This is NHS Check report no 12 originally published by Labour’s Shadow Health Team in July 2013

REVEALED:

  • 67,000 NHS staff now on zero hour contracts – up 10,000 under David Cameron
  • Clinical staff account for two thirds of list as three in four hospitals now use zero hour contracts
  • Over 300,000 social care workers on zero hour contracts – an extra 50,000 in two years

Labour calls on the Government to review the use of zero hour contracts and their impact on the care of patients and older people where they are used in place of permanently contracted staff.

Background

Zero hour contracts that give employees no guarantee of work are on the rise in England’s NHS and care services.

Such contracts for health and care workers:

  1. Do not guarantee to provide work;
  2. Only pay for work undertaken;
  3. Have no specified working hours or patterns.

Labour’s Shadow Health Team submitted requests under the Freedom of Information Act and Written Parliamentary Questions to reveal the numbers of health and care workers employed under these conditions.

Zero hour contracts in the NHS

In 2012/13, there were 67,242[1] members of NHS staff employed this way compared to 57,632 in 2009/10 – an increase of 9,610 NHS workers since Labour’s last year in Government.

The number of clinical staff employed on zero hour contracts has risen from 42,177 in 2009/10 to 47,433 in 2012/13 – now totalling 70% of all NHS staff using these contracts.

A distinction must be made between NHS staff who join a hospital’s ‘Bank’ for extra hours or increased inflexibility, and situations where staff are expected to be on call without payment and are unable to turn down a shift offered.

Labour’s concern is that the NHS is increasingly favouring casual contracts over offering permanent roles.

Of the 131 NHS hospital trusts that responded to the Freedom of Information request, 99 confirmed that ZHCs are used – 75% of hospitals.

The ten NHS hospital trusts with the highest number of zero hour contracts are:

Heart of England NHS Foundation Trust

5167

Luton and Dunstable University Hospital

2878

University Hospitals Coventry and Warwickshire NHS Trust

2844

The Royal Wolverhampton NHS Trust

2340

The Royal Liverpool and Broadgreen University Hospitals

1682

Oxleas NHS Foundation Trust

1629

Central Manchester University Hospitals

1627

Rotherham NHS Foundation Trust

1624

Hampshire Hospitals NHS Foundation Trust

1621

Barts Health NHS Trust

1586

Zero hour contracts in the social care sector

Ministers have also admitted, in a written response to a Labour question in Parliament, that 307,000 workers are employed are now employed on zero hour contracts – a figure that has increased by 49,000 since 2011.

The answer also confirms that 2011 saw a significant increase on Labour’s time in Government – “pre-2011 was not large enough to make robust estimates […] for these years, the proportion on zero-hours contracts was lower than in 2011.”

More than a quarter of the new zero hour contracts are in London – an extra 13,000 compared to two years earlier.  The Eastern region has experienced the most significant increase outside of London, with 7,000 extra contracts.

The figures by region are:[2]

Estimated number of adult social care workers on zero-hours contracts, by each English region

Region

2011

2013

Eastern

34,000

41,000

East Midlands

20,000

23,000

London

43,000

56,000

North East

13,000

17,000

North West

29,000

37,000

South East

43,000

50,000

South West

27,000

27,000

West Midlands

24,000

30,000

Yorkshire and The Humber

24,000

27,000

England

258,000

307,000

What does this mean for health and care in England?

On David Cameron’s watch, thousands of extra health and care workers are working on zero hour contracts whilst hospitals are short-staffed and social care has reached breaking point.

In the NHS, the rise in the number of staff employed on such contracts is a product of the Government’s mismanagement of the NHS £20 billion efficiency challenge – favouring the ‘low hanging fruit’ over longer-term efficiency savings.

Four thousand nursing jobs have been lost since the General Election and the regulator has uncovered 1 in ten hospitals without adequate staffing.

At the end of his three-year inquiry into Mid-Staffordshire, Robert Francis recommended benchmarks on safe staffing. Labour supported his recommendation but Ministers have chosen to ignore it.

Meanwhile in social care, the rise in zero hour contracts is symptomatic of the sector’s standing as a malnourished cut-price business grappling with a £1.8 billion local authority cut to older people’s care budgets.

Today’s 300,000 care workers on these contracts make up 20% of the entire social care workforce. If the staff do not have the security of knowing what they will earn from week to week they could find it harder to give a sense of security to those they care for.

