NHS spent £25 million on agency midwives last year, RCM reveals

An investigation by the Royal College of Midwives (RCM) has revealed that NHS spending on agency staff in maternity units in England rose from £11.75 million in 2013 to £24.95 million in 2015
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NHS spending on agency midwives doubled in the last 2 years to reach £25 million, according to a new report.

The RCM argued that the spending was enough money to pay for 2,063
full-time midwives with a decade of experience. Picture: IStock

The Royal College of Midwives (RCM) study found a rapid rise in spending on agency staff to plug rota gaps, as well as rising overtime costs and large spends on NHS bank staff.

The government has tried to clamp down on spiralling agency costs in the NHS, which have contributed to a £2.5 billion deficit, by introducing caps in 2015 on how much each trust can pay agency staff.

But the new report found hospitals are relying heavily on agencies, paying an average of £41.25 per hour for midwives. 

Freedom of Information requests 

Around half this cost goes straight to the agency. The RCM sent Freedom of Information requests to all NHS trusts in England with maternity units, of which 123 (92%) responded. 

Less than half of these (46) used agency staff in 2015, but they accounted for a £24.95 million spend.

This was up from £17.85 million in 2014 and £11.75 million in 2013. 

From 2012 to 2015, the total spend on agency midwives was almost £65 million.

Rise in agency spending 

Between 2014 and 2015, there was a 40% rise in agency spending and a 146% rise over the four years.

The report showed that the highest average spend on agency staff across England was in December, at £50.58 per hour – after the government introduced its pay cap.

A further £4.52 million was spent on overtime in 2015, while spending on bank staff was £43.23 million.

The NHS’ combined spend on agency midwives, overtime and bank midwives reached £72.7 million in 2015.

‘Wasteful’ staffing

The RCM argued it was enough money to pay for 2,063 full-time midwives with a decade of experience, or 3,318 full-time newly-qualified midwives.

RCM director for policy, employment relations and communications Jon Skewes said England currently had a shortage of 3,500 midwives.

He added: ‘This is an incredibly expensive and wasteful way to staff maternity units and it simply cannot continue.’ 

Mr Skewes said evidence showed that women had better outcomes when they saw the same team of midwives, which trusts can ensure by staffing their units with the right numbers of permanent staff.

Money-saving measures 

NHS Improvement said trusts had made good progress on reducing total agency spending, including other staff groups apart from midwives, and saved more than £600 million since last year.

It added that almost three quarters of trusts (73%) had reduced their agency spend, with more than half reducing their spend by more than a quarter, but said more needed to be done. 

Today it announced these additional measures to further reduce agency spending: 

  • The publication of league tables of agency spend on best and worst performing trusts.
  • Collecting anonymised information on the 20 highest earning agency staff per trust and of long-standing agency staff. 
  • Additional reporting to NHS Improvement including of shifts that cost more than £120 an hour.
  • Introducing an approval process for the appointment of any senior managers on an interim basis who charge more than £750 per day.
  • Ensuring trust boards have the right level of oversight of agency spend at their trust.

A NHS Improvement spokesperson said: ‘We are committed to helping the NHS cut the cost of agency midwives and all agency staff, so that patients get the right care, from the right staff, at the right time.’