THE cost of staffing ever-busier hospitals in Gwent – and the rest of Wales – has emerged as a key factor in health boards’ struggles to stay within budget.

Aneurin Bevan University Health Board had an estimated deficit of around £14 million at the end of August, according to its latest finance report, and is on course for a £35m overspend by the end of the financial year unless it can slow its spending.

But rising demand, in terms of unscheduled care and increasing numbers and complexity of patients coming through hospital ‘front doors’, is helping drive higher than expected spending on agency and locum staff.

The need to open additional capacity, and higher than average staff sickness, are also factors.

The situation is mirrored across Wales, and is getting so acute that health boards are struggling to find the extra nursing staff they need from agencies included in an all-Wales agency contract.

Employing agency staff is expensive and one that health boards such as Aneurin Bevan in Gwent have sought to minimise. Here, that has involved recruiting more staff.

But that has not kept pace with demand and in Gwent, nursing staff have had to be brought in from a non-contract agency, at an even higher cost.

In August, the health board spent £471,000 on agency nursing staff, with £391,000 going to an agency not on the contract and thus charging higher fees.

Locum doctor costs are also increasing, with a £342,000 spend in Gwent in August against a monthly average of £253,000.

“Everybody (in Wales) is bringing in extra capacity to deal with demand and that is creating issues with the availability of nursing staff,” said finance director Alan Brace.

“We are exhausting most of the agency supply in terms of staffing to capacity, which might impact on our ability to staff through the winter.”

Health board chairman David Jenkins said the Welsh Government’s emphasis is for boards to “maintain focus on delivering performance and not to take our foot off the pedal with regard to achieving them”.

He said there is usually extra funding announced for the NHS in the autumn, though no indication has been made yet this year.

But he added that by the next board meeting (at the end of November), the health board should know whether or not it is going to get extra money.