Warrington Hospital's agency staff cap breached more than a hundred times a week

Research by the Nursing Times has shown that Warrington and Halton Hospitals NHS Foundation Trust is the second-highest user of agency doctors and nurses in the region, behind only the Pennine Acute Hospitals NHS Trust.

Figures obtained by a freedom of information request showed that on average Warrington Hospital overrides caps on agency staff 139 times a week.

The caps were introduced in November, with trusts now prevented from paying agency doctors and nurses more than 55 per cent higher than permanent staff members.

The health secretary Jeremy Hunt said the caps would prevent agencies ‘ripping off the NHS’ and save £1billion over three years.

But the caps have been breached 60,000 times nationally since their introduction, with Warrington and Halton Hospitals NHS Foundation Trust a high offender.

Estephanie Dunn, regional director for the Royal College of Nursing in the north west, said: “Trusts are right to put patient safety first rather than arbitrary, nationally-set financial targets but what this is really about is a national failure of workforce planning and pay, terms and conditions failing to attract and retain sufficient permanent staff.

“NHS trusts who are prepared to stand up for patient safety rather than sticking to the cap should be congratulated but as this data shows this is an urgent problem because it’s not an effective or sensible way to spend money in the longer term and it is not sustainable.”

Ms Dunn predicted that the problem could persist for several years yet.

She added: “The NHS has relied on short-term agency staff to plug gaps for many years and the problem won’t be fixed overnight.

“Another significant problem is the fact that the number of nurses being trained in the UK has been reduced over the last few years for short-term financial reasons.

“The fix requires time and more investment – we need more nursing student places and to get rid of the financial disincentives that stop potential students from applying to study to become nurses.

“We also need to pay nurses and health care assistants fairly so that we are able to retain staff in the job.

“However, it takes three years for students to complete their nurse training so until then trusts will continue to struggle with the agency cap and continue to rely on overseas recruitment.”

The hospital says it has halved its agency cap breaches over the last three months.

Director of nursing Karen Dawber said: “We are working with the agencies to agree capped rates and have already reduced our agency cap breaches over the last three months by half.

“Our priority to ensure that our wards are safely staffed and we have robust rotas in place to ensure the correct skill mix and number of nurses.

“The areas where we are most likely to breach capped rates are in the highly-specialist areas such as intensive care, the emergency department and theatres where there is a national shortage of specialist staff.

“As patient safety is paramount we always try to ensure that staffing levels and skill mix are adequate for the specific area and sometimes this requires us paying an agency nurse above the capped rate, which in turn causes and agency cap breach.”