To ask about agency nurses

[Sallyingforth]

In the news we are told that hospitals are overspending on agency nurses that cost so much more than employed staff.
That being the case, why not save money by employing more of those nurses as permanent staff?
Is it because the nurses prefer temporarily work, or is there an artificial cap on staff numbers?
No politics please, I'd just like to know the answer.

temporary

Because they get paid way more working for the agency so don't want an NHS contract that will pay half the salary.

My dept wouldn't run without agency staff. People don't want to work in theatres for some reason.

They get paid more, can pick their own shifts, less hospital politics etc from the nurses in my hospital...

They get paid a hell of a lot more, can pick when to work, don't have to deal with workplace politics, can choose which hospitals and which departments they want to work in. Not sure how it works with annual leave/sick pay though.

Not sure how it works in Nursing but I'm a HCP and we have an ongoing staff situation (as does 99% of the NHS)

If a member of staff leaves , they give their notice ( 4 weeks for clinic staff, 12 weeks for manager)
The funding doesn't come back to our dept, it goes in The Pot.
To fill a vacancy takes months. Post advert. Give a closing date. Send out interviews (and the applicant might not want to tell their employer that they're looking so might need to take leave- so notice needed for that).
Interviews. If they turn up
Job offer
The applicant then gives their notice (a month)
So it can take 3 months+ (as I tell my patients)
"Oh is no-one going in for this job" they ask.
Loads but the system doesn't work like that.

IIRC , if staff leave the agency to go into the NHS, the NHS have to pay (a month salary I think) to release them.

Agency is good money (I did for 2 years) but no job security, more travel, no sick leave , no holiday, and I got the shitty clinics alot of the time.

Some wards will offer overtime to staff, but that's if they want to do another shift.
I can do overtime but as I'm P/T , i'd get time or pay at normal rate, not time-and-a-half that I would at F/T.

Also in wards, there's a legal minimum staff:patient ratio, so they will always need short notice staff.

2 nurses in my hospital have just left so that they can just work as agency nurses. They can pick their hours, get more than double the money and choose where they want to work. They are young, have no ties and this way can save up for a house.
We have at least one agency nurse a week working for us.

My friend is an agency nurse in London and she earns a good whack. She'd never work for the NHS.

There's alot of hostility towards agency staff though. I encountered some right PITA when I did it.
Though, I was fecking brilliant hard working, punctual and professional and some Heads of Service used to ask the agency for me by name . But is is hard to go to a completely new clinic and find your way round.

And we've had some truely awful Agency Staff (but they don't get invited back)

Choose when you work, rather than having a contract that specifically expects rotating shifts. And paid more.

Agency staff get paid a lot more money and have the freedom of choosing when they worked.

My friend who works as an agency nurse was taking home just under £1'000 a week by doing five night shifts a week.

In the last 6 months three of my colleagues have handed in their notices and now work only as Bank staff and definitely prefer it.

Thanks for the replies!
This explains why an agency has a recruiting office right across the road from our local hospital.
I didn't know how much of the money got through the agency to the nurses doing the work. Certainly in the home care service I'm familiar with the agency seems keep the lion's share of the clients' payments.

I'm not sure how much choice there is in where/when you work.
I did agency in the mid 90s (there were two agencies in London which covered my profession, one large and well organised, which I worked for. The other smaller, no idea how they were though)

The vibe was, if they offered work and you turned it down, that you wouldn't be first on the list when jobs came through.
If a HA needs a clinician today and are prepared to pay agency rates, they need to know the agency has the staff.
If I turned round and said "Erm, not today thanks" it looks bad on the agency too.

I did it for 2 years, I'd left a F/T job of 7 years and I wanted to try different Health Authorities but I had no intention of doing this long term.

Permanent staff are more expensive in the long term as they don't get sick pay, maternity, pension contributions, study leave etc.

They do get paid more but have to save about a third of that for tax, indemnity, insurance, and there is the lack of job stability. It's not all down to getting higher wages!!

