£70m agency nurse bill at record high
NEARLY £70m was spent on agency nurses last year to keep the Welsh NHS running – the highest amount on record, it has been revealed.
A Freedom of Information (FOI) request obtained by the Western Mail showed that Wales’ health boards forked out £69.04m on agency nurses between them in 2019.
That was up from £59.1m in 2018, £52.4m in 2017 and £54.6m in 2016.
Hywel Dda University Health Board, which covers Pembrokeshire, Carmarthenshire and Ceredigion, spent the most of any health board last year (£15.1m), followed by Betsi Cadwaladr UHB (£13.8m), and Cwm Taf Morgannwg UHB (£11.8m).
Agency nurses are often brought in by health boards across Wales to fill gaps in rotas due to high vacancy rates
or sickness levels.
It is claimed agency working is a more attractive career option for some qualified nurses due to the flexibility and control over hours and shift patterns, as well as higher rates of pay.
But there are claims these more lucrative positions are driving nurses away from the Welsh NHS and adding to their difficulty in recruiting.
Director of the Royal College of Nursing (RCN) Wales Helen Whyley said that unless serious and urgent action is taken by the Welsh Government, agency spending will continue to “spiral out of control”.
“These figures are very disappointing, but we are not surprised to see this increase in spending across health boards,” she said.
“Nurses are working in very difficult circumstances at the moment with the highest number of vacancies ever experienced. Urgent action is required by the Welsh Government to address the current recruitment crisis in nursing.”
Ms Whyley said an area of priority for the Welsh Government is to extend the Nurse Staffing Levels (Wales) Bill which sets a legal requirement on nurse staffing levels in medical and surgical wards.
She believes the law now needs to incorporate all areas where nurses care for patients.
She added: “To attract more people into nursing, the Welsh Government needs to make a long-term commitment to an NHS student bursary as a form of student finance.
“In addition, our members tell us that they want more flexible working arrangements and better access to continuing professional development, and that agency work gives them both of these things.”
In a separate FOI request, each health board was also asked the maximum amount they spent on a band 5 NHS-salaried nurse working a 12-hour shift on Christmas Day, compared to the maximum amount they spent on an agency nurse.
It revealed that the Welsh NHS spent, on occasion, more than three times as much on agency nurses as they did on NHS staff.
Plaid Cymru’s Leanne Wood, AM for the Rhondda, said the millions being spent on agency nurses exposes poor workforce planning.
She said: “Nurses with decades of experience behind them and with so much to give have told me they are reluctantly leaving nursing because the job is more pressurised and relentless than it has ever been.
“The Health Minister should be ensuring that nurses are supported and not left to work in intolerable conditions.
“Of course, the figures on the cost of agency nurses appear stark – and they are – but the reality is that the agency nurse will not be getting anywhere near all of that money per shift. A large proportion will be snapped up by the private agency.
“This is yet another example of creeping privatisation of the health service. During these times of tight budgets, we cannot afford to be squandering millions of pounds when frontline services are stretched already.”
Angela Burns, health spokeswoman for the Welsh Conservatives, described the figures as “scandalous”.
She said: “While no-one can dispute the hard work and dedicated professionalism of our nurses, one must question the ethics of a government that fosters a situation where an NHS nurse is paid almost a quarter of the rate a nurse working for an agency would receive for the same shift in the same hospital.
“Even the most dedicated nurse might look at his or her peer on four times the rate for the same shift, feel undervalued, and think ‘why not?’”
“This is unsustainable, and dangerously damaging to Wales NHS, and by extension all people in Wales that use its services.”
Nicky Hughes, associate director of nursing (employment relations), said looking after the health and wellbeing of NHS nurses is paramount in retaining them.
“The lower the sickness levels, the lower the spend on agency nursing,” she added. “We expect that the All Wales Managing Attendance at Work Policy, which has recently been implemented in all health boards across Wales, will be invested in as it is a key driver to assist with lowering sickness levels.”
In response to the figures, a Welsh Government spokeswoman said: “The number of registered nurses has continued to increase and training places have risen by more than 65% over the last five years.
“We have retained the NHS bursary for student nurses, midwives and allied health professionals and are recruiting additional nurses, supported by our Train Work Live campaign.
“We continue to work with NHS Wales to reduce reliance on agency staff. A workforce strategy has been developed by Health Education and Improvement Wales and Social Care Wales.”