NHS Lothian's bill for using bank and agency staff to cover shifts soars by 58 per cent in five years

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Lothian Tory MSP Miles Briggs says SNP’s workforce planning is ‘woeful’

The cost of using bank and agency staff to NHS Lothian has risen by an “eye-watering” 58 per cent in the last five years.

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A Freedom of Information request by the Scottish Conservatives revealed that the cost of drafting in the temporary staff to cover shifts soared from £51,438,688 in 2018/19 to £89,343,440 in 2022/23.

Across Scotland, in 2018/19, a total of 946,423 bank and agency shifts were advertised, but this rose by 110 per cent to an “astonishing” 1,984,722 in 2022/2023. Advertised agency shifts alone have risen by over 300 per cent in the period.

NHS Lothian and other health boards are likely to rely more on bank and agency staff to cover shifts due to a recruitment freeze.  Picture: Jeff Moore/PA WireNHS Lothian and other health boards are likely to rely more on bank and agency staff to cover shifts due to a recruitment freeze.  Picture: Jeff Moore/PA Wire
NHS Lothian and other health boards are likely to rely more on bank and agency staff to cover shifts due to a recruitment freeze. Picture: Jeff Moore/PA Wire

Lothian Tory MSP Miles Briggs described the SNP Government’s workforce planning as “woeful” and said the figures for bank and agency staff were a “damning indictment” of the SNP’s management of Scotland’s NHS during their 16 years in office.

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And an increase in reliance on bank and agency staff in the coming year seems inevitable after health boards were told in the wake of the Scottish Budget last month that there would have to be a recruitment freeze of unspecified length, along with increased savings and a two-year block on new capital projects.

The FoI figures show that NHS Lothian’s bill for bank staff rose from £42,729,409 in 2018/19 to £58,734,096 in 2022/23. And spending on agency staff increased from £8,709,279 in 2018/19 to £30,609,344 in 2022/23.

Mr Briggs said: “The rise in the cost of bank and agency staff on the SNP’s watch is absolutely eye-watering. Firstly, I am grateful to the bank and agency staff in NHS Lothian as the role they play is absolutely crucial.

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“However, the fact that they are needed in this capacity to this extent demonstrates the SNP’s woeful workforce planning and mismanagement of our health service, and it has left health boards like NHS Lothian increasingly reliant on them.

“This is a damning indictment of the SNP’s running of health over the last 16 years. The fact that nearly two million bank and agency shifts were advertised in Scotland last year alone is deeply alarming and a shameful reflection on the SNP’s record in charge of Scotland’s NHS.

“With NHS Lothian and NHS Scotland resources already at breaking point, the last thing needed is forking out millions of additional pounds on bank and agency staff. If SNP health secretary Michael Matheson can extract himself from the tangle of his various scandals, he must outline a proper workforce plan to reduce the dependence on bank and agency staff.”

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Mr Matheson responded to the Tories’ attacks, saying agency nursing was a “tiny fraction” of the £10 billion a year NHS Scotland staffing pay bill and the majority of temporary staff came from staff banks, meaning these were NHS staff, working on NHS terms and conditions.

He continued: "New controls were introduced by boards from April 1 to begin to reduce the number of shifts being filled by agency staff and from June 1 boards are no longer using off-framework agencies, unless in exceptional circumstances. Boards have reported significant progress in reducing reliance on agency staff as a result of these changes and we are considering what further steps we can take.

"Since October 2021 more than £18 million has been provided to recruit 1,250 international nurses, midwives and Allied Health Professionals by the end of this financial year, with around 1,000 successfully recruited so far.

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"We absolutely value our nursing staff and have reached historically high NHS staffing as well as investing £1 billion over two years on NHS Agenda for Change Pay which includes a 6.5 per cent pay rise for 2023-24."

Dr Iain Kennedy, chair of BMA Scotland said Scotland was in the grip of a doctor recruitment and retention crisis and the figures demonstrated the impact that was having.

"Agency shifts are expensive and not a sustainable way to staff our NHS, and it is worrying the health service in Scotland is becoming more and more reliant on them. Just days after our snap survey revealed 80 per cent of doctors who responded feel staffing levels are sometimes or regularly unsafe, this shows yet again how urgent a proper long term workforce plan for Scotland's NHS is.

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“By investing in permanent staff, rather than temporarily plugging the gaps, the NHS could provide the continuity of care to patients that the evidence shows leads to better health outcomes."

Alison MacDonald, executive nurse director for NHS Lothian said: “We have been working hard to significantly reduce our reliance on agency and bank staff while always maintaining safe staffing levels. Over the last six months we have been implementing enhanced daily staff monitoring and control measures to prioritise redeploying staff to areas across NHS Lothian with the greatest need where there are pressures. In addition, we have also recruited more than 500 new registered nurses and have a continuous process of recruitment for non-registered staff.”