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Patients more likely to see care as poor in hospitals with many temporary staff, study shows

Hospital trusts employing high numbers of temporary staff are more likely to have their quality of care rated poor by patients, a study shows


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Hospital trusts employing high numbers of temporary staff are more likely to have their quality of care rated poor by patients, a study shows.

Those spending the highest amounts on agency workers – combined with low ratios of nurses and doctors to beds and high bed occupancy rates – are also more likely to have staff reporting problems with their own well-being.

The study, called Risks to care quality and staff well-being of an NHS system under pressure and produced by patient experience charity Picker and health charity the King’s Fund, claims to be the first of its kind in the UK.

Absence rates

The charities’ analysis of 134 acute trusts in England found a link between staff well-being, patient experiences of their care and the proportion of money spent on agency workers.

The report comes after NHS Improvement data showed that NHS providers spent £2.9 billion on agency and contract staff in 2016-17.

The report says: ‘We found that staff experience was associated with sickness absence rates, spend on agency staff and staffing levels, indicating that staff well-being is impacted negatively by a workforce that is overstretched and supplemented by temporary staff.’

On reasons for poor patient experience, it says the use of agency staff provides less continuity and stability of care, and inadequate staffing and high bed occupancy will have a negative effect on the quality of inpatient care.

Systemic reliance

The report urges policymakers to reduce dependence on agency workers and to recognise that doing so is not simply a cost-cutting exercise but an essential way of maintaining and improving the experiences and safety of people using healthcare services.

Picker chief executive Chris Graham said: ‘The report does not suggest that agency staff provide lesser care than permanent members of staff, and it is important not to blame or demonise this group.

‘Nevertheless, the evidence demonstrates a need to ensure that the NHS and its workforce are suitably supported to provide high-quality person-centred care without a systemic reliance on temporary members of staff.’


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