommendations and Future Actions
"While the use of temporary staff to fill short-term workforce gaps is inevitable to some degree, this must be planned and managed effectively to ensure the long-term sustainability of services,"the auditor general said.
"The introduction of a new agency framework has delivered some important improvements, but agency costs remain high and better value for money could be achieved."
The report recommends that the Department of Health take targeted action to reduce both the usage of agency nursing staff and the associated expenditure. It also suggests looking to other parts of the UK where significantly lower levels of agency spending have been achieved.
