Nurses are earning up to £2,500 to cover shifts at struggling hospital trusts, it was claimed today as a winter of NHS-wide chaos looms.
Agency workers — which can include NHS-salaried medics looking for extra work — are increasingly being drafted in to plug gaps in rotas.
Figures from the BBC show spending on such staff across all medical professions hit £3billion in England last year, up 20 per cent — or £600m — on the year before.
NHS bosses have been so short-staffed they have breached Government pay caps in a desperate attempt to attract agency workers, including doctors and midwives as well as nurses.
Separate data from Labour also found some ailing NHS trusts have forked out as much as £2,500 to fill nursing shifts.
Some of the cash spent on agency staff will inevitably go to recruitment firms, but the exact proportion of what nurses will make will vary per company, their seniority and if they are a specialist like, for example, a mental health nurse.
It means that nurses — thousands of whom are set to walk out in the coming weeks in a devastating stand-off with No10 over pay — could make more money by taking on shifts at other hospitals during the planned action.
This graph shows the Royal College of Nursing’s demands for a 5 per cent above inflation pay rise for the bands covered by its membership which includes healthcare assistants and nurses. Estimates based on NHS Employers data
A Freedom of Information investigation by Labour found that Great Western Hospitals NHS Foundation Trust in Swindon (pictured) had paid £2,549 to single agency nurse in 2021/22
Dr Sarah Clarke, president of the Royal College of Physicians, said there is a ‘significant cost’ to paying agency workers to fill rota gaps but the move is needed to keep patients safe
Now the MIDWIVES start voting on strikes!
Midwives across Britain today began voting on whether to join the devastating wave of NHS-wide strikes this winter.
Ballots were sent out to more than 30,000 members of the Royal College of Midwives in England and Wales. The union is angry about No10’s ‘insulting’ pay offer – which amounts to roughly 4 per cent, or £1,400 – and wants an ‘inflation-busting’ hike.
Members in Scotland have already voted ‘overwhelmingly’ in favour of industrial action. A similar ballot is being prepared in Northern Ireland in the coming weeks.
Up to one million NHS workers could walk-out over pay and conditions this winter.
This includes thousands of nurses who will strike in the coming weeks, with disruption expected to begin before Christmas and rumble on until May. Junior doctors and paramedics could join them.
Dozens of hospitals will be affected, with thousands of routine operations like hip and knee replacements facing the axe, along with general appointments and vital cancer and dialysis treatment.
Action will come at a time when the NHS is already crippled, with the backlog for ops sitting at all-time high and A&E and ambulance services amassing worst-ever performances before winter pressures have even truly kicked in.
The Royal College of Nursing, which is orchestrating historic nursing strikes, is already facing pressure to call off its planned walk-outs. Members from within the 106-year-old union, described by critics as ‘militant’, have claimed action would be ‘irresponsible’ amid warnings that lives will be lost from any disruption.
Rishi Sunak’s Government has so far resisted calls to boost NHS salaries, with the Prime Minister yesterday saying the RCN’s demands were ‘not affordable’.
Agency rates can pay more than double what a regular NHS nurse earns.
More than 300,000 members were balloted by the Royal College of Nursing (RCN) in the first vote on UK-wide industrial action in the union’s 106-year history.
The union, described as ‘militant’ by critics, has confirmed to MailOnline that nurses striking will be able to pick up lucrative shifts elsewhere on strike days.
This could potentially include other striking hospitals seeking to plug staffing gaps, though the union has asked agency staff not to cover for striking members, however.
An RCN spokesperson said they strongly discouraged striking members from picking up any nursing shifts on strike days.
They said: ‘We would encourage members to show their support for being on strike by attending a picket line at their workplace and peacefully picketing.
‘Whilst we recognise the financial pressure nursing staff are facing and how many are already working extra shifts or agency shifts to make ends meet, we would not encourage this on strike days.’
The RCN is offering its members a £50 per day hardship payment for anyone taking part in strike action, with funds taken from its £50million war chest.
Some 100 trusts in England and almost all NHS employers in Scotland, Wales and Northern Ireland are set to be affected by walk-outs, which are expected to begin before Christmas and rumble on until May.
Agency rates are infamous for being well above what full-time NHS employees earn.
Some agencies are advertising agency jobs for band 5 nurses, which are the lowest paid in the NHS, at up to £30 per hour. In comparison the NHS rate for band 5 starts at £13 per hour.
The ad states an NHS trust is ‘currently offering fantastic escalated rates for band 5 ad-hoc shifts’.
This company also offers nurses a £100 golden hello to join their stable and also gives a £500 referral bonus to those who encourage medics to sign on.
NHS nurses wanting to work in other health roles generally need permission from their employer to do so and are forbidden from working agency shifts while on sick leave.
They are also encouraged to join the NHS bank, a system where staff can sign up to take on extra shifts at a cheaper rate for the health service than employing an external agency.
