Restrictions on agency nurse spend may hinder safe staffing goals

National Audit Office report into NHS finances reveals trusts' £843 million deficit


Interventions by the Department of Health (DH) on agency nurse staffing in NHS trusts are conflicting with the need to meet safe staffing guidelines, according to the National Audit Office (NAO). 

A report by the NAO said the DH’s measures to reduce trust spending on agency nurses came at a time when acute trusts needed to recruit more nurses to ensure safe staffing and when the vacancy rate for permanent nurses was high. This gap has previously been filled by using agency staff.

The NAO has also warned that the decline in the finances of NHS trusts in England has been severe and worse than expected.

Two-thirds of NHS acute hospital trusts are in deficit, the NAO report said.  

Three-quarters of NHS trusts and foundation trusts were in the red for the first six months of this financial year. 

This comes after they recorded a £843 million net deficit for 2014/15, a sharp increase from the £91 million net deficit for 2013/14. 

NHS commissioners, NHS trusts and NHS foundation trusts combined moved from a £722 million surplus in 2013/14, to a deficit of £471 million for 2014/15.

The NAO said that ‘effective oversight by the DH and its arm’s-length bodies will become harder if the number of trusts in financial distress rises further’. 

It said the DH has taken steps to learn how trusts could reduce costs, ‘but the wider use of this learning and how it will improve trusts’ finances is not clear’.

The government has pledged an extra £8.4 billion to the health service during this parliament. 

NAO head Amyas Morse said: ‘Running a deficit seems to be becoming normal practice for acute trusts.

‘The government’s commitment to give the NHS more funding, with almost half of this coming upfront, could be a significant step towards financial sustainability, if this funding can be devoted to improving the financial position of trusts rather than dealing with new costs.’

Read the NAO report here.

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