Nottingham hospital leaders have given assurances that their expenditure remains within acceptable parameters after figures exposed that almost £900 million was devoted to temporary personnel over a seven-and-a-half-year period.
Nottingham University Hospitals (NUH), which operates the Queen’s Medical Centre and City Hospital, allocated £315 million toward agency employees between 2019 and June 2026, while committing a further £565 million to bank workers throughout the same timeframe.
These substantial amounts, disclosed via a freedom of information request submitted by the Nottingham Post, prompted a local NHS campaign organisation to demand restrictions on temporary worker costs, asserting that third-party operators are deliberately exploiting gaps to make substantial profits.
NUH, which required almost two years to provide the figures, arriving 492 working days beyond the legal deadline, attributed the elevated totals to the Covid pandemic and indicated that spending had subsequently been reduced to comply with NHS England thresholds.
Two years prior, the trust identified escalating agency expenditure as one of the factors contributing to its precarious financial situation, which has resulted in leadership cutting hundreds of positions and seeking tens of millions in additional financial assistance in recent years.
NHS bank workers are flexible temporary employees who maintain direct contracts with individual trusts and undertake supplementary shifts to address staffing shortfalls. Agency workers, by contrast, are engaged through external recruitment businesses.
Total expenditure reached its highest point at £158 million in 2022 and £157 million in 2023, with the majority directed toward temporary nurses, midwives and other clinical professionals.
Considerable sums were also allocated toward administrative personnel, while senior managers accounted for expenditure in the hundreds of thousands.
Spending has progressively decreased since that peak, though it stayed above £100 million in both 2024 and 2025. More than £50 million has already been committed during 2026.
The campaign organisation Keep Our NHS Public maintained that the figures provided additional proof that the NHS is being steadily run down, with increasing amounts of money going to private health companies.
Mike Scott, representing the Nottingham branch, stated that the underlying problem stems from trusts receiving insufficient funding to recruit permanent employees for these roles, compelling them to engage agencies that typically charge twice the actual cost of a directly employed worker.
He said such organisations are knowingly and deliberately profiting from these gaps. He suggested that the government is counterproductively exacerbating the situation. His view was that agencies should either be completely prohibited or trusts instructed to utilise only their own staffing pools or establish new ones if required. He noted that agency workers frequently comprise NHS employees undertaking overtime at inflated rates, which exposes another fundamental issue: basic NHS remuneration across all pay grades remains inadequate.
Danielle Petch, NUH’s chief people officer, explained that to sustain safe staffing levels and protect patient services, the trust, like other NHS organisations, occasionally depends on temporary personnel. She said NHS England establishes spending thresholds and NUH is presently operating within those parameters. She noted that following heightened reliance on temporary staff during and after the Covid pandemic, agency expenditure had been cut by 64 per cent and bank costs reduced by 11 per cent between 2022 and 2025. She said rigorous safeguards ensure temporary staff are deployed only when essential to preserve safe services.
The trust also expressed regret for the delayed response to the freedom of information request.
The organisation stated that at the time of the request, it faced difficulties responding to all FOIs promptly and offered sincere apologies for the delay and any inconvenience caused.
Across England, the combined expenditure of 181 NHS trusts totalled just over £3 billion between 2020 and 2023, according to research conducted by the Royal College of Nursing.
A spokesperson for the Department of Health and Social Care stated that the government is delivering record investment to restore the NHS, with thousands of additional staff recruited and this year marking a record number of doctors in service. The government aims to eradicate agency expenditure by the end of the parliamentary term and has already achieved reductions amounting to hundreds of millions.