Agency and bank nurses: NHS spending hits record high
Posted 06 June 2024 - 15:05
Health service employers’ bills for filling roster gaps rocket as union calls for long-term solution to nurse workforce crisis
The NHS in Scotland clocked up a record annual bank and agency nursing bill in 2023-24, as workforce pressures continued and staff worked extra shifts to cope in the cost-of-living crisis.
Combined spending on bank and agency staff has more than doubled in NHS Scotland in four years, from £188 million in 2019-20 to £490 million in 2023-24. At £151 million, the agency bill for 2023-24 is around six times higher than in 2019-20.
Nurses turning to agency and bank work
The RCN’s annual employment staff survey published last month revealed that a third (32.8%) of 11,287 respondents worked bank or agency shifts in order to cope with rocketing living costs.
One staff nurse at an NHS hospital in Scotland said: ‘I have worked in the NHS for eight years. I am leaving the NHS permanently to do full-time agency. Better work-life balance, more pay and less responsibility in terms of being made to be in charge.'
NHS Greater Glasgow and Clyde, the country’s largest NHS health board, spent the most, with a £148 million bill for agency and bank nurses, while the second-largest employer, NHS Lothian, spent £64 million.
‘The NHS has policies to support flexible working but, despite this, registering for the bank or an agency is still the best way for staff to fit work around their families’
Matt McLaughlin, health lead, Unison Scotland
Impact of gaps in nursing workforce
RCN director for Scotland Colin Poolman said that while investment in bank and agency nursing will always be needed to cover unexpected events, it is not a long-term solution to the nursing workforce crisis.
‘It’s true some nursing staff will be attracted by the higher rates of pay agencies offer and the greater flexibility in being able to choose when they work banks and agencies allow,’ he said. ‘But the gaps in the permanent workforce are having a significant impact on continuity of patient care and staff morale.’
Meanwhile, Unison Scotland’s head lead Matt McLaughlin said many nurses are opting for agency work to accommodate family and caring needs.
He said: ‘The NHS in Scotland has some policies to support flexible working but, despite this, registering for the bank or an agency is still the best way for staff to fit work around their families. Too many clinical areas are inflexible and lack vision when it comes to shift patterns and rostering of staff – especially those with children or care responsibilities.’
Agency spending ‘a fraction’ of NHS staffing bill
The Edinburgh government said new controls were introduced in June 2023 to gradually reduce the number of shifts being filled by high-cost agency staff.
A spokesperson added: ‘NHS Scotland staffing pay bill is over £10 billion a year, with spending on agency nursing a tiny fraction of this. It is important to note most temporary staffing comes from staff banks; these are NHS staff, working on NHS rates of pay.’
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