Depends on what the media is considering agency staff too. In my trust we do not get overtime so any extra shifts are dealt with by an agency called retinue... We used to be with nhs professionals. when we woRk overtime we are therefore technically agency staff.

I think as well there's a feeling now that you are better off bringing more cash in day by day than having a good pension pot. One reason is living today is just so expensive, the other is that if you are in a position to save personally and invest in property etc that can work out better for some peopl. And ultimately, we know how the government works now and pensioners get taken care of, with state pension and pension credits etc.

I don't work anymore as I,m a carer but in the mental health trust I worked for they cut down the numbers of staff working on the wards massivly , for example about ten years ago there would be about 12 staff nurses on one ward and now there are about eight so it only takes one to go off sick sick and people having annual leave etc and the wards are massivly under staffed they relied hugely on agency staff.

My mum went from ft (well 3x12hr night shifts on the same days every week), a big gap then onto agency work.

She said she couldn't go back to permanent staff as they now all do changeable shifts and day shifts are now all 12 hours which she didn't feel physically able to do in her 50s/60s. They used to have 6 hour day shifts but she said they have all gone now.

She was always too conscientious to take sick leave anyway so never benefitted from that as a perm employee.

As for pensions, it was too late by her 50s/60s for more payments to make a difference.

Mat leave is also not an issue at that age!

There are also plus points like being able to choose your holidays and not having to work over Christmas and new year.

I'm in a field where I'll be able to go agency in a couple of years. It does sound appealing- I hate office politics and get bored in one job too long.

One thing I've observed in a couple of trusts now is the preference for reducing staffing through wastage I.e not replacing anyone who leaves.

What happens then is eventually targets get missed = fines or accidents/mistakes occur to frequently to ignore. Agency are then bought in and recruitment takes a really long time (mainly because of red tape and bureaucracy. My last trust was city wide and the ceo had to sign off on every vacancy advertised after it had been through a panel that only met once a month. It would often take 3-4 attempts to get it past the panel after making amendments) meanwhile the trust will occasionally panic at the budget and cease all agency contracts immediately. Then the cycle begins again.

Obviously staff discover the perks of being agency and are reluctant to apply for permanent because usually have experienced the worst of the nhs and its downsizing/restructures/blatant disregard for safety in any area and figure they're better off.

IMHO although a lot of trusts have adopted 'business' as a buzzword they don't really have management in place who understand it. 90% of nhs 'product' is its staff and if you expect everyone of them to run at 100% capacity 100% of the time you will run into problems because it's just not possible. You need slack to pick up the peaks in usage and other circumstances which leave you running short.

It's a classic case of buy cheap buy twice. It would take a brave management team to initiate going over budget one year to justify savings down the line.

Also the government I believe reduced the number of places available for nurse training which now means that we have an inevitable shortage of trained nurses hence having to recruit from overseas etc. I think there is a shortage of around 22,000 nurses in the NHS but don't quote me on that! Therefore nowadays there is a plethora of agency shifts available, certainly in my trust anyway so you really can pick and choose what shift and where.

Ironically Rozbos student mental health nurses , in the trust I worked for can't get jobs as there are just no vacancies they have been shutting down wards and units for the past ten years at least most students are getting jobs in the private sector.

I have just left a permanent job, albeit in the private sector, for agency work. Reasons being - ability to pick my own hours, I never want to work nights ever again I HATE them. In a permanent job I have no choice. I work no more than 2 weekend days per month and will have every bank holiday plus Christmas off.

This way I can fit my work around DD and spend a hell of a lot more time with her. You just cannot get that in a permanent job.

I only work two days a week at present and make roughly the same as in my old job but I was quite senior there at a Sister level and was only part time too. If I chose to work more days I could rack up a lot more money and I haven't chosen to work for the highest paid agencies either.

I am in London though and specialise, huge shortage of ITU nurses here so work is plentiful. I will never go back to a permanent position it just doesn't make sense.

No sick leave obviously but I do get annual leave at a normal rate.