More than one in 10 registered nursing posts here were vacant in late 2019, with temporary staff costing the health service £115 million a year.

These are among the main findings of a new report published today by the Northern Ireland Audit Office

Comptroller and Auditor General, Kieran Donnelly’s report on ‘Workforce planning for nurses and midwives’ examined the nursing and midwifery workforce within both the Health and Social Care (HSC) and independent care sectors.

It reviewed whether the workforce is capable of dealing with future challenges and increasing demands on services.

The report finds that total HSC nursing and midwifery staffing vacancies have risen very significantly, from 770 in 2013 to over 2,700 in 2019. These vacancies include 2,100 unfilled registered nursing posts, with as many as 1,600 additional nurses also required to ensure safe staffing levels.

‘The reliance on temporary nurses, particularly agency staff, has not only resulted in soaring costs, it also can compromise the quality and safety of patient care as staff are deployed in less familiar clinical settings’

The report also finds that a decision by the Department of Health to reduce the training budget for pre-registration nursing has contributed to the workforce shortages, with 732 fewer nursing training places being created between 2011-12 and 2016-17, compared with 2009-10 levels. The training budget was reduced from an annual average of £30.1 million between 2008-09 and 2010-11, to £28.8 million between 2011-12 and 2016-17, in response to financial and affordability pressures.

However, the report notes that these cuts were implemented when demand for care was continuing to rise. This has had longer-term implications, contributing to an increased reliance on more expensive temporary staffing solutions.

Today’s report finds that expenditure on temporary staff (from internal banks and external agencies) has increased dramatically, from £14.6 million in 2006-07 to £115 million in 2018-19.

It concludes that the increase in agency costs, from £8.6 million to £52 million has provided particularly poor value for money. In 2018-19, Trusts incurred costs of up to £1,700 for single nursing bank holiday shifts.

Mr Donnelly said: “At a time when the focus should have been on growing the nursing and midwifery workforce, short term savings were instead pursued. Substantially reducing the number of training places over a lengthy period has left the HSC and independent care sectors with an insufficient staffing pool to cope with the rising demand for care.

“I accept that workforce planning is a challenging area to manage, particularly given the rising demands, limited resources and intense global competition for staff facing the health service. Nonetheless, short-term decisions taken at a strategic level have meant that overcoming these serious challenges will take even longer.

“The reliance on temporary nurses, particularly agency staff, has not only resulted in soaring costs, it also can compromise the quality and safety of patient care as staff are deployed in less familiar clinical settings. It is clear that this does not represent value for money.”

 
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