Agency, bank and overtime spending in maternity units in ......The FOI found agency spending on...

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Agency, bank and overtime spending in maternity units

in England - 2015October 2016

Agency, Bank and Overtime Spending A4 20pp_2.indd 1 12/10/2016 10:56

2 | The Royal College of Midwives

Agency, bank and overtime spending in maternity units in England - 2015

OUR PREVIOUS REPORT SHOWED THAT AGENCY SPENDING IN ENGLAND WAS £10,159,099 IN 2012; £11,753,497 IN 2013; AND £17,849,767 IN 2014. THIS IS AN INCREASE OF 39.8% ON AGENCY SPENDING IN THE LAST YEAR AND AN INCREASE OF 145.6% OVER THE LAST FOUR YEARS.

AGENCY SPENDING ON MATERNITY STAFF IN THE NHS IN 2015 WAS £24,950,157.

THE AVERAGE SPEND PER HOUR ON AGENCY STAFF WAS £41.25. THE HIGHEST AVERAGE MONTHLY SPEND WAS IN DECEMBER 2015 WHEN SPENDING PEAKED AT £50.58 PER HOUR. THIS WAS AFTER THE GOVERNMENT INTRODUCED A PAY CAP FOR AGENCY STAFF IN THE NHS.

OVERTIME SPENDING WAS £4,522,440 FOR MIDWIVES IN NHS ORGANISATIONS IN ENGLAND IN 2015. OVERTIME SPENDING RESULTED IN THE LOWEST COST PER HOUR AT AN AVERAGE OF £23.06 PER HOUR.

BANK SPENDING WAS £43,225,603 FOR MIDWIVES IN NHS ORGANISATIONS IN ENGLAND IN 2015. THE AVERAGE SPEND PER HOUR FOR BANK MIDWIVES WAS £25.63 PER HOUR.

THE KEY FINDINGS OF THIS REPORT ARE:


www.rcm.org.uk | 3

October 2016

Executive SummaryIn January 2016 the Royal College of Midwives (RCM) sent a freedom of information request (FOI) to all the NHS trusts in England that have maternity units to ask them how much they have spent on agency and bank staff and overtime for every month in 2015. The FOI also asked about the numbers of hours of staff time this equated to. This report follows on from the RCM’s report on agency spending in maternity units between 2012-2014 which was published in February 2015. 123 trusts responded to the FOI giving a response rate of 91.1%

IN TOTAL, NHS ORGANISATIONS SPENT £72,698,200 ON AGENCY, OVERTIME AND BANK MIDWIVES.

£72,698,200 IS ENOUGH MONEY TO PAY FOR 2,063 FULL TIME, EXPERIENCED MIDWIVES (PAID AT THE TOP OF BAND 6 AT £35,255 A YEAR) OR 3,318 FULL TIME, NEWLY QUALIFIED MIDWIVES (STARTING SALARY IS £21,909 PER YEAR).

THERE WERE 23 ORGANISATIONS IN TOTAL THAT SPENT MORE THAN £1 MILLION ON AGENCY, BANK AND OVERTIME.

TWELVE OF THE TWENTY HIGHEST SPENDERS ON BANK, AGENCY AND OVERTIME WERE IN LONDON.




RecommendationsWhile bank and overtime spending are much better value for money than agency spending it is clear that organisations are far too reliant on temporary staffing. NHS organisations need to develop a total workforce strategy to ensure that they have the appropriate numbers of staff; to ensure that they are retaining their existing staff and to ensure they are recruiting enough staff to deal with the increased demand on the service and replace staff who leave.

The RCM makes the following recommendations:

• NHS organisations should review their maternity staffing levels using a recognised workforce planning tool, such as Birthrate Plus, to ensure they have the appropriate midwifery establishment for their workload. Any resulting vacancies should be recruited to as a matter of urgency.

• NHS organisations should review their midwifery turnover rates and vacancy data to identify posts that have recruitment and retention issues. NHS organisations should then make use of recruitment and retention premia (RRP) in Agenda for Change for midwives to counter existing shortages.

• The Government should end their policy of public sector pay restraint and allow the NHS Pay Review Body to make unfettered recommendations for NHS staff, including midwives, and break the 1% pay cap to ensure that midwives are fairly rewarded for the job they do.

• NHS organisations should sign up to the RCM’s Caring for You Charter to improve midwives’, student midwives’ and maternity support workers’ health, safety and wellbeing at work. The Caring for You Charter includes a commitment on undermining behaviours and bullying and a commitment on flexible working and breaks.

• The Government should re-think its plans to abolish the bursary for midwifery students and not introduce tuition fees as both of these actions will have consequences for the numbers of new students training to be midwives.

In the meantime, NHS organisations should empower their managers to authorise the use of overtime payments as an alternative to using far more expensive agency staff.

