Northern Trust responds as agency nursing costs soar to £162m across Northern Ireland

Inset: Interim chief executive of the Northern Health and Social Care Trust

The interim chief executive of the Northern Health and Social Care Trust has acknowledged the publication of the Northern Ireland Audit Office report on the use of temporary nursing staff across Northern Ireland.

Speaking at a meeting of the Trust board at Causeway Hospital, Coleraine, on Thursday morning, Suzanne Pullins said the report “sends out a very important message about reliance on temporary staff, particularly agency workers”, adding that the Trust has been moving away from this “high-cost” model.

“We are committed to improving and sustaining our workforce. There is Trust oversight of this issue,” she said.

A nursing, midwifery and healthcare support framework was established in 2023, which the Department of Health described as “a vital step in delivering a reduction in agency staff costs incurred by the health service in Northern Ireland”.

The Department reported in December last year that spending on off-contract nurses, midwives and healthcare support workers across Northern Ireland’s health and social care system had reduced by £120 million since May 2023.

However, annual expenditure on agency nursing staff in Northern Ireland has tripled in six years, reaching £162 million in 2024-25, according to a report published earlier this week by Northern Ireland Comptroller and Auditor General Dorinnia Carville.

The report found that annual permanent nursing and midwifery staff costs across Northern Ireland reached £1.1 billion in 2024-25.

Meanwhile, the registered nursing workforce has increased since the Northern Ireland Audit Office’s 2020 review, rising from around 14,000 whole-time equivalent nurses in March 2019 to approximately 17,000 in March 2025. Reported nurse vacancies have decreased by 45 per cent over the same period.

The report also stated that an agency nursing framework introduced in 2023 has “helped to largely eliminate” the use of very expensive off-contract nursing agencies — a practice it said had previously been prevalent across Trusts.

According to the report, agency nursing staff cost, on average, £11 per hour more than staff employed through Trusts’ internal bank systems, where workers are employed directly by the Trusts.