Overseas recruitment drive sees agency nurse costs tumble

Richard Youle, local democracy reporter

A hospital’s agency nurse costs have tumbled following the successful recruitment of hundreds of overseas nurses.

Morriston Hospital agency costs were £11.7 million in 2023-24 compared to £20.2 million in 2022-23, a report about nurse staffing levels said.

And agency expenditure for the current financial year – 2024-25 – is forecast to drop further to £3.7 million.

The report said the £3.7 million would be for extra nurses in the emergency department and one-to-one care for patients who needed extra oversight for safety reasons, among other things.

Swansea Bay University Health board has hired around 500 overseas nurses in recent years – 20 of whom have subsequently left – and also taken on more student nurses. Many of the overseas nurses have come from India.

Challenges remain

But recruitment and retention challenges remain and agency nurse costs at Singleton Hospital and Neath Port Talbot Hospital have not fallen as much as at Morriston, although no figures were provided in the report. It added that key recruitment target areas were neonatal nursing, mental health and community nursing, and that there were a number of Band 5 nurse vacancies in paediatric inpatient wards.

The report said: “Skill mix is the big risk area currently as the wards have taken on a large number of internationally-trained nurses and newly-registered nurses that has left a skills gap on ward areas.”

The report concluded that the health board was complying with the Wales-wide Nurse Staffing Levels Act, which covers acute medical and surgical wards and paediatric in-patient wards.

Health board members were told at a meeting that the 20 overseas nurses who had left had gone to other parts of the UK. Exit interviews were offered to them, and a pilot project was under way to try to find out if nurses were thinking of leaving so that steps could be taken to retain them.

Staff turnover

Sarah Jenkins, interim director of workforce and organisational development, said a new retention “lead” had just started work, and that some staff turnover was a good thing. She said: “It’s about making sure that turnover is not out of kilter nationally.”

She added that there was still work to do to help nurses progress through the bands, particularly overseas nurses. Health board chairwoman Emma Woollett said it was important to ensure that ethnicity did not disadvantage nurses in their bid to progress.

Gareth Howells, interim director of nursing and patient experience, was asked how health board thinking was informed for staffing levels in areas not covered by the Nurse Staffing Levels Act. He said there was an assessment framework similar to the act.

The real challenge, he said, was in areas such mental health, low dependency units and, to some extent, maternity services because of their different approach to monitoring care and outcomes. Mr Howells added that 40 overseas mental health nurses were due to join the health board in the next few weeks.

Last year it emerged that 1,585 nurses and midwives left the health board between 2019-20 and 2022-23, with 1,274 joining during the same period.