If you have any questions about this report please contact Amy Leversidge, Employment Relations Advisor at the RCM on [email protected]


www.rcm.org.uk | 5

October 2016

Findings of the Freedom of Information RequestIn January 2016 the RCM sent a FOI to all the NHS trusts in England that have maternity units to ask them how much they have spent on agency and bank staff and overtime for every month in 2015. The FOI also asked about the numbers of hours of staff time this equated to. This report follows on from the RCM’s report on agency spending in maternity units between 2012-2014 that was published in February 2015. 123 trusts responded to the FOI giving a response rate of 91.1%.

This section gives the findings for:

• Agency spending• Overtime spending• Bank spending• Agency, overtime and bank spending combined

Agency SpendingThe FOI found agency spending on maternity staff in the NHS in 2015 was £24,950,157. The table below shows the total spending on agency staff In England by month.

0

500000

1000000

1500000

2000000

2500000

3000000

Total Agency Spending in England NHS January - December 2015




Our previous report showed that agency spending in England was £10,159,099 in 2012; 2013 was £11,753,497 in 2013; and £17,849,767 in 2014.This means that there was an increase of 39.8% in agency spending in the last year and an increase of 145.6% over the last four years.

The graph below shows the spending on agency staff for all four years.

The graph above shows that every month in 2015 had a higher spend on agency staffing than the corresponding month in 2014, 2013 and 2012.

The findings also reveal that there is a peak in agency spending every year between August and October. This is traditionally when the shortage of midwives is at a peak each year while new students are awaiting their registration to be confirmed with the Nursing and Midwifery Council (NMC).

In total, 46 NHS organisations in England used agency staff at some point during 2015; which is 37.4% of the NHS organisations in England that responded to the FOI. 28 of the 46 organisations used agency staff every month. 8 NHS organisations spent more than £1 million on agency staff in 2015. The highest spending trust spent £2,249,797 on agency staff in 2015 and the average spend per trust was £542,394. Eight of the twenty highest spending organisations were based in London.

Total Spending on Midwives Supplied by an Agency January 2012 - December 2015

0

500000

1000000

1500000

2000000

2500000

3000000

2012

2013

2014

2015


www.rcm.org.uk | 7

October 2016

0 500000 1000000 1500000 2000000 2500000

West Hertfordshire Hospitals NHS Trust

Chelsea and Westminster Hospital NHS Foundation Trust

University Hospitals Of Morecambe Bay NHS Foundation Trust

Southend University Hospital NHS Foundation Trust

St George's Healthcare NHS Trust

King's College Hospital NHS Foundation Trust

Royal Free London NHS Foundation Trust

Homerton University Hospital NHS Foundation Trust

Croydon Health Services NHS Trust

London North West Healthcare NHS Trust

Lewisham and Greenwich NHS Trust

Milton Keynes Hospital NHS Foundation Trust

Medway NHS Foundation Trust

Guy's and St Thomas' NHS Foundation Trust

Epsom and St Helier University Hospitals NHS Trust

Barking, Havering and Redbridge University Hospitals NHS Trust

Peterborough and Stamford Hospitals NHS Foundation Trust

Barts Health NHS Trust

University Hospital Southampton NHS Foundation Trust

The Hillingdon Hospitals NHS Foundation Trust

Mid Essex Hospital Services NHS Trust

East and North Hertfordshire NHS Trust

Surrey and Sussex Healthcare NHS Trust

East Kent Hospitals University NHS Foundation Trust

University College London Hospitals NHS Foundation Trust

Maidstone and Tunbridge Wells NHS Trust

Frimley Health NHS Foundation Trust

Colchester Hospital University NHS Foundation Trust

James Paget University Hospitals NHS Foundation Trust

Airedale NHS Foundation Trust

Pennine Acute Hospitals NHS Trust

Royal Berkshire NHS Foundation Trust

The Princess Alexandra Hospital NHS Trust

Heart of England NHS Foundation Trust

Chesterfield Royal Hospital NHS Foundation Trust

Mid Yorkshire Hospitals NHS Trust

Plymouth Hospitals NHS Trust

Birmingham Women's NHS Foundation Trust

Royal Surrey County Hospital NHS Foundation Trust

Wye Valley NHS Trust

Sheffield Teaching Hospitals NHS Foundation Trust

George Eliot Hospital NHS Trust

The Dudley Group NHS Foundation Trust

The Newcastle Upon Tyne Hospitals NHS Foundation Trust

University Hospitals of Leicester NHS Trust

Yeovil District Hospital NHS Foundation Trust

Total Agency Spending by NHS Organisation January - December 2015

The graph below shows agency spending by trust.




