Our analysis has revealed that hospitals across the capital have spent £630,474,376 on temporary nursing staff between 2020 - 2022 to plug chronic staff shortages.1 This money could have paid the salaries of 6,077 full-time nurses each year in London.2
The analysis is based on the findings from a Freedom of Information (FOI) request sent to NHS trusts across England. The findings show over £3 billion was spent on agency staff by hospitals in England to plug chronic staff shortages.
In London Trusts, spending increased by 57% in three years, going from £163,469,848 in 2020 to £256,841,966 in 2022. London had the highest spend on temporary agency nursing staff compared to any other region in England.
Long before 2020, NHS leaders were grappling with the challenge of recruiting and retaining enough nursing staff in the capital. Nurse vacancy rates in London have been consistently higher than any other part of the country for several years. Currently, London’s NHS has over 10,000 vacant nurse posts. At the same time, the health system is desperately trying to get to grips with high waiting times while being told to be more productive and make cost efficiency savings.
Our research in 2020 showed that 57% of the city’s nurses said they were likely to leave the capital within the following five years because they simply couldn’t afford to live and work in the city. This risk of more nursing staff leaving has spiralled due to the continuing cost of living crisis in the capital, especially the impact of hikes in interest rates, rents and travel costs.
Whilst vast sums are being spent to plug holes in rotas in the short term, we are asking how the aspirations in the NHS Long Term Workforce Plan will be funded. Spending on temporary staff is draining budgets which could be better spent on funding the Workforce Plan, growing a permanent nursing workforce, and improving patient services.
To grow the nursing profession, the government needs to demonstrate it is committed to making nursing a more attractive profession, starting with fair pay. Otherwise, even more funds will be spent on agency staff and the workforce in London will continue to be left with thousands of vacant posts.
RCN London Regional Director Lisa Elliott, said:
“The nursing workforce shortage in London is not new. The reality is that it has been building for several years, despite RCN London and our members raising the alarm with the city’s politicians for a number of years.
It is placing significant pressure on London’s NHS leaders to keep services running against a backdrop of short staffing, rising waiting lists and demands to deliver further efficiency savings. Ultimately, it’s patients who will suffer.
London is a fantastic city to live and work, but the reality is that nursing staff simply cannot afford to stay long term due to the high cost of living. It’s no surprise that hospitals in the capital are forced into spending millions on agency staff to fill rota gaps to be able to care for Londoners.”
More information:
1. The RCN submitted a Freedom of Information request to NHS trusts in England on spending on agency nursing staff for the calendar years 2020 to 2022. A total of 182 trusts provided usable data that showed £3,211,438,575 was spent on agency staff. All NHS Trusts in London responded, however, two trusts provided data that was non-compliant (in financial year format). This left the data of 32 trusts that could be used.
2. The average agency spend each year in London (£210,158,125), would pay for 6,077 permanent full-time equivalent (FTE) nurses each on the top of a Band 5 salary (£34,581) at the 2023/24 NHS pay scales. This calculation does not include London weighting.
