Trusts are being urged to hold down excessive agency staffing costs as figures reveal the first rise in long-term NHS vacancies for five years.

The advice comes amid fears of growing locum costs and has sparked complaints from agencies that the NHS is being “hostile and aggressive”.

The NHS Information Centre figures reveal the proportion of medical and dental staff vacant for three months rose from 0.9 per cent in 2008 to 1.5 per cent in 2009.

Among qualified nursing staff, long-term vacancies rose from 0.5 per cent to 0.7 per cent.

In London, 12.6 per cent of qualified medical posts were vacant in March, compared with 3.6 per cent in the East Midlands.

NHS Employers director Sian Thomas said she hoped the figures meant organisations were using resources to recruit a more flexible workforce, and looking beyond the UK to find workers.

The majority of bank and agency staff were cheaper in the long term than full-time employees, she said.

But she added: “There are still agencies charging disproportionate fees. We’re not saying people shouldn’t be making a profit but…it’s taxpayers’ money.

Ms Thomas encouraged trusts to work collectively, such as by agreeing a maximum fee for agency staff.

Fears over increasing agency costs are growing. Board minutes reveal West Hertfordshire Hospitals trust is spending 11 per cent of staffing costs on overtime, agency or bank staff against its target of 3 per cent.

At Barts and the London trust, agency spend as a percentage of pay budget increased from 4.3 per cent in May to 5.8 per cent in June and has been given a red risk rating.

But Healthcare Locums executive vice chairman Kate Bleasdale said that instead of being brought into discussions on how to fill the gaps, agencies are being “left out on their own”.

She said: “Sometimes we’re seeing a hostile and aggressive approach to agencies, which is counter-productive.

“We’re recruiting from countries in the world that hospitals in the UK would never have thought of, and being extremely innovative.”

She blamed the vacancies on poor workforce planning, demographic changes and immigration rules that she said have created “huge problems” in recruiting doctors from outside the EU.

DRC Locums chief executive Imraan Ladak said the European working time directive had also led to a “massive shortfall in available cover”.

The “onerous requirements for pay control” in national framework agreements had encouraged doctors in areas facing the highest shortages, such as A&E, to work with agencies outside of the framework, he claimed.