The FOI also asked organisations to give the data on the number of hours the agency midwives were employed for. The average spend on agency midwives worked out to be £41.25 per hour on average. In November 2015, following instructions from the Department of Health, NHS Improvement introduced a mandatory cap on the hourly rates paid for agency staff and an annual ceiling for agency spending for each trust. The cap had a staggered introduction, with nursing and midwifery staff affected first and other professions added later and the rate of the hourly cap was reduced over time. Significantly, NHS Improvement allows organisations to break the cap on ‘exceptional safety grounds’. As we can see from the graph below, the highest average monthly spend was in December 2015 when spending peaked at £50.58 per hour. This was after the government introduced a pay cap for agency staff in the NHS.

This is compared to a qualified midwife, with ten years’ experience; working full time in the NHS in England who is paid a yearly salary of £35,225, an hourly rate of £18.02 per hour. A newly qualified midwife working full time is paid a yearly salary of £21,909, an hourly rate of £11.21. The average hourly agency spend of £41.25 per hour is 128.9% higher than the hourly rate of pay for a qualified midwife. Our last report into agency spending revealed that midwives report getting paid on average £22.84 per hour for an agency shift. This indicates that the agency are earning nearly half the hourly cost in fees.

0

10

20

30

40

50

60

Hourly Rate for Agency Midwives January to December 2015


www.rcm.org.uk | 9

October 2016

Overtime SpendingThe FOI found overtime spending on maternity staff in the NHS in 2015 was £4,522,440. The table below shows the total spending on overtime in England by month.

0

100000

200000

300000

400000

500000

Total Overtime Spending in England January - December 2015

In total, 84 NHS organisations in England paid staff overtime at some point during 2015; which is 68.3% of the NHS organisations in England that responded to the FOI. 53 of the 84 organisations used overtime every month.

The spending per trust tended to be much lower than agency, with the highest spending trust spending £310,496. The average spend per trust was £53,906. Organisations in the North of England were far more likely to authorise the use of overtime spending with nine of the twenty highest spending organisations based in the North.




0 50000 100000 150000 200000 250000 300000 350000

Sheffield Teaching Hospitals NHS Foundation Trust Royal Berkshire NHS Foundation Trust

East Kent Hospitals University NHS Foundation Trust University Hospitals of Leicester NHS Trust

Croydon Health Services NHS Trust Central Manchester University Hospitals NHS Foundation Trust

North Cumbria University Hospitals NHS Trust South Warwickshire NHS Foundation Trust

Plymouth Hospitals NHS Trust Surrey and Sussex Healthcare NHS Trust

Mid Yorkshire Hospitals NHS Trust Shrewsbury And Telford Hospital NHS Trust

Calderdale and Huddersfield NHS Foundation Trust County Durham And Darlington NHS Foundation Trust

The Newcastle Upon Tyne Hospitals NHS Foundation Trust Pennine Acute Hospitals NHS Trust

Nottingham University Hospitals NHS Trust University Hospital Southampton NHS Foundation Trust

Northern Devon Healthcare NHS Trust St Helens and Knowsley Hospitals NHS Trust

Colchester Hospital University NHS Foundation Trust Airedale NHS Foundation Trust

North Tees and Hartlepool NHS Foundation Trust United Lincolnshire Hospitals NHS Trust

Blackpool Teaching Hospitals NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust

Warrington And Halton Hospitals NHS Foundation Trust Northern Lincolnshire And Goole NHS Foundation Trust

University Hospitals of North Midlands NHS Trust King's College Hospital NHS Foundation Trust

Royal United Hospital Bath NHS Trust University Hospital of South Manchester NHS Foundation Trust

Ipswich Hospital NHS Trust Countess of Chester Hospital NHS Foundation Trust

Royal Devon and Exeter NHS Foundation Trust Portsmouth Hospitals NHS Trust

University Hospitals Coventry And Warwickshire NHS Trust Medway NHS Foundation Trust

Bedford Hospital NHS Trust George Eliot Hospital NHS Trust

Great Western Hospitals NHS Foundation Trust Hull and East Yorkshire Hospitals NHS Trust

Western Sussex Hospitals NHS Foundation Trust Walsall Healthcare NHS Trust

Barts Health NHS Trust Brighton and Sussex University Hospitals NHS Trust

Harrogate and District NHS Foundation Trust Barnsley Hospital NHS Foundation Trust

Weston Area Health NHS Trust James Paget University Hospitals NHS Foundation Trust

Buckinghamshire Healthcare NHS Trust Leeds Teaching Hospitals NHS Trust

Hinchingbrooke Health Care NHS Trust Wrightington, Wigan And Leigh NHS Foundation Trust

Wirral University Teaching Hospital NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust

Yeovil District Hospital NHS Foundation Trust Burton Hospitals NHS Foundation Trust

Hampshire Hospitals NHS Foundation Trust South Tyneside NHS Foundation Trust

West Suffolk NHS Foundation Trust The Dudley Group NHS Foundation Trust

University Hospitals Of Morecambe Bay NHS Foundation Trust Sherwood Forest Hospitals NHS Foundation Trust

