Health chiefs' cash blast

The cost of employing stand-in nurses at the hospital is spiralling with health chiefs admitting that it spent over £2.6 million on bank and agency staff in 12 months.

This figure -- 20 per cent higher than the previous year -- is expected to be even higher this year, hospital chiefs predict.

A damning report has accused hospitals throughout Britain of over-using temporary staff accusing bosses of risking care standards From Page 1 and leaving patients vulnerable. Health chiefs at the Royal Bolton Hospital, though, have defended their spending policies saying the national problem of staff vacancies is forcing them to use the nurse banks.

As reported in the BEN in July, the Royal Bolton Hospital management admitted staff shortages have caused them to overspend on nursing banks by £356,000 in June this year compared to a May overspend of £56,000.

This resulted in the Royal Bolton Hospital director of finance, Beverly Peacock, warning hospital chiefs that they could face debts of up to £3 million putting them in a severe financial crisis.

Now, they are to introduce "significant changes" to the way it uses its bank and agency staff to cut costs.

The Bolton Hospitals NHS Trust is the second largest employer in Bolton but has high levels of staff vacancies. The exact figure of vacancies has not been revealed.

To make up for shortfalls, the hospital has been forced to pay nursing banks and agencies to cover the work.

The independent health watchdog, the Audit Commission, reports that during 1999 and 2000, the average trust spent £2.5 million.

Yet, in Bolton during that same year, the Bolton Trust spent £2,640,000 -- eight per cent of the Trust's nursing budget.

And hospital bosses admitted that the need to use bank and agency staff has increased above this level in Bolton "due to a combination of fluctuations in the number of patients who need a lot of nursing care and staff vacancies".

The Bolton Hospital's NHS Trust has assured the BEN that it is continuing its "rigorous campaign" to fill vacancies and retrain staff.

Figures published by the Audit Commission, reveal that millions of pounds are wasted through a failure to check nurses' incorrect timesheets, unnecessary shift bookings and high commission charges paid out to private nursing agencies.

And, the report warns, while temporary nurses make an "enormous contribution" covering for NHS staff shortfalls, their use can mean patients receive a poorer quality of care than they might otherwise get.

Changes will now be put in place in Bolton to prevent further overspending including strengthening the Trust's nurse bank by recruiting more staff in order to move away from the use of expensive private agencies.

Other measures include more central control and management of these banks complete with a dedicated bank manager and support team.

A new computer system is also hoped to match up skilled staff with appropriate-skill vacancies.

And finally, the hospital want to pay temporary staff weekly.

The Wigan and Bolton Health Authority is due to discuss the hospital's financial situation during a behind-closed-doors meeting next week.

Sue Reed, Director of Nursing for Bolton Hospitals NHS Trust, said: "Bank and agency staff make an important contribution to hospital care and we value this.

"We will always need them to cover vacancies and to introduce new services until those posts are filled, and they also play a vital role at particularly busy times.

"However, we will of course continue to seek permanent staff. These changes are not just about eventually reducing costs, but about ensuring that the nursing care we give our patients is organised efficiently and is of a consistently high standard."

In the study of more than 4,000 nurses in every NHS trust across England and Wales, researchers unearthed a catalogue of risks, cost cutting and a lack of checks on Britain's thousands of temporary nurses.

The Audit Commission warns: "The circumstances in which temporary staff are booked and carry out their duties are sometimes less than ideal. They all increase the risks of something going wrong."

The study found pre-employment checks are not always completed thoroughly, and induction may be inadequate or non-existent. Three out of five bank nurses said they had no induction prior to working in unfamiliar areas.

and leaving patients vulnerable. But health chiefs at the Royal Bolton Hospital have defended their spending policies, saying the national problem of staff vacancies is forcing them to use the nurse banks.

The Royal Bolton Hospital management admitted staff shortages caused them to overspend on nursing banks by £356,000 in June compared to a May overspend of £56,000.

This resulted in the Royal Bolton Hospital director of finance, Beverly Peacock, warning hospital chiefs that they could face debts of up to £3 million, putting them in a severe financial crisis.

Now, they are to introduce "significant changes" to the way the hospital uses its bank and agency staff to cut costs.

The Bolton Hospitals NHS Trust is the second largest employer in Bolton but has high levels of staff vacancies. The exact figure of vacancies has not been revealed.

To make up for shortfalls, the hospital has been forced to pay nursing banks and agencies to cover the work.

The independent health watchdog, the Audit Commission, reports that during 1999 and 2000, the average trust spent £2.5 million.

Yet, in Bolton during that same year, the Bolton Trust spent £2,640,000 -- eight per cent of its nursing budget.

And hospital bosses admitted that the need to use bank and agency staff has increased above this level in Bolton "due to a combination of fluctuations in the number of patients who need a lot of nursing care and staff vacancies".

The Bolton Hospital's NHS Trust has assured the BEN that it is continuing its "rigorous campaign" to fill vacancies and retrain staff.

Figures published by the Audit Commission reveal that millions of pounds are wasted through a failure to check nurses' incorrect timesheets, unnecessary shift bookings and high commission charges paid out to private nursing agencies.

And, the report warns, while temporary nurses make an "enormous contribution" covering for NHS staff shortfalls, their use can mean patients receive a poorer quality of care than they might otherwise get.

Changes will now be put in place in Bolton to prevent further overspending including strengthening the trust's nurse bank by recruiting more staff in order to move away from the use of expensive private agencies. Other measures include more central control and management of these banks complete with a dedicated bank manager and support team.

A new computer system is also hoped to match up skilled staff with appropriate-skill vacancies.

In addition, the hospital wants to pay temporary staff weekly.

The Wigan and Bolton Health Authority is due to discuss the hospital's financial situation during a behind-closed-doors meeting next week.

Sue Reed, Director of Nursing for Bolton Hospitals NHS Trust, said: "Bank and agency staff make an important contribution to hospital care and we value this.

"We will always need them to cover vacancies and to introduce new services until those posts are filled, and they also play a vital role at particularly busy times.

"However, we will of course continue to seek permanent staff. These changes are not just about eventually reducing costs, but about ensuring that the nursing care we give our patients is organised efficiently and is of a consistently high standard."

In the study of more than 4,000 nurses in every NHS trust across England and Wales, researchers unearthed a catalogue of risks, cost cutting and a lack of checks on Britain's thousands of temporary nurses.

The Audit Commission warns: "The circumstances in which temporary staff are booked and carry out their duties are sometimes less than ideal. They all increase the risks of something going wrong."

The study found pre-employment checks are not always completed thoroughly, and induction may be inadequate or non-existent. Three out of five bank nurses said they had no induction prior to working in unfamiliar areas.