In the latest attack on healthcare staffing firms supporting the NHS, an investigation by The Ferret claims that Scotland’s health boards collectively spent £985 million on agency workers between 2021 and 2023.

NHS Scotland’s spending on agency workers includes medical and dental staff of all specialities working in hospitals and GP practices. The investigation was able to account for £100 million spent on agency staffing from the expenditure reports. Reports have to include all expenses over £25,000.

The report names the top agencies providing medical staff between 2021 and 2022 including Scottish Nursing Guild, which was paid £25.7 million by NHS Scotland. It is part of the Acacium Group, owned by the Canadian private equity firm, Onex. Other major providers include Locum People, owned by Cook Recruitment Group Ltd which earned nearly £4 million from NHS Grampian and ID Medical Group which earned £4.3 million from NHS Grampian. Brookson Solutions, Interact Medical and Retinue Solutions (part of nGage) were also named in the report.

The investigation also claims that some recruitment agencies are owned in tax havens, that some directors have been paid up to $800,000 while the health service struggles and that millions of pounds have been paid out in dividends to shareholders. The Ferret also found that, due to staffing shortages, nurses have reportedly been offered £2,000 a shift by agencies supplying NHS Scotland.

Kate Shoesmith, deputy chief executive at the Recruitment and Employment Confederation, said agencies are vital to the NHS and that the “growth in demand” for temporary staff is down to ‘successive governments’ inability to come up with the right workforce plan’ for the NHS.

Shoesmith argued that ‘many healthcare workers want a greater work/life balance, and so choose to work in a temporary way”’ She added, “There are caps and controls on agency margins in the NHS – and they haven’t been reviewed or increased in years.

“Agency workers are still health workers, and the cost of their shifts is mainly made up of the worker’s salary because an agency fee on framework is capped at around 10 per cent of the hourly rate for a nurse. It is worth reflecting that much of the increase in temporary workforce spend since the pandemic is down to NHS staffing banks and off-framework providers who are not restricted by pay caps,” Shoesmith said.

A Scottish government spokesperson claimed Scotland had ‘historically high levels of staff in our NHS and in March last year’, adding that ministers published the National Health and Social Care Workforce Strategy, which sets out a ‘long-term vision for achieving a sustainable health and social care workforce’.

The spokesperson continued, “The majority of temporary staffing come from staff banks; these are NHS staff, working on NHS terms and conditions. New controls were introduced by boards from 1 April in order to gradually reduce the number of shifts being filled by agency nursing staff and from 1 June boards are no longer using off-framework agencies such as SNG, unless in exceptional circumstances.” Off-framework agencies don't have to abide by pre-agreed pay scales and often charge three or four times the framework rate.

We Own It, a public ownership campaign group, said it was ‘disgraceful’ that private firms are ‘profiting from pain’ while Scottish Labour said The Ferret’s revelations were ‘deeply worrying’.

Scottish Labour MSP Jackie Baillie said that a ‘lack of a sustainable workforce plan and the volume of vacancies’ means the SNP (Scottish National Party) are taking a ‘sticking plaster approach that allows private companies to charge such obscene prices’ for nurses.