Stockport NHS Foundation Trust York Teaching Hospital NHS Foundation Trust

Maidstone and Tunbridge Wells NHS Trust Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Birmingham Women's NHS Foundation Trust East Lancashire Hospitals NHS Trust

Torbay and South Devon NHS Foundation Trust Heart of England NHS Foundation Trust

The Royal Wolverhampton NHS Trust The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust

Northumbria Healthcare NHS Foundation Trust Homerton University Hospital NHS Foundation Trust

Poole Hospital NHS Foundation Trust Epsom and St Helier University Hospitals NHS Trust

City Hospitals Sunderland NHS Foundation Trust Mid Essex Hospital Services NHS Trust

Worcestershire Acute Hospitals NHS Trust Salisbury NHS Foundation Trust

Southend University Hospital NHS Foundation Trust Tameside Hospital NHS Foundation Trust

Total Overtime Spending by NHS Organisation January - December 2015

The graph below shows the overtime spending by trust.


www.rcm.org.uk | 11

October 2016

We understand that it is sometimes difficult for managers in NHS organisations to pay overtime rates. There is a single harmonised rate of overtime set out in Agenda for Change (time and a half for all overtime apart from public holidays which is double time). However the FOI reveals that spending on overtime is the best value cost per hour with an average cost of £23.06 per hour.

Bank SpendingThe FOI found bank spending on maternity staff in the NHS in 2015 was £43,225,603.02. The table below shows the total bank spending in England, by month.

0 500000

1000000 1500000 2000000 2500000 3000000 3500000 4000000 4500000

Total Bank Spending in England January - December 2015

In total, 107 NHS organisations in England used bank staff at some point during 2015; which is 87.0% of the NHS organisations in England that responded to the FOI. 97 of the 107 organisations used bank staff every month. The highest spending trust was much higher than agency spending, however the average spend was lower than agency spend.

The highest spending trust spent £3,102,222 and the average spend per trust was £401,857. Organisations in London were most likely to use bank staff with eleven of the twenty highest spending organisations based in London.




0 500000 1000000 1500000 2000000 2500000 3000000 3500000 Barts Health NHS Trust

King's College Hospital NHS Foundation Trust Lewisham and Greenwich NHS Trust

Royal Free London NHS Foundation Trust University College London Hospitals NHS Foundation Trust

London North West Healthcare NHS Trust Guy's and St Thomas' NHS Foundation Trust

Chelsea and Westminster Hospital NHS Foundation Trust Heart of England NHS Foundation Trust

Maidstone and Tunbridge Wells NHS Trust Central Manchester University Hospitals NHS Foundation Trust

Mid Essex Hospital Services NHS Trust Barking, Havering and Redbridge University Hospitals NHS Trust

West Hertfordshire Hospitals NHS Trust Southend University Hospital NHS Foundation Trust

Croydon Health Services NHS Trust Cambridge University Hospitals NHS Foundation Trust

Frimley Health NHS Foundation Trust Portsmouth Hospitals NHS Trust

St George's Healthcare NHS Trust Walsall Healthcare NHS Trust

North Bristol NHS Trust Surrey and Sussex Healthcare NHS Trust

Peterborough and Stamford Hospitals NHS Foundation Trust Brighton and Sussex University Hospitals NHS Trust

East and North Hertfordshire NHS Trust Royal Surrey County Hospital NHS Foundation Trust

Luton And Dunstable University Hospital NHS Foundation Trust Kingston Hospital NHS Foundation Trust

Hampshire Hospitals NHS Foundation Trust The Dudley Group NHS Foundation Trust

The Princess Alexandra Hospital NHS Trust Royal United Hospital Bath NHS Trust

University Hospitals Coventry And Warwickshire NHS Trust Homerton University Hospital NHS Foundation Trust

Northern Lincolnshire And Goole NHS Foundation Trust Milton Keynes Hospital NHS Foundation Trust

Epsom and St Helier University Hospitals NHS Trust Tameside Hospital NHS Foundation Trust

The Hillingdon Hospitals NHS Foundation Trust Medway NHS Foundation Trust

Poole Hospital NHS Foundation Trust Basildon and Thurrock University Hospitals NHS Foundation Trust

Worcestershire Acute Hospitals NHS Trust West Suffolk NHS Foundation Trust

The Rotherham NHS Foundation Trust East Lancashire Hospitals NHS Trust Dartford and Gravesham NHS Trust

Wrightington, Wigan And Leigh NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust

Leeds Teaching Hospitals NHS Trust The Royal Wolverhampton NHS Trust

St Helens and Knowsley Hospitals NHS Trust Mid Yorkshire Hospitals NHS Trust

Buckinghamshire Healthcare NHS Trust Nottingham University Hospitals NHS Trust

Bolton NHS Foundation Trust Warrington And Halton Hospitals NHS Foundation Trust

Pennine Acute Hospitals NHS Trust Northumbria Healthcare NHS Foundation Trust

Taunton and Somerset NHS Foundation Trust Northampton General Hospital NHS Trust

Shrewsbury And Telford Hospital NHS Trust Birmingham Women's NHS Foundation Trust