Bank staff are prioritised for shifts over external agencies but demand for staff is so great NHS bosses sometimes have little option but to pay extra.
Dr Sarah Clarke, president of the Royal College of Physicians, said there is a ‘significant cost’ to paying agency workers to fill rota gaps but the move is needed to keep patients safe.
A Freedom of Information investigation by Labour found that Great Western Hospitals NHS Foundation Trust in Swindon had paid £2,549 to single agency nurse in 2021/22.
There are currently almost 47,000 nursing vacancies in the NHS, or roughly one in ten of its entire workforce.
The RCN is fighting for an inflation-busting pay rise of approximately 17 per cent — around £6,000 for an average nurse who earns £35,000.
The graph shows the current average salary of public sector workers (blue bars) and how much more their unions are asking their pay to be increased by (yellow bars). The nurses’ union is asking for a salary increase of five per cent on top of RPI inflection, which current sits at 12.6 per cent
Official figures show 7.1million people in England were in the queue for routine hospital treatment, such as hip and knee operations, by the end of September — the equivalent of one in eight people (red line). The figure includes more than 400,000 people who have been waiting, often in pain, for over one year (yellow bars)
Meanwhile, emergency care performance has deteriorated to fresh lows. More than 1,400 A&E attendees were forced to wait in more than 12 hours for care every day in October (yellow bars), while the lowest proportion ever recorded were seen within four hours — the NHS target (red line)
Ambulance performance statistics for October show paramedics took longer to arrive to category one, two and three call outs since records began in 2017. Ambulances took an average of 1 hour, one minute and 19 seconds to respond to category two calls (red bars), such as burns, epilepsy and strokes. This is more than three times as long as the 18 minute target
Cancer care plummeted in September. Just 60.5 per cent of patients started cancer treatment within two months of being referred for chemotherapy or radiotherapy (red line). The figure is down from 61.9 per cent one month earlier and is the lowest ever recorded in records going back to October 2009. The NHS states 85 patients should start treatment within this timeframe
Nursing strikes Q&A: Everything you need to know
What was the result of the strike?
Nurses at the majority of NHS organisations on the ballot voted to strike – 176 out of 311 NHS employers across the UK. Some did not meet the 50 per cent turnout threshold.
When will strikes last and how long will the strike last?
Strikes are expected to begin in early December and could take place over two dates, potentially a Tuesday and a Thursday. They could last until early May 2023.
What level of care can patients expect?
The RCN handbook says nursing provision during the strike period should be equal to the skeleton staffing usually seen on Christmas Day, although the NHS says it has well-tested procedures to limit disruption.
Which nurses will remain in post?
Emergency nurses in A&E and intensive care will keep working, as will district nurses who help elderly people in the community. Other exemptions will be negotiated at a local level.
Why are nurses going on strike?
The Royal College of Nursing is campaigning for a pay rise of five per cent above inflation, claiming an experienced nurse’s salary has fallen by 20 per cent since 2010.
What is the pay deal they are unhappy with?
Nurses in England and Wales received a pay increase of at least £1,400 this year, but the RCN claims this left them effectively working a day a week for free.
Have there been nursing strikes before?
Yes – some nurses from the union UNISON went on strike in 2014 and RCN nurses in Northern Ireland walked out in 2019 but this is the first time the RCN has balloted all its 300,000 members in all UK countries in its 106-year history.
Who could be next to strike?
Hundreds of thousands of junior doctors, midwives, physiotherapists, paramedics, ICT staff and porters are among NHS staff either being balloted or expected to be balloted on strike action over anger about pay rises. The next result should be from Unison, who closes its ballot on November 25 after asking 350,000 NHS workers whether they want to strike.
However, the Government says this would cost the taxpayer £9billion to fund.
Dr Clarke, a cardiologist, told BBC Breakfast that agency staffing was already costing the taxpayer.
‘Staff shortages have meant we have had to dip into the public spending and pay for agency and locum staff and this of course comes at a significant cost,’ she said.
Asked about agency staff making more than regular NHS workers, Dr Clarke added: ‘Unfortunately, they are employed by agencies so the agency sets the fees.
‘If we’re short-staffed, we have to go and get more staff because this is about patient safety. We have to have people there to care for our patients.
‘But [in] the longer term, it is fixing the workforce issue.’
She said using agency staff is a short-term fix but the Government needs to produce a workforce plan on how it intends to staff the NHS long term.
NHS leaders, charities and thinktanks have been repeatedly calling on the Government to publish a workforce plan.
The BBC also reported evidence of aggressive marketing by agencies, which take a cut of the shift pay, with one boasting it is the ‘best’ time to try it, because the fees that can be commanded are increasing.
Agency pay rates are capped at 55 per cent above what a normal employee would receive.
But for nearly nine in 10 agency shifts for doctors and dentists, and four in 10 for nurses, the caps were exceeded last year.
NHS bosses can only do this if there is a significant risk to patient safety.
