The Taking the temperature report from Liaison Workforce – in its first release since before the Covid-19 pandemic – showed significant improvement in the use of bank staff in recent years. The proportion of temporary medical staff sourced through in-house banks as opposed to more expensive agencies had increased to 38% in 2022/23, up from 28% in 2018/19 – credited to the development of medical banks.
However, the workforce management system specialist said there was room for much greater use of bank staff, which would help ease financial pressures and meet NHS long-term workforce plan targets. On top of the savings from switching from agency to bank staff, Liaison said further savings could also be made by moving long-term agency workers to the substantive workforce.
Overall in 2021/22, spending on temporary staff was £8.16bn – £5.2bn on bank staff and 2.96bn on agency workers. The long-term workforce plan said this was an increase in spending on temporary staff of 51% in just three years, partly as a result of the response to the Covid pandemic. The plan stated that use of agency staff offered poor value for money and could have a negative impact on patient experience and continuity of care. NHS England is aiming to reduce the reliance on temporary staffing in full-time equivalent terms from 9% in 2021/22 to around 5% from 2032/33.
The Liaison report said that, based on total costs to the trust, a consultant booked through an agency is 32% more costly than one employed through a bank. Foundation year 2 doctors are almost 50% more expensive when sourced through an agency.
Pathology and general medicine consultants attracted the highest hourly pay rates – up to £210 per hour, while 28% of all agency bookings exceeded the £100 per hour limit that requires chief executive sign-off – a 20 percentage point increase from 2018/19. Liaison also highlighted the high costs being incurred for some individuals. For agency workers working at the trusts in the sample, a third had been in their post for more than a year. The top 10 highest earning consultants in 2022/23 cost £3.4m, which could pay the salaries of 36 full-time substantive consultants.
‘Where savings can be made for the trusts, while also meeting NHS England’s aims to reduce temporary staffing levels, the message is clear that the increased use of banks is a necessary step for managing work forces,’ said Liaison Workforce’s managing director, Judith Shaw (pictured).
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