The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust

Bedford Hospital NHS Trust South Tyneside NHS Foundation Trust

James Paget University Hospitals NHS Foundation Trust Chesterfield Royal Hospital NHS Foundation Trust City Hospitals Sunderland NHS Foundation Trust

East Cheshire NHS Trust County Durham And Darlington NHS Foundation Trust

University Hospital of South Manchester NHS Foundation Trust Mid Cheshire Hospitals NHS Foundation Trust

Great Western Hospitals NHS Foundation Trust Ipswich Hospital NHS Trust

Wye Valley NHS Trust Plymouth Hospitals NHS Trust

University Hospitals Of Morecambe Bay NHS Foundation Trust Colchester Hospital University NHS Foundation Trust

Wirral University Teaching Hospital NHS Foundation Trust Salisbury NHS Foundation Trust

Stockport NHS Foundation Trust York Teaching Hospital NHS Foundation Trust

United Lincolnshire Hospitals NHS Trust Gateshead Health NHS Foundation Trust

Torbay and South Devon NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust

Doncaster and Bassetlaw Hospitals NHS Foundation Trust Weston Area Health NHS Trust

Burton Hospitals NHS Foundation Trust Royal Devon and Exeter NHS Foundation Trust

University Hospitals of Leicester NHS Trust East Kent Hospitals University NHS Foundation Trust

Isle of Wight NHS Trust Airedale NHS Foundation Trust

Yeovil District Hospital NHS Foundation Trust North Cumbria University Hospitals NHS Trust

George Eliot Hospital NHS Trust Northern Devon Healthcare NHS Trust

Harrogate and District NHS Foundation Trust Oxford University Hospitals NHS Trust

Sheffield Teaching Hospitals NHS Foundation Trust Countess of Chester Hospital NHS Foundation Trust

North Tees and Hartlepool NHS Foundation Trust Royal Berkshire NHS Foundation Trust

Hinchingbrooke Health Care NHS Trust

Total Bank Spending by NHS Organisation January - December 2015

The graph below shows the overtime spending by trust.


www.rcm.org.uk | 13

October 2016

0

1000000

2000000

3000000

4000000

5000000

6000000

7000000

8000000

Agency, Overtime and Bank Spending Combined January - December 2015

Spending onbank midwives

Spending onovertime for midwives

Spending onagency midwives

The average spend per hour for bank midwives was £25.63 per hour. This is much better value than the agency cost per hour at £41.25 an hour but slightly higher than the average overtime rate of £23.06 per hour.

Agency, Overtime and Bank Spending CombinedIn total, NHS organisations spent £72,698,201 on agency and bank staff and overtime for midwives. The breakdown of spending was £24,950,157 on agency midwives; £4,522,440 on overtime for midwives; and £43,225,603 on bank midwives.




£72,698,201WOULD PAY FOR:

3,318FULL TIME,

NEWLY QUALIFIED MIDWIVES

2,063FULL TIME,

EXPERIENCED QUALIFIED MIDWIVES

= 100 MIDWIVES

The month with the highest overall spend was September 2015 when NHS organisations in England spent £6,748,483 on agency midwives, bank midwives and overtime for midwives.

The total spend of £72,698,201 is enough money to pay for 2,063 full time, very experienced midwives (paid at the top of band 6 at £35,255 a year) or 3,318 full time, newly qualified midwives (starting salary is £21,909 per year). There is currently a shortage of around 3,500 midwives in England so this would be enough to almost clear the shortage of midwives.


www.rcm.org.uk | 15

October 2016

0 5 10 15 20 25 30 35 40 45

Average hourly spend on agency midwife

Average hourly spend for a bank midwife

Average hourly spend on overtime for a midwife

Hourly rate for a midwife with ten years experience

Hourly rate for a newly qualified midwife

Comparison of Average Hourly Rates of Pay for Agency, Bank, Overtime and Permanent Staff

In total 116 organisations used agency, bank and/or overtime for midwives. This is 94.3% of the total number of organisations that responded to the FOI. 28 organisations (22.8%) used agency, bank and overtime; 48 organisations (39.0%) used bank and overtime; 17 organisations (13.8%) used agency and bank; 1 organisation (0.8%) used agency and overtime; 15 organisations (12.2%) used bank only; 7 organisations (5.7%) used overtime only; no organisations only used agency; and 7 organisations (5.7%) did not use agency, bank or overtime.

There were 23 organisations in total that spent more than £1 million on agency, bank and overtime. Out of the highest twenty spenders on bank, agency and overtime twelve were London trusts. The highest spending organisation spent £3,687,581 and the average spend was £628,266.




