HEALTH: NHS spending on temporary staff soars by a third to £567 million

By Lucy Ashton

NHS Scotland spending on locum doctors and agency and bank nurses soared to £567 million in 2022-23 – up more than a third on the previous year.

The eye-watering sum represents a 165-per-cent rise on the £213.5 million spent in 2014-15 – the first year for which complete data is available – and it dwarfs the £323.6 million spent just two years ago.

The figure comprises a record £447.4 million spent on temporary nursing and midwifery staff and £119.6 million on locum doctors and dentists.

The ever increasing rise flies in the face of SNP promises back in 2017 to give “significant priority” to reducing the use of agency nurses and locum doctors because of their “cost to the health service”.

Agency staff typically cost more than NHS staff, as a fee is paid to the agency on top of the employee’s salary.

Scottish Conservative shadow health secretary Dr Sandesh Gulhane said the surging figures represented the “ultimate false economy” and were a “shameful reflection of the SNP’s appalling workforce planning and mismanagement”.

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP, pictured left,  said: “These shocking figures highlight where our NHS is going wrong under the SNP.

“The seemingly unstoppable rise in spending on agency staff is a shameful reflection of the nationalists’ appalling workforce planning and mismanagement.

“Having worked as both a permanent and a locum doctor in the NHS myself, I know the key role locum doctors and nurses play in our healthcare service.

“But because the SNP have failed to ensure there are enough permanent frontline staff to properly resource our health service, we have become dependent on more expensive agency or locum staff.

“It’s the ultimate false economy. Every penny is a prisoner given the huge demands on the NHS, so we can’t afford to spend ever-increasing sums on fees to agencies, in addition to paying the temporary staff they provide.

“Some of this locum spending will have even gone towards permanent staff or retirees begged to take on extra shifts in order to plug the enormous staffing shortfall.

“Michael Matheson has been left an almighty mess to clear up by Humza Yousaf, but he must get an urgent grip on NHS workforce planning and this wasteful, dysfunctional system if we’re to get the modern, efficient, local health service we need.”

Scotland’s NHS is facing a ‘perfect storm’ of collapsing workforce numbers and soaring agency costs, Scottish Labour has said today.

Scottish Labour Health Spokesperson Jackie Baillie said: “It is clear for all to see that a decade and a half of SNP failure has left our NHS facing a perfect storm of falling staffing levels and soaring agency costs.

“From soaring agency bills to lengthening NHS waits, the people of Scotland are now paying the full price of SNP incompetence and useless Humza Yousaf’s disastrous track record as Health Secretary.

“NHS staff are working around the clock but are not being supported by this government – with an exodus from the NHS as a result.  Michael Matheson may not have created this crisis but he has a duty to tackle it.”

Health Secretary Michael Matheson, his predecessor First Minister Humza Yousaf, Scottish Labour’s health spokesperson Jackie Baillie and LibDem leader Alex Cole-Hamilton.

LibDem leader Alex Cole-Hamilton MSP said: “These astronomical figures expose the yawning gaps within the NHS workforce, putting staff in a desperate situation.

“The complete failure by this SNP-Green government to recruit and retain staff stretches all the way back to Nicola Sturgeon cutting training places and claiming that was ‘sensible’.

“Without fresh action every plan to recruit new people, treat people quickly and curtail the backlogs will fall flat. It’s why Scottish Liberal Democrats would deliver the proper implementation of the safe staffing legislation that Parliament agreed years ago. We also need an urgent Burnout Prevention Strategy – a plan the SNP/Green Government were wrong to vote down.”

Total spend on agency locums and on nursing and midwifery agency/ bank staff soared by more than a third in a year to reach more than half a billion pounds. In the year ending 31 March 2023, total spend was £567 million. This is made up of £170 million on nursing and midwifery agency staff, £278 million on nursing and midwifery bank staff and £120 million on medical and dental agency locums. (TURAS Data Intelligence, NHS Scotland workforce, bank and agency dashboard, 6 June 2023, link).

Spending on agency staff has more than quadrupled over the last two years and is up 91% in a year. Total spend on nursing and midwifery agency staff was £169.7 million in 2022/23. This is up from £88.9 million in 2021/22 and £39.3 million in 2020/21. (TURAS Data Intelligence, NHS Scotland workforce, bank and agency dashboard, 6 June 2023, link).

The SNP promised to make reducing agency and locum staff a ‘significant priority’ in 2017, but since then total agency spending has increased by over £160 million. In 2017/18, total spend on agency locums and nursing and midwifery staff was £124 million. In 2022/23, total spend was £289.3 million. That is a 133.3% increase, or an increase of £165.3 million. (National health and social care workforce plan, 28 June 2017, link; TURAS Data Intelligence, NHS Scotland workforce, bank and agency dashboard, 6 June 20223, link).

National spend on agency locums increased by 17% in just a year, with almost £120 million spent in total. The national spend on agency locums increased by 16.8% to £119.6 million in the year ending 31 March 2023. 10 out of 11 mainland health boards had an annual increase in spend for the year, with the largest relative increase being seen in NHS Forth Valley, where the total spend was up 102.1%. NHS Grampian spent the most on medical agencies: £17.6m. (NHS Scotland Workforce, 6 June 2023, link).

NHS Scotland 

Financial year Medical agency locum spend % change on previous year Nursing and midwifery agency/ bank spend Total spend % change on previous year
      Bank Agency Total    
2022/23 £119.6 million 16.8% £277.7 million (+19.6%) 169.7 million (+91.0%) £447.4 million £567.0 million 33.9%
2021/22 £102.4 million 16.9% £232.2 million (+18.0%) £88.9 million (+126.2%) £321.0 million £423.4 million 30.8%
2020/21 £87.6 million -14.9% £196.7 million (+9.3%) £39.3 million (+22.3%) £236.0 million £323.6 million 2.7%
2019/20 £102.9 million 5.0% £180.0 million (+11.2%) £32.1 million (+22.4%) £212.1 million £315.0 million 10.1%
2018/19 £98.0 million -2.4% £161.9 million (+6.5%) £26.2 million (10.9%) £188.1 million £286.1 million 3.6%
2017/18 £100.4 million -8.8% £152.1 million (+7.1%) £23.6 million


£175.7 million £276.1 million -0.2%
2016/17 £110.1 million 12.0% £142.0 million (+5.5%) £24.5 million (+4.4%) £166.5 million £276.6 million 7.9%
2015/16 £98.3 million 44.7% £134.6 million (+3.8%) £23.5 million (+46.8%) £158.1 million £256.4 million 2.7%
2014/15 £67.9 million 0.9% £129.6 million (+9.7%) £16.0 million (+71.6%) £145.6 million £213.5 million N/A



  1. To become a medical practitioner requires study and hard work and not every one is willing or able to do that study.

    And therein lies a problem. And it’s not just medicine. STEM subjects or Science Technology, Engineering and Maths are avoided by many preferring instead subjects like retail, tourism or humanities.

    Nothing wrong with softer subjects. Careers in retailers like McDonald’s, KFC and retail outlets are big business. Just don’t get sick or want to produce high tech engineering.

    Make you wonder how many of the political class pursued the harder edged subjects.

    1. It should not take a person with a crystal ball to work out that staff will require to be replaced when they leave. Nor should it take a genius to realise when you have a nurse being paid less in the NHS than in the private sector then that person is most likely to opt for the job with the highest salary. Doctors used to have to have Latin. It was a pre-requisite to taking a course in medicine. Now they don’t even teach Latin in our schools.

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