Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how much NHS trusts have spent on agency and contract staff in (a) each year since 2009-10 and (b) 2014-15 to date; and how much NHS trusts plans to so spend in 2015-16.

National Health Service spend on agency and contract staff is recorded in the table below:

As at 31 December 2014, the NHS had spent £1.3 billion at NHS foundation trusts (FTs) and £1.1 billion at NHS trusts on agency and contract staff.

In 2015-16, the NHS plans to spend £568.2 million at NHS FTs.

The planned spend for NHS trusts is not currently available.

Following the Francis report many trusts increased their spend on temporary staffing to meet safe staffing levels. The Department expects trusts to have a strong grip on their finances, and manage their contract and agency staffing spend (including use of locums) responsibly through effective and efficient workforce planning and management and to minimise temporary staffing costs in future years.

To support the NHS to reduce agency spend, we are working to improve the deployment of the existing employed nursing workforce, for example, through spreading good practice in use of electronic rostering; improve workforce planning and supply to ensure we achieve safe staffing levels through better recruitment and retention including, for example, supporting nurses who want to “Return to Practice”. In addition , we are working to reduce the cost of agency staff by, where it is possible and appropriate, requiring the NHS to use existing frameworks (e.g. trusts receiving financial help under the Health and Social Care Act 2012) so they can secure agency staff at market rates.

Notes:

The figures reported by FTs were different in definition from those collected from other organisations before 2012-13, and were different in status. FTs published figures for “Agency/contract” expenditure in their annual audited accounts. Other organisations did not provide this level of detail in their audited accounts, but reported expenditure on “Non-NHS Staff” in annual Financial Returns. These returns followed on after the accounts and were reconciled to them, but were not part of the audited accounts.

Financial Returns were discontinued in 2013 to reduce the burden on the NHS. At the same time, the definition was aligned with FTs as “Agency/contract”. Excluded from the “Agency/Contract” category are costs of staff recharged by another organisation where no element of overhead is included i.e. where the staff costs are shared between the NHS trust and other bodies; staff on secondment or on loan from other organisations; amounts payable to contractors in respect of the provision of services (for example, cleaning or security).

The figure for 2009-10 includes primary care trusts (PCTs). PCTs provided significant amounts of patient services (in 2010, 19% of NHS nurses were employed by PCTs), and most of these services have transferred into trusts. It is not possible to separate out PCT expenditure between provider and commissioner costs.

For the first time, the Department collected unaudited financial data from NHS trusts for 2013/14 on Contract and Agency staffing costs and income to give a net expenditure figure. The data was collected on the NHS Summarisation Schedules that form the basis of the Department’s Annual Report and Accounts