Agency, Bank and Overtime Spending Combined January - December 2015

0 1000000 2000000 3000000 4000000 King's College Hospital NHS Foundation Trust

Barts Health NHS Trust Chelsea and Westminster Hospital NHS Foundation Trust

West Hertfordshire Hospitals NHS Trust Lewisham and Greenwich NHS Trust

Royal Free London NHS Foundation Trust Southend University Hospital NHS Foundation Trust

London North West Healthcare NHS Trust St George's Healthcare NHS Trust

Guy's and St Thomas' NHS Foundation Trust University Hospitals Of Morecambe Bay NHS Foundation Trust

Croydon Health Services NHS Trust University College London Hospitals NHS Foundation Trust

Homerton University Hospital NHS Foundation Trust Barking, Havering and Redbridge University Hospitals NHS Trust

Mid Essex Hospital Services NHS Trust Maidstone and Tunbridge Wells NHS Trust

Central Manchester University Hospitals NHS Foundation Trust Heart of England NHS Foundation Trust

Peterborough and Stamford Hospitals NHS Foundation Trust Milton Keynes Hospital NHS Foundation Trust

Medway NHS Foundation Trust Surrey and Sussex Healthcare NHS Trust

Epsom and St Helier University Hospitals NHS Trust East and North Hertfordshire NHS Trust

Frimley Health NHS Foundation Trust The Hillingdon Hospitals NHS Foundation Trust

Portsmouth Hospitals NHS Trust Cambridge University Hospitals NHS Foundation Trust

Walsall Healthcare NHS Trust North Bristol NHS Trust

The Princess Alexandra Hospital NHS Trust East Kent Hospitals University NHS Foundation Trust

University Hospital Southampton NHS Foundation Trust Brighton and Sussex University Hospitals NHS Trust Royal Surrey County Hospital NHS Foundation Trust

Luton And Dunstable University Hospital NHS Foundation Trust Royal United Hospital Bath NHS Trust

Pennine Acute Hospitals NHS Trust Hampshire Hospitals NHS Foundation Trust

Kingston Hospital NHS Foundation Trust The Dudley Group NHS Foundation Trust

University Hospitals Coventry And Warwickshire NHS Trust Northern Lincolnshire And Goole NHS Foundation Trust

Royal Berkshire NHS Foundation Trust Mid Yorkshire Hospitals NHS Trust

Colchester Hospital University NHS Foundation Trust Tameside Hospital NHS Foundation Trust

James Paget University Hospitals NHS Foundation Trust Poole Hospital NHS Foundation Trust

Sheffield Teaching Hospitals NHS Foundation Trust Basildon and Thurrock University Hospitals NHS Foundation Trust

St Helens and Knowsley Hospitals NHS Trust Worcestershire Acute Hospitals NHS Trust

Shrewsbury And Telford Hospital NHS Trust West Suffolk NHS Foundation Trust

Nottingham University Hospitals NHS Trust Plymouth Hospitals NHS Trust

The Rotherham NHS Foundation Trust East Lancashire Hospitals NHS Trust

Warrington And Halton Hospitals NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust

Airedale NHS Foundation Trust Wrightington, Wigan And Leigh NHS Foundation Trust

Leeds Teaching Hospitals NHS Trust University Hospitals of Leicester NHS Trust

Dartford and Gravesham NHS Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust

The Royal Wolverhampton NHS Trust Buckinghamshire Healthcare NHS Trust

County Durham And Darlington NHS Foundation Trust Bolton NHS Foundation Trust

North Cumbria University Hospitals NHS Trust Northumbria Healthcare NHS Foundation Trust

Taunton and Somerset NHS Foundation Trust Bedford Hospital NHS Trust

Chesterfield Royal Hospital NHS Foundation Trust Birmingham Women's NHS Foundation Trust

Northampton General Hospital NHS Trust University Hospital of South Manchester NHS Foundation Trust

South Warwickshire NHS Foundation Trust South Tyneside NHS Foundation Trust

The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust Ipswich Hospital NHS Trust

Great Western Hospitals NHS Foundation Trust City Hospitals Sunderland NHS Foundation Trust

United Lincolnshire Hospitals NHS Trust East Cheshire NHS Trust

Mid Cheshire Hospitals NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust

Wye Valley NHS Trust Wirral University Teaching Hospital NHS Foundation Trust

Stockport NHS Foundation Trust Salisbury NHS Foundation Trust

York Teaching Hospital NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust

Northern Devon Healthcare NHS Trust Royal Devon and Exeter NHS Foundation Trust

Weston Area Health NHS Trust Gateshead Health NHS Foundation Trust

Doncaster and Bassetlaw Hospitals NHS Foundation Trust Torbay and South Devon NHS Foundation Trust

North Tees and Hartlepool NHS Foundation Trust Burton Hospitals NHS Foundation Trust

Blackpool Teaching Hospitals NHS Foundation Trust George Eliot Hospital NHS Trust

Countess of Chester Hospital NHS Foundation Trust University Hospitals of North Midlands NHS Trust

