Agency staff are bumping up NHS costs

Queen Alexandra Hospital.
Queen Alexandra Hospital.
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THE NHS in Portsmouth has spent millions on getting rid of staff, while payments for agency workers has gone up, reports PRIYA MISTRY.

In just over two years the NHS trust that runs Queen Alexandra Hospital has spent almost £5m on redundancy packages to staff, The News can reveal.

The cull in staff has provided Portsmouth Hospitals NHS Trust savings of £4,747,000 since April 2010, in a bid to cut back on its debt.

In total 31 people took voluntary redundancy between April 2010 and March 2011.

Of those, 14 people were paid between £25,000 and £50,000 in pay packages.

According to figures obtained by The News through the Freedom of Information Act, in 2010/11, £1,046,000 was paid out compared to £3,701,000 between April 2011 and March 2012.

Tim Powell, director of workforce and organisational development, said: ‘There was a redundancy scheme in 2010/11, called the Mutually Accepted Redundancy Scheme (Mars) and that ran on its own.

‘It gave staff, who wanted to leave on redundancy terms the chance to do that with the trust, which created efficiencies.

‘In 2011/12 there was a compulsory redundancy scheme that was introduced as well as Mars.

‘That took away staff from corporate functions, such as the communications team, human resources and financial department, rather than nursing.

‘This is in line with making a five per cent saving. In 2011/12 we had a budget of £243m to pay staff – a five per cent reduction on the year before.

‘We had to determine a certain amount of savings, so the redundancies needed to be made.’

But The News can reveal that despite taking these steps, the trust is still £3.1m adrift of its planned deficit.

It had factored in a loss of £3.8m, but latest figures show that at the end of last month the debt stands at £6.9m.

In the same timeframe 41 people opted for voluntary redundancy, but a further 26 posts were lost through a compulsory cutback.

Last year 20 staff members were paid between £50,000 and £100,000 and four people were paid between £150,000 to £200,000.

But in the same time frame the number of agency staff used by the trust has doubled from 1.5 per cent of the total pay bill to three per cent.

The trust says there is not a direct link between more agency staff being used as the number of redundancies have doubled.

In 2010/11, £3.7m was spent on recruiting agency nurses, admin and clerical assistants and locum doctors.

But this spend doubled to £7.5m the following year.

‘You may think we have made redundancies, but we have doubled the number of agency staff, which is a fair challenge,’ says Mr Powell.

‘But the majority of agency staff have been recruited because there’s been a demand on the accident and emergency services.

‘You have elective patients that will come in for things like hip operations, and that is booked in.

‘But for those that come in because of accidents or a medical emergency has increased by eight per cent.

‘This means we have had to increase our resources rapidly. It is in the pipeline to reduce this though.’

Unison – the union which represents medical staff such as nurses, says it’s aware PHT does recruit a high number of agency staff.

Mike Wilson, from Unison, said: ‘I do know that for some time PHT agency spend has been above targeted figures.

‘I don’t think that’s unusual in the NHS.

‘I think we would find the trust would agree to have more full time staff than short term agency staff in.

‘It does show that in some areas the trust struggles and they are not helped by agencies in the NHS have been affected by central government pay freezes.’

He also indicates the local picture is echoed nationally.

‘That’s the impact in the whole NHS. People are leaving the NHS because they are worried about the future of the organisation and their rules with the changes as a result of the health and social care bill,’ added Mr Wilson.

‘I have been told by the trust fairly recently that they don’t have any plans for more mass redundancies at present.

‘They lost quite a few people in around October-November last year and I hope they can hold on to staff because without staff services inevitably suffer.

‘The administration in the NHS is as essential to services as frontline roles.’

The trust said it has no plans for further redundancies, is working on employing more fulltime staff to reduce the number of agency employees used.

‘We have invested £2.2m in resourcing levels of permanent nursing staff,’ says Mr Powell.

‘We have to pay a high premium for using agency staff, for example to use an agency oncology nurse will cost us 20 per cent more than recruiting a substantive nurse.

‘From autumn we have 100 nurses coming into the trust and we’re going to continue to be proactive with filling posts.

‘Redundancy is always a last option for us when it comes to delivering savings.’

MP Mike Hancock, who represents Portsmouth South, says he understands why staff expenditure is needed.

He said: ‘As someone who has had help from QA recently, I have nothing but admiration for the staff.

‘I’m very sorry the financial situation is the way it is, but it’s not easy to run a hospital if you don’t have many staff.

‘They have to look at what is economical.’


THE number of medical staff working at the hospital and within the ambulance service taking time off for stress is increasing.

Figures released from South Central Ambulance Service show that in 2009, 31 people working in Hampshire took time off because of stress, with the longest stay being 131 days.

But since then the number has been rising to 43 in 2010, 52 in 2011 and 48 for this year so far.

Worryingly, the longest amount of days taken off has also increased – this year it stands at 180 days.

The figures, which were given following a Freedom of Information Act request, show the number of average days lost due to staff being off with stress is 43.

Positions in the ambulance service range from technicians, paramedics, student paramedics, emergency call takers and fleet drivers.

A Scas spokeswoman said: ‘We can confirm we have a number of plans/resources in place should our staff be suffering from any form of stress.

‘This can be stress caused for a number of reasons, not only the types of stress that sometimes can happen through working within often highly-charged emotional situations.

‘That said we have a new team structure in place which offers more support to staff than ever before.

‘We also have invested in developing a specific programme whereby staff are trained to provide support to colleagues who might need additional help due to emotional distress caused by critical incidents they attend.

‘Staff are also supported by a number of organisations that specialise in stress management and counselling.

‘These include our employee assist programme and occupational health.’

And at Portsmouth Hospitals NHS Trust, which runs Queen Alexandra Hospital, since April 2010, 659 staff members have had time off for stress.

The shortest absence was a day and the longest 189 days, giving an average of 22 days.

Tim Powell, director of workforce and organisational development at PHT, said: ‘I don’t think stress is linked to job losses.

‘I think people work very hard here and there’s a lot of pressure to provide high-quality care and service to patients.

‘We have started a pilot programme called Fit for Work, which is self-referral to counsellors if things get too much for them.’