This week, Camilla Cavendish’s report for the Government on the training and support of healthcare assistants raised the increasing use of zero hour contracts as a key issue affecting the care sector.

Cavendish notes that “Some low paid HCAs and support workers will heroically keep going as long as they feel they are still giving good care. But the advent of zero hours contracts, fee cuts and no payment for travel time is making it financially prohibitive for some domiciliary care workers to struggle on. Attrition rates are already dangerously high: and they will only increase when carers feel that they can no longer even give good care. Society will lose some talented carers unless the commissioning process changes radically and Government starts to move money from health to reward social care for its contribution to lowering NHS costs.”

She also adds, “For home care workers on zero-hours contracts, who are not guaranteed a fixed number of hours work per week, the need to travel for longer distances to do fewer visits is making it harder to make ends meet. The fact that some employers will not pay for travel time between clients means that there are now serious questions about whether some workers are actually being paid less than the National Minimum Wage.”

In England, a care system has developed where too many operators cut corners on the care of vulnerable older people to increase profit margins. At present, society believes that looking after someone else’s parents is the lowest calling a young person can answer, rather than the highest.

Labour is calling on the Government to review the use of zero hour contracts and their impact on the care of patients and older people.

Appendix 1 – Number of staff on zero hour contracts in each NHS hospital trust in 2009/10 and 2012/13

