25.01.16
Higher spend on agency midwives last year ‘enough to employ 511 staff’
After increasing their spending on agency midwives by nearly 76% between 2012 and 2014, trusts across England have poured nearly £18m into employing temporary midwives last year, or enough to employ 511 full-time staff.
The figures, obtained by the Royal College of Midwives (RCM) using Freedom of Information replies from 130 trusts, revealed the scale of the “incredibly expensive and wasteful” practice of staffing maternity units.
The spend per hour on agency midwives is £49, or nearly three times the amount of a permanently employed midwife and almost two times the amount of paying overtime.
Overall, expenditure on agency midwives ballooned from just over £10m in 2012 to nearly £18m in 2014, an increase of 75.7%. In a separate survey of heads of midwifery last year, the RCM found that almost 73% of respondents had to call in bank and/or agency staff every day or at least a few times a week.
The organisation’s director for policy, employment relations and communication, Jon Skewes, said the heavy reliance on agency midwives to ensure safe staffing levels means costs are “spiralling out of control year after year”.
“This is an incredibly expensive and wasteful way to staff maternity units especially because over half the spend per hour that the trusts are paying is not going to the midwives, but are on-costs going to the agencies,” he said.
“We have found that many midwives who chose to work for an agency did so because they were denied the right to work part-time or flexibly. In turn we have a ridiculous situation when midwives leave an organisation because they can’t work flexibly and then are employed by the same trust as an agency midwife. This results in the trust paying 2.7 times more for that midwife, and over half of that goes to the agency.”
The royal college argued that the best solution to this growing issue is eliminating the shortage of midwives by training and employing more staff and retaining the existing ones by improving fair pay policies and granting flexible working requests.
“We have found that too often trusts tightly control the spending on bank shifts and overtime for midwives, which results in an over reliance on agency midwives,” Skewes added.
“This is clearly more expensive and needs to be corrected sooner rather than later. Managers should be authorised to pay voluntary overtime to existing staff rather than calling in more expensive agency staff.”
Shadow public health minister Andrew Gwynne argued that ministers need to set out their plans to tackle staff shortages and ensure expectant mothers get the care they need.
But a Department of Health spokesperson said the analysis was not based on the latest figures and therefore does not reflect the current situation in the NHS, especially given last year’s capped agency rates policy.
“For too long staffing agencies were able to charge hospitals extortionate hourly rates but the tough new controls we introduced last year are helping hospitals clamp down on agency staff, improving continuity of care for patients and will reduce the overall agency staff pay bill by £1bn over the next three years,” the department added.
Overall, however, the health service’s agency bill has hit a remarkable £4bn, as revealed by NHS England chief Simon Stevens last week. Along with NHS Improvement, NHS England is now looking to tighten controls on temporary staffing companies even further by “effectively re-procuring for new agency and locum contracts to have a competitive fee process”, squeezing fees even more.
Read more about agency and what trusts are doing to keep rates down and improve the bank offer in the upcoming January/February edition of NHE.
(Top image c. David Jones, Press Association)