Harrogate and District NHS Foundation Trust Yeovil District Hospital NHS Foundation Trust

Isle of Wight NHS Trust Hull and East Yorkshire Hospitals NHS Trust

Barnsley Hospital NHS Foundation Trust Hinchingbrooke Health Care NHS Trust Oxford University Hospitals NHS Trust

Sherwood Forest Hospitals NHS Foundation Trust

Total Agency Spend

Total Overtime Spend

Total Bank Spend

The chart below shows the total spend for each organisation in England.


www.rcm.org.uk | 17

October 2016

Appendix One: Total Spending on Agency, Bank and Overtime January - December 2015

Total Agency Spend

Total Overtime

Spend

TotalBank

Spend Total King’s College Hospital NHS Foundation Trust 1527813 44765 2115003 3687581

Barts Health NHS Trust 549472.03 22875.61 3102223 3674571

Chelsea and Westminster Hospital NHS Foundation Trust 1932850 1238620 3171470

West Hertfordshire Hospitals NHS Trust 2249797 845755 3095552

Lewisham and Greenwich NHS Trust 764316 2076796 2841112

Royal Free London NHS Foundation Trust 1317000 1519000 2836000

Southend University Hospital NHS Foundation Trust 1713705 161 793907 2507773

London North West Healthcare NHS Trust 908367.42 1335124 2243492

St George’s Healthcare NHS Trust 1618954.34 617430.6 2236385

Guy’s and St Thomas’ NHS Foundation Trust 673706 14263 1296029 1983998

University Hospitals Of Morecambe Bay NHS Foundation Trust 1848000 7800 112000 1967800

Croydon Health Services NHS Trust 930586.57 203053.2 726077.6 1859717

University College London Hospitals NHS Foundation Trust 263617.36 1386553 1650171

Homerton University Hospital NHS Foundation Trust 1204039 1498 409102 1614639

Barking, Havering and Redbridge University Hospitals NHS Trust 589370 886128 1475498

Mid Essex Hospital Services NHS Trust 451592.24 858 972775.3 1425226

Maidstone and Tunbridge Wells NHS Trust 262947 6346 1145157 1414450

Central Manchester University Hospitals NHS Foundation Trust 195585 1140775 1336360

Heart of England NHS Foundation Trust 65917 2715 1165245 1233877

Peterborough and Stamford Hospitals NHS Foundation Trust 584700 572900 1157600

Milton Keynes Hospital NHS Foundation Trust 753483 384069 1137552

Medway NHS Foundation Trust 734950 31932 339984 1106866

Surrey and Sussex Healthcare NHS Trust 317615 161111 576037 1054763

Epsom and St Helier University Hospitals NHS Trust 609000 1325 384000 994325

East and North Hertfordshire NHS Trust 443088 506107 949195

Frimley Health NHS Foundation Trust 200979 678485 879464

The Hillingdon Hospitals NHS Foundation Trust 455694 340882 796576

Portsmouth Hospitals NHS Trust 34002 655820 689822

Cambridge University Hospitals NHS Foundation Trust 681362.4 681362.4

Walsall Healthcare NHS Trust 23219 616284 639503

North Bristol NHS Trust 603213 603213

The Princess Alexandra Hospital NHS Trust 152762 442181 594943




East Kent Hospitals University NHS Foundation Trust 309593 244949 32223 586765

University Hospital Southampton NHS Foundation Trust 496674.7 82260 578934.7

Brighton and Sussex University Hospitals NHS Trust 20864 555319 576183

Royal Surrey County Hospital NHS Foundation Trust 15216 486010 501226

Luton And Dunstable University Hospital NHS Foundation Trust 485169 485169

Royal United Hospital Bath NHS Trust 44238 433752 477990

Pennine Acute Hospitals NHS Trust 169079.78 87972.26 216869 473921

Hampshire Hospitals NHS Foundation Trust 13185 457562 470747

Kingston Hospital NHS Foundation Trust 464029 464029

The Dudley Group NHS Foundation Trust 902.46 7958 453941 462801.5

University Hospitals Coventry And Warwickshire NHS Trust 33936 421727 455663

Northern Lincolnshire And Goole NHS Foundation Trust 55600 390950 446550

Royal Berkshire NHS Foundation Trust 165547 263264 4959 433770

Mid Yorkshire Hospitals NHS Trust 33579 147065 235148 415792

Colchester Hospital University NHS Foundation Trust 181696 73821 110507 366024

Tameside Hospital NHS Foundation Trust 153 363157 363310

James Paget University Hospitals NHS Foundation Trust 181525.33 18147.23 160062.7 359735.2

Poole Hospital NHS Foundation Trust 1403 335759 337162

Sheffield Teaching Hospitals NHS Foundation Trust 1741.24 310496.88 15880.19 328118.3