2009/10

2012/13

Name of Trust

Clinical

Non-Clinical

Total

Clinical

Non-Clinical

Total

TOTALS

42177

11480

57632

47433

13334

67242

5 Boroughs Partnership NHS Foundation Trust

361

26

387

324

29

353

Aintree University Hospitals NHS Foundation Trust

264

33

297

253

13

266

Alder Hey Children’s Hospital NHS Foundation Trust

852

53

1095

1185

193

1378

Ashford & St Peter’s Hospitals NHS Foundation Trust

49

0

49

22

0

22

Barking, Havering and Redbridge University Hospitals

20

2

22

525

137

662

Barnsley Hospital NHS Foundation Trust

916

106

1022

1124

115

1239

Barts Health NHS Trust

1495

559

2054

184

402

1586

Basildon and Thurrock University Hospitals

0

0

0

0

0

0

Berkshire Healthcare

113

85

198

192

87

279

Birmingham Children’s Hospital NHS Foundation Trust

N/A

N/A

432

N/A

N/A

565

Birmingham Women’s NHS Foundation Trust

0

0

0

0

0

0

Bridgewater Community Healthcare NHS Trust

N/A

N/A

N/A

103

370

473

Brighton and Sussex University Hospitals Trust

165

47

212

862

238

1100

Buckinghamshire Healthcare NHS Trust

776

60

836

375

51

426

Calderdale and Huddersfield NHS Foundation Trust

324

317

641

204

363

567

Cambridge University Hospitals NHS Foundation Trust

0

0

0

0

0

0

Camden and Islington NHS Foundation Trust

1213

189

1402

5

0

5

Central and North West London NHS Foundation Trust

N/A

N/A

N/A

609

191

800

Central Manchester University Hospitals

376

502

878

908

719

1627

Chelsea & Westminster NHS Foundation Trust

0

0

0

0

0

0

Cheshire and Wirral Partnership NHS Foundation Trust

382

93

475

325

143

468

Colchester Hospital University NHS Foundation Trust

60

14

74

67

57

124

County Durham and Darlington NHS Foundation Trust

0

0

0

0

0

0

Coventry and Warwickshire Partnership NHS Trust

417

124

541

448

205

653

Croydon Health Services NHS Trust

0

0

0

0

0

0

Cumbria Partnership NHS Foundation Trust

0

0

0

0

0

0

Derbyshire Community Health Services NHS Trust

N/A

N/A

N/A

203

49

252

Devon Partnership NHS Trust

0

0

0

0

0

0

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

N/A

N/A

N/A

N/A

N/A

N/A

Dorset County Hospital NHS Foundation Trust

N/A

N/A

N/A

168

39

207

Ealing Hospital NHS Trust

1226

377

1603

621

260

881

East and North Hertfordshire NHS Trust

0

0

0

0

0

0

East Cheshire NHS Trust

N/A

N/A

N/A

423

77

500

East Lancashire Hospitals NHS Trust

0

0

0

0

0

0

East Sussex Healthcare NHS Trust

N/A

N/A

N/A

N/A

N/A

N/A

Epsom and St Helier University Hospitals NHS Trust

0

0

0

0

0

0

Frimley Park Hospital NHS Foundation Trust

0

0

0

0

0

0

Great Ormand Street Hospital for Children NHSFT

N/A

N/A

N/A

N/A

N/A

584

Great Western Hospitals

1060

228

1288

1025

236

1261

Hampshire Hospitals NHS Foundation Trust

N/A

N/A

211

N/A

N/A

1621

Harrogate and District NHS Foundation Trust

68

84

152

231

105

336

Heart of England NHS Foundation Trust

4144

601

4745

4540

627

5167

Heatherwood and Wexham Park Foundation Trust

N/A

N/A

N/A

94

87

181

Hertfordshire Community NHS Trust

0

0

0

0

0

0

Homerton Hospital NHS Trust

0

0

0

0

0

0

Hounslow and Richmond Community Healthcare

N/A

N/A

N/A

539

284

823

Humber NHs Foundation Trust

110

85

195

448

166

614

Imperial College Healthcare NHS Trust

N/A

N/A

N/A

N/A

N/A

299

James Paget University Hospitals Trust

375

122

497

424

128

552

Kent Community Health NHS Trust

N/A

N/A

N/A

172

6

178

Kettering General Hospital NHS Foundation Trust

0

0

0

0

0

0

King’s College Hospital NHS Foundation Trust

64

15

79

31

13

44

Lancashire Teaching Hospitals NHS Foundation Trust

N/A

N/A

N/A

469

168

637

Leeds and York Partnership NHS Foundation Trust

377

62

439

563

74

637

Leeds Teaching Hospitals NHS Trust

0

0

0

0

0

0

Liverpool Heart and Chest Hospital NHS Foundation Trust

119

13

132

165

14

179

Liverpool Women’s NHS Foundation Trust

N/A

N/A

N/A

63

6

69

Luton and Dunstable University Hospital

1862

662

2524

2169

709

2878

Medway NHS Foundation Trust

519

152

671

43

0

43

Mid Essex Hospital Services NHS Trust

188

4

192

141

6

147

Mid Staffordshire NHS Trust

455

160

615

480

176

656

Mid Yorkshire Hospitals NHS Trust

381

52

433

241

25

266

Milton Keynes Hospital NHS Trust

N/A

N/A

N/A

N/A

N/A

220

Moorfields Eye Hospital NHS Trust

0

0

0

0

0

0

Norfolk and Norwich University Hospitals

722

168

890

875

119

994

North Cumbria University Hospitals NHS Trust

305

69

374

358

70

428

North Devon Healthcare NHS Trust

N/A

N/A

N/A

21

1

22

North Tees and Hartlepool NHS Foundation Trust

672

155

827

682

85

786

North West London Hospitals NHS Trust

0

0

0

0

0

0

Northampton General Hospital NHS Trust

40

140

180

88

124

212

Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

449

131

580

381

91

472

