High staff vacancies push up NHS pay bill

NHS Improvement’s quarterly performance report revealed there were 108,000 whole time equivalent staff vacancies in the first quarter of 2018-19, with this trend predicted to worsen over the year.

The data revealed the number of nursing posts vacant has increased by almost 17 per cent between quarter four of last year and quarter one of 2018-19 – there are now 41,722 nursing vacancies in total.

Medical vacancies also increased with 9,982 empty posts reported in quarter four, which has risen to 11,576 in quarter one of this year. Whereas the majority of nursing vacancies are being filled by bank staff, over half of empty medical posts are filled by agency staff.

The regulator has also reported “significant regional and sector vacancy variation”. Mental health nurse vacancies increased by 18 per cent compared to the end of last year and 15 per cent of nursing posts in London are vacant.

For medics, the Midlands and East has the highest number of vacancies, with an increase of 15 per cent between quarters four and one.

The high number of staff vacancies has resulted in an overspend of £102m on bank staff and £32m on agency staff, which is 11 per cent higher than the same period in 2017-18.

Controlling agency spend has been a national priority for NHS Improvement since 2015 when it introduced a nationwide cap on all agency spending, including nursing and medical workers.

However, providers spent £599m on agency staff this quarter, an increase compared to £592m spent during the same period last year.

The total overspend on staff pay is £42m, which according to NHSI is “entirely attributable” to the acute sector, which overspent by £63m. The regulator said this reflects “continuing intense operational pressure” and added this is forecast to rise to £72m by year-end.

NHSI added that quarter one pay bill figures do not include expenditure relating to the Agenda for Change pay award, but it predicted the impact of this should be “broadly cost neutral”. It said that “cost pressures will arise for providers” who have legal commitments to make other payments linked to Agenda for Change.

Chris Hopson, chief executive of NHS Providers, said: “Trusts tell us they are most worried about the workforce shortages they face, and it’s a real concern that these figures have shown such a big increase in vacancy levels. It’s worrying that this problem is getting worse rather than better.”