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Agency nurse bill for England tops £4.3 billion over five years

Government criticised for ‘short-sightedness and poor planning’ after almost £838 million was spent on agency staff in England in 2020-21 alone amid growing workforce crisis

Government criticised for ‘short-sightedness and poor planning’ after almost £838 million was spent on agency staff in England in 2020-21 alone amid growing workforce crisis

Graphic showing an agency contract, a calendar and a man calculating costs
Picture: iStock

The NHS in England spent more than £830 million on agency nurses last year, with the five-year bill to 2021 topping £4.3 billion, sparking warnings temporary staff cannot be used to fill workforce gaps.

The bill for locum agency nursing staff in 2020-21 came to almost £838 million, according to figures released by the government this week. Total spending figures for 2021-22 are expected to be released in January 2023.

Temporary staff cannot offset lack of nursing workforce planning

While this is a slight drop in the previous year’s total of more than £878 million, the data, requested by shadow health secretary Wes Streeting in a written question to parliament, show the NHS has been spending more than £800 million a year on agency nurses since 2016-17; in that year it reached £966 million.

RCN general secretary Pat Cullen said that while agency nurses have a ‘vital role’ to play in providing safe care, temporary staff should not be used to offset a lack of full-time registered nurses.

‘Ministers have repeatedly failed to address the nursing workforce crisis,’ she said. ‘This short-sightedness and poor planning means there are record levels of unfilled nurse posts. Ministers must finally heed our call for a fully-funded workforce plan for each part of the UK.’

Agency nurse spending by NHS providers from 2016-21

Year Spending on agency nurses
2016-17 £966,198,000
2017-18 £808,662,000
2018-19 £843,282,000
2019-20 £878,521,000
2020-21 £837,823,000

Source: NHS providers: trust accounts consolidation (TAC) data publications

Department of Health and Social Care defends long-term workforce plan

The RCN is currently balloting around 300,000 members on strike action over poor pay and working conditions, with many nurses leaving the profession for better paid jobs in shops and bars.

The Department of Health and Social Care (DHSC) says there are more nurses working in the NHS now than in 2019, and that health and social care secretary Thérèse Coffey ‘is focused on delivering for patients with her “ABCD priorities”’. The priorities have previously come under fire for the omission of ‘N’ for nursing.

‘There are over 29,000 more nurses working in the NHS now compared with September 2019, and NHS spending on agency staff has dropped by a third since 2015-16,’ a spokesperson said. ‘We have also commissioned NHS England to develop a long-term workforce plan to help recruit and retain more NHS staff.’

DHSC policy is to reduce the use of agency staff by helping NHS trusts develop in-house staff banks that can be given priority over external agencies.


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