Basildon and Thurrock University Hospitals NHS Foundation Trust 325982.1 325982.1

St Helens and Knowsley Hospitals NHS Trust 76625.15 248041 324666.2

Worcestershire Acute Hospitals NHS Trust 563 320524 321087

Shrewsbury And Telford Hospital NHS Trust 134296 181450 315746

West Suffolk NHS Foundation Trust 8340.78 300587.3 308928.1

Nottingham University Hospitals NHS Trust 83489 224701 308190

Plymouth Hospitals NHS Trust 25455 166131 112701 304287

The Rotherham NHS Foundation Trust 296816.2 296816.2

East Lancashire Hospitals NHS Trust 3990.22 289368 293358.3

Warrington And Halton Hospitals NHS Foundation Trust 55660 221373 277033

Western Sussex Hospitals NHS Foundation Trust 26067 250761 276828

Airedale NHS Foundation Trust 180449 65081 27899 273429

Wrightington, Wigan And Leigh NHS Foundation Trust 14970 255818 270788

Leeds Teaching Hospitals NHS Trust 16509 250513 267022

University Hospitals of Leicester NHS Trust 440 230378 32964 263782

Dartford and Gravesham NHS Trust 257000 257000

The Newcastle Upon Tyne Hospitals NHS Foundation Trust 552 88751 167473 256776

The Royal Wolverhampton NHS Trust 2331.34 249448.1 251779.4

Buckinghamshire Healthcare NHS Trust 17127 224969 242096

County Durham And Darlington NHS Foundation Trust 96777.74 139435 236212.7

Bolton NHS Foundation Trust 221804 221804

North Cumbria University Hospitals NHS Trust 193419.4 25022.21 218441.6

Northumbria Healthcare NHS Foundation Trust 1832 206691 208523


www.rcm.org.uk | 19

October 2016

Taunton and Somerset NHS Foundation Trust 203939 203939

Bedford Hospital NHS Trust 31791 165604 197395

Chesterfield Royal Hospital NHS Foundation Trust 39659 156511 196170

Birmingham Women’s NHS Foundation Trust 17130 4563.83 170412.1 192105.9

Northampton General Hospital NHS Trust 183785 183785

University Hospital of South Manchester NHS Foundation Trust 42488 139275 181763

South Warwickshire NHS Foundation Trust 175000 175000

South Tyneside NHS Foundation Trust 13011.66 161323.8 174335.4

The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust 2277.47 168413 170690.5

Ipswich Hospital NHS Trust 40957.73 128439 169396.7

Great Western Hospitals NHS Foundation Trust 28883 134858 163741

City Hospitals Sunderland NHS Foundation Trust 1013 151733.3 152746.3

United Lincolnshire Hospitals NHS Trust 63723.54 86801.79 150525.3

East Cheshire NHS Trust 147532 147532

Mid Cheshire Hospitals NHS Foundation Trust 137000 137000

Lancashire Teaching Hospitals NHS Foundation Trust 59267 71360 130627

Wye Valley NHS Trust 5152.08 121594.4 126746.4

Wirral University Teaching Hospital NHS Foundation Trust 14283 105561 119844

Stockport NHS Foundation Trust 6787 102365 109152

Salisbury NHS Foundation Trust 369 105000 105369

York Teaching Hospital NHS Foundation Trust 6431.28 97177.41 103608.7

Calderdale and Huddersfield NHS Foundation Trust 101234.95 101235

Northern Devon Healthcare NHS Trust 77473 20494.7 97967.7

Royal Devon and Exeter NHS Foundation Trust 35217 55472 90689

Weston Area Health NHS Trust 18318.49 59688.6 78007.09

Gateshead Health NHS Foundation Trust 77046 77046

Doncaster and Bassetlaw Hospitals NHS Foundation Trust 5328.81 70021.29 75350.1

Torbay and South Devon NHS Foundation Trust 2957 71523 74480

North Tees and Hartlepool NHS Foundation Trust 64853 8902 73755

Burton Hospitals NHS Foundation Trust 13431 56184 69615

Blackpool Teaching Hospitals NHS Foundation Trust 61769 61769

George Eliot Hospital NHS Trust 1285 30934 20595 52814

Countess of Chester Hospital NHS Foundation Trust 38913 9175 48088

University Hospitals of North Midlands NHS Trust 45966 45966

Harrogate and District NHS Foundation Trust 20197.49 19976 40173.49

Yeovil District Hospital NHS Foundation Trust 160 13702 25513.62 39375.62

Isle of Wight NHS Trust 28519 28519

Hull and East Yorkshire Hospitals NHS Trust 26543 26543

Barnsley Hospital NHS Foundation Trust 18847.58 18847.58

Hinchingbrooke Health Care NHS Trust 15161.53 2442.23 17603.76

Oxford University Hospitals NHS Trust 16997 16997

Sherwood Forest Hospitals NHS Foundation Trust 7285.2 7285.2


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