Siva Anandaciva, chief analyst at the King’s Fund think tank, told the BBC the NHS is caught in a ‘vicious cycle’.
He said a combination of staff shortages, Covid sickness absences and rising demands is driving the increase in reliance on agency workers.
Shadow health secretary Wes Streeting called it an ‘infuriating’ use of money.
‘Taxpayers are picking up the bill for the Conservatives’ failure to train enough doctors and nurses,’ he said.
A Department of Health and Social Care spokesman said: ‘We have a clear policy to reduce agency spend through capping the hourly pay of agency and temporary staff, ensuring they are only hired through approved NHS agreements to ensure value for money and prioritising NHS staff rather than external agency staff where extra shifts need filling.
‘These measures have seen agency spend fall by a third overall between 2016 and 2021.
‘We have also commissioned the NHS to develop a long-term workforce plan to help recruit and support NHS staff and we have given over one million NHS workers a pay rise of at least £1,400 this year.’
Emergency care won’t be disrupted by the RCN walk-outs, yet health insiders fear lives will still be lost as a result of the action.
A senior NHS boss yesterday insisted hospitals will do all they can to ‘minimise harm’ to patients but admitted ops and appointments will inevitably be cancelled or postponed, worsening the backlog that sits at an all-time high of 7.1m in England alone.
Specialist cancer hospitals, including London’s Royal Marsden and the Clatterbridge Cancer Centre in Liverpool, voted for action, putting chemotherapy appointments at risk. Care at maternity hospitals and specialist children’s hospitals will also be disrupted, while nurses will also strike at the biggest hospitals in London, including Guy’s and St Thomas’, opposite the House of Commons.
Tories have labelled the action ‘criminal’ and warned that lives will be lost as a result of the action. One MP told the Mail: ‘It’s not a job you choose if hoarding wealth is what you’re looking for.’
Pat Cullen, general secretary of the RCN — a union that has been described as ‘militant’, said: ‘We don’t intend to place any patient at further risk during the strike.
‘We will manage that safely and effectively.’
In total, 176 NHS organisations across the UK voted in favour of strikes, out of a total of 311 employers included in the ballot. Some did not meet the 50 per cent turnout threshold.
The fact that not all trusts will strike is expected to exacerbate a postcode lottery of care, with different areas of the country to suffer vast disparities in waiting times for appointments, treatment and ambulance responses.
The latest NHS data recorded that about 45,000 nursing posts in England are vacant as of the end of June. London has highest percentage missing, with 15 per cent of nursing posts unfilled
NHS data shows efforts to get more nurses into the health service are only barely keeping pace with the number of experienced nurses quitting
Critical care in life threatening situations should not be put at risk if strikes take place, however elective treatment, outpatient care and other healthcare services, including chemotherapy, dialysis and surgery, are likely to be impacted.
In addition to nurses, approximately one million NHS staff members, including junior doctors, midwives, ICT staff and porters, are either being balloted or are expected to be balloted on strike action over anger about pay rises.
MPs have warned workers to ‘think very carefully’ over strike action and pay demands that ‘would just break the NHS completely’.
Health insiders said if the strikes went ahead, it could see hospitals fall into disrepair and patients’ calls go unanswered. One source added: ‘The impact of coordinated strikes will be that death rates will rise.’
Tory MP Mark Jenkinson said: ‘Nurses do a wonderful job and are under tremendous pressure but it’s not a job you choose if hoarding wealth is what you’re looking for.
‘You don’t choose a job like that if caring isn’t the centre of your thinking. Ultimately the people who will be hurt the most are the patients.’
It comes as NHS waiting lists sky-rocketed to a new record high yesterday amid warnings that the health service is already at ‘breaking point’ before winter pressures have even kicked-in.
Official figures show 7.1million people in England were in the queue for routine hospital treatment, such as hip and knee operations, by the end of September — the equivalent of one in eight people.
The figure includes more than 400,000 people who have been waiting, often in pain, for over one year.
The figures reflect the situation before winter pressures, such as an expected rise in Covid and flu admissions, have been felt in hospitals.
And it comes ahead of industrial action by NHS nurses, which is expected to see thousands of operations and treatments cancelled as the NHS is reduced to a ‘bank holiday’ service on strike days.
Meanwhile, emergency care performance has deteriorated to fresh lows.
More than 1,400 A&E attendees were forced to wait in more than 12 hours for care every day in October, while the lowest proportion ever recorded were seen within four hours — the NHS target. The situation is thought to be even worse than the official data suggests.
And cancer care approached its worst-ever performance in September, with just six in 10 newly-diagnosed patients starting treatment within two months.
Top oncologists warned there is a ‘real and frightening possibility’ that Government won’t provide sufficient investment needed to catch-up and more lives will be lost.
The NHS bragged that it has cut the number of patients who have been queuing for hospital treatment for 18 months, while dealing with a rise in Covid and flu patients, as well as emergency care pressures.