Spending on agency staff has ‘increased markedly’ by 171% to cover vacancies across Welsh NHS

NHS spending on agency staff in Wales has risen 171% in the last seven years, the majority of which is spent by the health service to provide cover for vacant positions, according to the Welsh Audit Office (WAO).

The financial watchdog said NHS spending on agency and locum staff reached £135.7m in 2017-18, peaking in Wales at £164.4m in 2016-17, and attributed the rise in spending to escalating hourly rates charged by agencies, an increase in demand for services, and difficulties recruiting and retaining staff.

The auditor general’s support stated that 82% of agency spend so far in 2018-19 was spent on providing cover for vacant positions and, whilst each health board holds data on agency staff use, there was still no all-Wales analysis.

Temporary staff usually cost more than equivalent employees on substantive contracts, with agency staff typically the most expensive source of temporary staff.

On average, nearly half of the total agency cost was spent on medical and dental staff since 2014-15 and a third went on nurses and midwives.

The auditor general Adrian Crompton called for strong leadership and a change to management, and said more consistent and comparable data to understand the root causes of agency spend was needed to deal consistently with difficult decisions across all Welsh NHS bodies.

NHS Wales is looking to reduce the demand for agency staff and the price it pays for them as NHS bodies across the UK suffer with workforce shortages. In November, three leading think-tanks said the situation was so severe, it now posed the biggest threat to the future of NHS.

Crompton said: “This report is packed with useful statistics and insights on the current picture of NHS agency expenditure in Wales.

“I hope it will be used by a wide range of people and professionals in Wales, along with the data tool we have produced, to help NHS Wales continue to bring down and control these costs at a time of significant financial pressure.”

The WAO’s report states that the two key challenges to improving agency staff spending are the need for stronger leadership to drive change and deal with difficult decisions, and the lack of consistent and comparable data on an all-Wales level to track the volume, nature, and cost of agency staff.

Earlier this month, the National Audit Office published a report revealing that four in 10 NHS organisations don’t have a grip on their spending and criticised “unacceptable” levels of financial weakness.

 Image credit - PeopleImages


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