Audit report lays bare fallout of cuts on nurse training budget as agency costs 'soar'
THE impact of slashing nursing training places in Northern Ireland to make "short term savings" has been laid bare in a damning watchdog report which reveals a staggering rise on agency staff spending.
Auditors discovered that successive cuts by the Department of Health to undergraduate places at a time of increased patient demand led to a 150 per cent hike in the bill for 'temporary' staff over a seven-year period - from £45m in 2011-12 to £115m in 2018-19
During bank holidays last year, three health trusts were forced to pay private recruitment agencies up to £1,700 to cover single nursing shifts, with warnings these firms provided "particularly poor value for money".
It is noted the department "has not achieved a target to reduce reliance on temporary staff".
The publication of the detailed 'Workforce planning for nurses and midwives' report comes six months after strike action was taken by the Royal College of Nursing over pay parity and "unsafe" staffing levels.
Vacancies among the nursing and midwifery sector are also highlighted by the watchdog, with more 2,700 jobs lying empty last year despite repeated recruitment campaigns by the health service.
In a lookback exercise, auditors say cost-cutting measure taken to reduce the nurse training budget led to 732 fewer nursing training places being created between 2011-12 and 2016-17, compared with 2009-10 levels.
While this practice stopped and efforts have been made to significantly increase the number of student places, it has been "insufficient to keep pace with identified need" with an aging population and increased demands on health and social care.
By the end of last year, more than one in ten registered nursing posts here were vacant.
These vacancies include 2,100 unfilled registered nursing posts, with as many as 1,600 additional nurses also required to "ensure safe staffing levels".
And although the north's registered nursing workforce increased by 8.8 per cent between 2012 and 2019, the report finds an increase of more than 23 per cent was required to meet the rising level of demand.
Comptroller and Auditor General, Kieran Donnelly, issued a stark warning about the far-reaching impact of "short term" money-saving decisions made at the highest government levels.
"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," he said.
"I accept that workforce planning is a challenging area to manage.... Nonetheless, short-term decisions taken at a strategic level have meant that overcoming these serious challenges will take even longer."
And he said that the reliance on agency staff had not only resulted in "soaring costs" but could also "compromise the quality and safety of patient care" as staff are deployed to work in less familiar hospital settings,
"It is clear that does not represent value for money," he said.
The report also found that post-registration training budget, which helps nurses acquire new specialist skills, was cut from almost £9.5 million in 2008-09 and 2009-10, to an average of £8 million between 2010-11 and 2018-19.
A 10 year 'vision' plan to improve care was launched by the department in 2016 and acknowledged the need to tackle "fundamental" problems with the supply, recruitment and retention of the north's healthcare workforce by 2026.
The watchdog report concludes that if issues around recruitment and vacancy levels are not effectively addressed, the health service will face "intolerable pressure".