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£3.2bn agency spend could have paid salaries of 31,000 nurses

New RCN analysis reveals cost of short-term approach to filling staffing gaps.

Nurses in clinical setting

Findings from a Freedom of Information (FOI) request to NHS trusts in England expose a total of £3.2bn spent on agency staff by hospitals between 2020 and 2022.

Poor government planning and underfunding have forced trusts across the country to spend millions covering staff shortages to keep wards open.

According to RCN analysis, three-quarters of nursing vacancies in the NHS in England could be filled if the money had been redirected to hiring permanent staff. Cash spent on agencies could cover the salaries of 30,956 permanent full-time equivalent nurses paid at the top of a Band 5 salary (£34,581).

Instead, the recruitment crisis in the NHS is forcing hospitals to spend vast sums on agency staff as services run under the strain of more than 40,000 vacant nursing posts.

Alternatively, the findings reveal money spent on agencies could have trained over 86,000 new nurses. Research by London Economics for the RCN estimates the cost of training a nurse is £37,287.

Every year trusts are spending more on agency staff, and the findings demonstrate costs spiralling by 63% from £800m in 2020 to £1.3bn in 2022.

Costs were highest in London, where hospitals spent £630m on agency staff, while in the North of England, hospitals paid out £109m for staff working temporary shifts across the three years.

RCN Chief Nurse Professor Nicola Ranger said: “Ministers have got their priorities wrong – forcing trusts to spend billions on agency staff while they provide miserly funding for fair pay and nurse education.”

While vast sums are being spent to plug holes in rotas in the short term, the RCN is asking how the NHS Long Term Workforce Plan will be funded. To grow the profession, the government needs to demonstrate it’s committed to making nursing more attractive, starting with fair pay.

Alarmingly, despite the need to increase nursing student numbers to achieve the plan’s targets, the most recent figures show a 12% drop in the number of people accepted onto courses to study nursing. An average nursing student takes on a debt burden of £50,000.

The RCN is calling on the government to abolish tuition fees for prospective nursing students and provide loan forgiveness for those who have already paid for their education.

Nicola continued: “With cuts to nurse education and maintaining unfair pay levels, ministers are choosing to spend the money on much higher private agency bills instead. This is yet another false economy when it comes to NHS spending.

“This should act as a wake-up call. The government must give nursing staff and patients the investment and respect they deserve. Not acting now will mean even more patients on waiting lists and the crisis in the nursing workforce deepening further.”