Northumberland, Tyne and Wear NHS Foundation Trust

3

35

38

12

75

87

Oxford University Hospitals NHS Trust

973

160

1133

973

180

1153

Oxleas NHS Foundation Trust

979

142

1121

1357

272

1629

Papworth Hospital NHS Foundation Trust

N/A

N/A

N/A

N/A

N/A

216

Pennine Acute Hospitals NHS Trust

2488

647

3135

N/A

N/A

N/A

Pennine Care NHS Foundation Trust

430

72

502

579

224

803

Peterborough and Stamford Hospitals NHS Foundation Trust

0

0

0

0

0

0

Poole Hospital NHS Foundation Trust

N/A

N/A

N/A

511

151

662

Portsmouth Hospitals NHS Trust

321

354

675

319

158

477

Princess Alexandra Hospital NHS Trust

89

32

121

113

14

127

Queen Elizabeth Hospitals Kings Lynn Trust

246

91

337

279

97

376

Queen Victoria Hospital NHS Foundation Trust

0

0

0

0

0

0

Rotherham NHS Foundation Trust

847

82

1429

1357

267

1624

Rotherham, Doncaster and South Humber NHS Foundation Trust

128

48

176

194

116

310

Royal Berkshire NHS Foundation Trust

93

36

129

67

38

105

Royal Bournemouth and Christchurch Hospitals

1004

227

1231

1084

304

1388

Royal Brompton and Harefield NHS Foundation Trust

0

0

0

0

0

0

Royal National Hospital for Rheumatic Diseases

52

28

80

55

20

75

Royal National Orthopaedic Hospital NHS Trust

0

0

0

0

0

0

Royal Orthopaedic Hospital NHS Foundation Trust

155

71

226

94

55

149

Royal United Hospital Bath NHS Trust

504

208

712

494

192

686

Salford Royal NHS Foundation Trust

25

76

101

17

73

90

Salisbury NHS Foundation Trust

1474

636

2110

N/A

N/A

N/A

Sheffield Children’s NHS Foundation Trust

N/A

N/A

N/A

34

23

57

Sheffield Teaching Hospitals NHS Foundation Trust

205

73

278

246

49

295

Sherwood Forest Hospitals NHS Foundation Trust

136

107

243

226

108

334

Shrewsbury and Telford Hospital NHS Trust

579

224

803

782

176

958

South London and Maudsley NHS Foundation Trust

N/A

N/A

N/A

6

0

6

South Tees Hospitals NHS Foundation Trust

331

67

398

226

86

312

South Tyneside NHS Foundation Trust

0

0

0

0

0

0

Southend University Hospital NHS Foundation Trust

0

0

0

0

0

0

Southport and Ormskirk Hospitals NHS Trust

0

0

0

0

0

0

St George’s Healthcare NHS Trust

280

14

294

1029

17

856

St Helens and Knowsley Teaching Hospitals NHS Trust

565

124

689

443

75

518

Staffordshire and Stoke on Trent Partnership

N/A

N/A

N/A

1278

240

1518

Surrey and Sussex Healthcare NHS Trust

0

0

0

0

0

0

Sussex Community NHS Trust

N/A

N/A

N/A

1140

374

1514

Tameside Hospital NHS Foundation Trust

0

0

0

0

0

0

Tavistock and Portman

15

84

99

51

92

143

The Christie NHS Foundation Trust

40

52

92

67

46

113

The Ipswich Hospital NHS Trust

0

0

0

0

0

0

The Robert Jones & Agnes Hunt Orthopaedic Hospital NHSFT

N/A

N/A

N/A

94

56

150

The Royal Liverpool and Broadgreen University Hospitals

1714

224

1938

1403

279

1682

The Royal Wolverhampton NHS Trust

1338

57

1395

1661

679

2340

The Walton Centre NHS Foundation Trust

0

0

0

0

0

0

Torbay and Southern Devon Health and Care NHS Trust

606

135

741

607

117

724

University Hospital of North Staffordshire

702

129

831

816

248

1064

University Hospital of South Manchester NHS Foundation Trust

123

99

222

68

43

111

University Hospitals Birmingham NHS Foundation Trust

181

57

238

618

131

749

University Hospitals Bristol NHS Foundation Trust

1199

513

1712

912

298

1210

University Hospitals Coventry and Warwickshire NHS Trust

N/A

N/A

3206

N/A

N/A

2844

University Hospitals of Leicester NHS Trust

1227

485

1712

671

138

809

University Hospitals of Morecambe Bay NHS Foundation Trust

0

0

0

0

0

0

Walsall Healthcare NHS Trust

468

99

567

569

166

735

Warrington and Halton Hospitals NHS Foundation Trust

29

94

123

48

116

164

West Hertfordshire Hospitals NHS Trust

0

0

0

0

0

0

West Middlesex University Hospital NHS Trust

395

205

600

304

54

358

West Suffolk NHS Foundation Trust

0

0

0

0

0

0

Western Sussex Hospitals NHS Trust

0

0

0

0

0

0

Weston Area Health NHS Trust

148

26

174

123

19

142

Worcestershire Acute Hospitals NHS Trust

142

53

195

502

63

565

Worcestershire Health and Care NHS Trust

N/A

N/A

N/A

502

143

645

Wrightington, Wigan and Leigh NHS Foundation Trust

N/A

N/A

126

N/A

N/A

126

Yeovil District Hospital NHS Foundation Trust

251

41

292

206

39

245

York Teaching Hospital NHS Foundation Trust

83

83

166

923

146

1069

[1] Based on 136 responses from Trusts in England.  Detailed statistics to be found in Appendix 1

[2] House of Commons Debate, 8 July 2013, Official Report, Column 98W

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One Comment

  1. jenw17 says:

    How can these nurses and care workers be expected to care when the Trusts they work for do not care enough about them to give them security of employment?

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