Agency nursing – an obvious vicious circle

Today in the press it was reported that – The Belfast Trust – Northern Ireland’s largest health trust – spent just over £47m in that period on bank and agency staff (see here for full story).  Read that again…£47m… cover patches and shortages in services – covering but not providing, I may add. Temporary covering.

This article is related to Northen Ireland, but it can easily be seen in reflection across the UK’s nursing services. I look around most wards within the acute trusts will see lots of agency workers with different uniforms on all working together.  But at what cost, and not just financially.

The true effect of nursing agencies and the impact on the permanent working force can be and is devastating, and if often stems from unhappiness in the workplace.  Consider this situation and see if it sounds like a situation you have witnessed or are familiar with.

‘Changes’ happen within a working area, maybe some ‘streamlining’ of services (I love that phrase :/ ).  Some staff are unhappy and decide to leave, but some are happy and remain. The positions that are currently unfilled are replaced with agency staff for the short term.  The short term becomes longer term. The then happy staff have to work that bit harder due to working with agency staff who are not fully familiar with the environment and roles etc. The hard work becomes more regular, often daily on shifts due to lack of regular staff.

The once happy regular staff become unhappy and job hunt, some may leave. More agency staff are used. The first staff posts who left are filled, but the new staff arrive to an already upset and over-worked team….and they consider looking for another role….  sound like something going on in an area you know?

We are facing what could be the biggest NHS crisis ever, both in the public eye and on the ground within each department.  So, where do we go from here?

The NHS can’t really be that stretched, can it?

As a nurse working within the NHS in a number of roles over recent times, it does not surprise me to hear that the NHS is in decline in the public eye.  Often via social media and the general news it is easy to find horror stories of patients left in corridors, mis-diagnosis of symptoms, cancelled appointments and the list goes on….sadly.

taking bloodpressure

I contact another service, today it is an assessment team which is required to assess suitability for hospital admission of a patient.  The assessment team tell me there is nobody available to carry out the assessment….and that there are not any beds available, and that the bed management team are not available for a few hours.

Bear in mind we have a patient that who is that poorly that they potentially require hospital admission….a rock and a hard place spring to mind!

daily mirror nhs is dying

That little glimpse right there, that is a DAILY occurrence within our jobs as nurses. The sad truth is how easy as professionals we accept these responses. We are all aware that ALL SERVICES are stretched beyond belief.


I cannot remember a service or area that is not stretched or working to past capacity. Take a look and chat to anyone working within care – doctors, receptionists, nurses, social workers, HCAs – speak to any of them and ask them the question “so how is your job at the minute” and I guarantee that most if not all will talk about changes, cut-backs and staff sickness levels. I guarantee this as, as a nurse on the ‘coal-face’ so to speak, it is everywhere and every department is feeling what we read about in the papers or hear in the news.

Often the news does not reflect day-to-day activities and does not directly affect us as individuals. With the NHS facing the biggest financial crisis in it’s history it is only a matter of time before every single person requiring health services will be affected – and it has already hit the working staff, and hard.

Cutting Bursaries for Student Nurses

So, our treasury in the UK are considering cutting bursaries for our student nurses and replacing them with loans – see here for the story.

Nursing for many years has been a career that is often a path that mature students follow – a passion for caring that had been put on hold whilst other things (family and life commitments) often take priority.  When people come to a time in their life that their personal commitments lessen, often that is the time that they look at getting into the profession.

A major factor of this is ease of access. If a candidate did not have the required qualifications then there are the option of access courses which allow entrance to nurse training.  A nursing bursary is given to help support the student through their training AND tuition fees are currently waivered.  As career paths go, nursing has access for those who have the passion to work in the field.

student nurse writing

Fast forward to the current government’s train of thought… many of you who are working as registered nurses would have taken the path if the cost of the path were so great  – think £27,000 tuition fees PLUS living expenses. I fear that this might just be enough to put off a lot of potential fantastic nurses.  

And with the obvious shortages of nursing staff kicking around our services now…..good move Mr government!

So what do nurses and students alike think of this? Personally, I think this will be a big, big mistake.