Nursing shortages and high cost of agency staff given an ‘extreme’ risk rating by Western Trust, new audit report notes

The Northern Ireland Audit Office (NIAO) says the high cost of using agency staff is a risk factor across the north’s health system with more than one in ten nursing posts vacant in late 2019.

The annual temporary staff spend has now reached £115 million.

Comptroller and Auditor General Kieran Donnelly’ report on ‘Workforce planning for nurses and midwives’ states:

“The impact of nursing shortages has been recorded in recent years on the corporate risk registers of all of the HSC Trusts excluding Belfast, with the Northern, South Eastern and Western Trusts having allocated this an `extreme’ risk rating. This further highlights the scale of challenge facing the Department and Trusts in addressing the significant staffing gaps and shortfalls.”

Last week the ‘Journal’ revealed how the Western Trust is paying up to £77.45 an hour for specialist A&E trained agency nurses.

Mr. Donnelly said: “Today’s report finds that expenditure on temporary staff (from internal banks and external

agencies) has increased dramatically, from £14.6 million in 2006/07 to £115 million in 2018/19. It concludes that the increase in agency costs, from £8.6 million to £52 million has provided particularly poor value for money. In 2018/19, Trusts incurred costs of up to £1,700 for single nursing bank holiday shifts.”

Commenting on the report’s findings, Mr Donnelly said: “At a time when the focus should have been on growing the nursing and midwifery workforce, shortterm savings were instead pursued. Substantially reducing the number of training places over a lengthy period has left the HSC and independent care sectors with an insufficient staffing pool to cope with the rising demand for care.

SDLP MLA Mark H. Durkan said: “For years I have been raising concern about this - not just the cost - but more importantly the impact on the capacity to deliver care, safe staffing levels and the impact of other nurses in terms of workforce and morale. It is important to remember that pre-COVID, the nurses’ strike was not just about pay but rather safe staffing. This is a pre-existing problem, brought about by years of failures with workforce planning under previous executives.

“The pandemic demonstrated, not that it needed to, the importance of having a full cohort of staff. The service was forced to throw students and retirees onto the frontline just to bear the brunt of COVID-19. It was thanks to the Herculean efforts of health staff and swift actions of the public here that mitigated the potential impact of this crisis. But I shudder to think what would have happened had we been hit harder here.”

Last week the Western Trust said it was trying to address the issue of high agency costs.

“The actions being taken to reduce the expenditure on off-framework agencies include: managing absence; monitoring and managing vacancies; regularly recruitment of registered nurses.

“The Trust also plans to recruit a larger number of the adult nurses who complete their pre-registration training in August/September 2020,” it said.