Temporary health staff costs rocket to £9m in three years

Monday 11 March 2019

Spending on temporary health staff has rocketed from £3million to £9million in just three years – and government officials are unsure as to why.

New figures showed that in 2016 costs for locum staff including nurses, specialist consultants, allied health professionals and social workers working both in the hospital and externally stood at £3,019,916.

The following year, they nearly doubled to little under £5.7million, before escalating to £9.2million in 2018.

Despite the well-documented recruitment difficulties within the sector – with agency nurses now covering roughly 600 shifts per month – the Health Minister, Deputy Richard Renouf, said he was taken aback by the rise.

Pictured: Between 2016 and 2018, locum staff costs shot up by over £6million.

Challenged by Express over the tripling in expenditure, Deputy Renouf said the root cause of the dramatic jump was not immediately clear.

“I was surprised, and I’ve asked people in the department to drill down into the figures. I want to get a better understanding.”

He emphasised that the spend was not “additional”, as the temporary staff were filling vacancies that would need to be filled on a permanent basis anyway, but added that the involvement of recruitment agencies can inflate the overall cost of a fixed-term hire.

“I understand it’s about a 50% increase cost by the time you’ve paid agency fees, but it does depend exactly what post you’re looking at.”

While acknowledging the budgetary impact of outsourcing health staff, the Minister denied that the government was being “milked” by agencies.

However, he said the latest figures were evidence that there was some “good negotiation” to be done, which his team were already “gearing up” to do.

Pictured: The Health Minister, Deputy Richard Renouf.

“I’m confident when I came into office that we’ve got a good team in the department who are really bearing down on these costs and giving a robust challenge to them,” Deputy Renouf said.

He later added that, given the government’s already significant expenditure with outsourcing firms, he expected the department would “have a bit of clout” in attempting to “pare down the agency costs that are involved”.

Covering shortages of nurses has previously been identified as coming at a major cost to the government.

Last year the Health Minister revealed that vacancy rates for nurses were at 11.5% - a figure a fellow politician branded as “problematic”, given that it was more than double the industry standard.

Meanwhile, a response to an FOI request last year showed that the Health and Social Services Department is using 12 agencies to source UK nurses to cover an average of 582 shifts per month. Since the beginning of 2016, nearly £6million has been paid to such agencies.

However, the Health Minister said the key “pressure” was the recruitment and retention of mental health staff and social workers.

Pictured: Agency nurses cover nearly 600 shifts per month.

The shortage epidemic for both posts has stretched over many years, but now appears to be hitting crisis point – with worrying implications for islanders’ wellbeing.

A Scrutiny review last week highlighted how the island’s mental health service is now stretched beyond its limit, while the Children’s Commissioner has previously drawn attention to the problems for children caused by the high turnover and low retention rates of social workers. The Royal Court has even been forced to consider the recruitment difficulties in considering applications for children to be sent off-island.

The Health Minister assured that any drive to keep costs down would be balanced with a focus on patient wellbeing.

“I’ve had long meetings in the last fortnight with [the Health Department] and my assistant ministers. We’ve been talking about how we can achieve better value for money and at the same time ensuring we keep up standards and keep up good standards of patients care,” he said.

“Part of this has been around what we spend on locums and also better recruitment efforts. And that’s happening – we are getting better at it.”

Indeed, the Minister said that four consultant psychiatrists are due to join "in the next few weeks" - "that's a great step forward because we've been lacking those."

Pictured: The Children's Commissioner said that high social worker turnovers had a detrimental impact on children.

A key improvement, according to the Minister, has been the provision of accommodation to key workers - something he said is already paying dividends.

"Plaisant Court in Val Plaisant - there are families going in there now who are working in mental health... We knew that it was something that's needed because finding accommodation here is so difficult. And I've seen it - it's very pleasant accommodation, and I'd be very happy to live there."

This, Deputy Renouf said, went hand-in-hand with increased support to those moving to the island to work in health - "not just leaving them to work it out" - including assisting them with bringing vehicles over.

In autumn, rules were also relaxed for 'essential' health workers' families, allowing children aged up to 25 or their co-habiting partners to access more categories of employment.

The news of the Health Department's escalating locum staff costs, in part driven by the dearth of social workers, comes just as the Government of Jersey announced the launch of its largest ever recruitment campaign for the job role that the island has ever seen in a bid to establish a permanent workforce.

Entitled 'Let's Be Honest', the campaign doesn't shy away from the historic failings of the government in dealing with children uncovered in the Care Inquiry and is brutally honest about its aims.

Pictured: The 'Let's Be Honest' campaign launched last week.

Mark Rogers, Director General for Children, Young People, Education and Skills (CYPES), explained that, while "home-grown talent" will become qualified for the role via a newly-launched on-island degree in 2022, the government needs to "do something now to reduce our high vacancy levels".

As part of the campaign, he has penned a brutally honest letter alongside the Children's Minister, Senator Sam Mézec, "setting out the reasons why we need to attract and recruit social workers to the island".

It opens: "I want to be honest with you about the historic failings of the Jersey government to protect its children. And I want your help to ensure that it never happens again.

"The past abuse, neglect and suffering of hundreds of children over 75 years... is unforgivable."

Explaining the tone of the letter, Mr Rogers said: "We need to be clear from the outset. We haven't done enough to protect vulnerable children. That's not an easy thing to face up to. Every child deserves a bright future, and we are making sure that ambition becomes a reality."

A key element of the new campaign will be attending national recruitment fairs. That began last week with a visit to Birmingham, with a trip to Manchester scheduled for May and one to London later this year.