Acute trusts are inadvertently increasing staffing costs and reducing patient safety through indecision over whether to employ bank staff, according to a report seen by HSJ.
The report by the health service’s in-house temporary staff bank NHS Professionals is based on data from 80 trusts, including acute, teaching, foundation and mental health trusts.
It reveals acute trusts used 15 per cent more agency workers in the first quarter of 2010-11 than in the same period last financial year. The total of shifts rose from 7,575 to 8,695.
The report also shows the trend appears to be increasing month on month, with agency shifts in acute trusts rising from 2,602 in April to 2,953 in May and then 3,140 in June.
The report criticises acute trusts for waiting too long to decide whether to pay for bank workers, in the hope of plugging shortages internally to save money, with the result that they leave themselves with no option but to rely on external agencies.
The report states: “This practice is clearly counterproductive to the trusts’ aims in terms of both cost reduction and patient safety.”
NHS Professionals chief executive officer Neil Lloyd told HSJ: “Trusts seldom budget adequately for temporary staffing requirements.”
He said: “Consequently there are occasions when the best endeavours of trust finance teams to optimise efficiency savings can mean that shift request authorisations are not released in good time.”
Nursing, finance and human resources departments should agree processes that meet trusts’ operational needs while minimising costs, he said.
NHS Professionals expects the proportion of shifts released at short notice to keep growing.
James Buchan, professor of social science and healthcare at Queen Margaret University College, Edinburgh, said: “It [resorting to agencies] may be a short term knee jerk solution to financial problems but it’s only storing up problems in the long term.”
Unison head of health Karen Jennings said: “This isn’t a safe or considered way to organise cover where there are shortages of staff. Trusts need to think more strategically about how they manage vacancies and holidays.”
However, a spokeswoman from agency HCL Locums said it “wholly rejected” NHS Professionals’ claims on safety.
She said: “Quality and continuity of patient care is paramount, and we are committed to continuing to work with the NHS to provide a service that is not only reliable, but cost effective too.”
The NHS Professionals report suggests agency demand has fallen in London and the mental health sector. Agency shifts in mental health trusts totalled 6,874 in June 2009 but 5,113 in June 2010.