Health boards have until November to stop their use of agency nurses in efforts to save money.

Agency nurses – nurses usually employed by private companies who are offered temporary roles across the NHS to cover staffing gaps, usually at an enhanced hourly rate – will only be allowed in ‘clear situations’ where clinical safety is at risk or where services would otherwise be suspended.

In a letter sent to board chief executives, the Scottish government’s Director of Health Workforce and Interim Chief Nursing Office say that all use of agency nurses to plug gaps thereafter will need to be signed-off by a local executive director.

A similar policy stopping the use of agency staff to fill healthcare support worker and unregistered staff shifts was put into place from April this year.

Both measures come as part of wide-ranging cost saving measures being put into place across the NHS in Scotland.

Health boards together face more than £800m of savings cuts this financial year.

 

Why does NHS Scotland use agency nurses?

Most health boards report that recruitment challenges to substantial posts have increased their use of expensive agency staff over this time.

There are more than 3,102 whole-time equivalent (WTE) vacancies within nursing and midwifery across NHS Scotland.

Meanwhile, new safe staffing requirements to cut the working week to 37 hours for nurses have also seen boards draft in agency nurses to meet their legal obligations and maintain safe services.

The number of nurses in Scotland employed by agencies has grown by 120.5% over the past decade.

However, health boards report that their reliance on agency nurses has meant there is little consistency in staff teams, which can negatively impact patient care.

NHS Lothian reports that it has cut its use of agency staff across all sites, already saving £6m this year.

It has an established nurse bank – a pool of temporary NHS nurses who can cover shortfalls, without the often-inflated hourly rate of their agency counterparts – which it is using to fill the gaps instead.

Other, more rural boards say they rely on agency nurses in specialities where there are local skill gaps.

NHS Grampian says it has managed to reduce its use of agency nurses by a third in the last year.

However,  Grampian’s Director of Finance reports in board papers that the deadline will be ‘challenging’ to meet in areas like prison healthcare, neonatal, and endoscopy where specialist skill sets are not readily available locally.

NHS Grampian has already spent £6.2m more than it had budgeted for within nurse staffing.

NHS Borders reports its reliance on agency nurses stems from a steady 30-40 WTE registered nurse substantial positions not being filled at any one time.

While agency nurses fill these gaps, they do not provide consistency and can hinder the development of team dynamics, which the board says can be detrimental to patient care.

Agency staff spending continues to be a significant pressure areas for NHS Dumfries and Galloway.

Last year, the board spent more than £565,000 on agency nurses and projections show this year’s spending on agency staff is likely to remain almost as high.

The board has an ongoing recruitment programme to fill its high level of nursing vacancies.

The Scottish government says it will monitor boards’ use of agency staff to support them working towards the end of October target.

Read more: New nurses and midwives left jobless by NHS cuts; “Difficult” budget cuts to health and care

 

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