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Turnover down £160m for temporary staffing firm

Published on: 23 Jul 2024

Turnover and profits are down at the NHS’s biggest supplier of agency staff.

Acacium Group, which runs Pulse and other temporary staffing companies supplying the NHS, saw revenues fall 12 per cent over the past year.

Documents filed with Companies House last week show the company, owned by Canadian private equity firm Onex, booking a turnover in the UK of £730m in 2023 – down from £897m.

The international firm’s annual accounts do not break down profit and loss by country, but its overall revenue fell from £2.3bn to £1.4bn and profits fell from £50m to £3m over the same period. The UK-based company paid £104m in dividends, the accounts said.

Agency staffing costs are always targeted by trust finance directors looking to achieve savings targets, and each trust is supposed to have a capped spend. Systems are expected to eliminate off-framework agency spending this month.

Overall NHS trust spending on agency staff surged to £3.5bn in 2022-23, HSJ reported in December.

In March, NHS England told systems to “collaborate and share data” on agency pay rates to improve compliance against the agency price cap, as well as the usage of bank staff. 

Acacium said while NHS spend on agency staff was down, it had seen better results from its clinical outsourcing firm Xyla – used by trusts for waiting list catch-up drives – and Maxxima, which runs bank staff services for trusts.

HSJ analysis indicates a trust spend of £69m on Xyla since 2020, with Frimley Health Foundation Trust accounting for nearly a third of this.

Total spend in the English NHS went from £14m in 2022 to £42m in 2023, although this does not include work ordered by integrated care boards.

Maxxima brought in revenue of £3.5m from English NHS trusts since 2020, data published on HSJ Intelligence indicates.

The company’s annual accounts said: “The group is mindful that developed nations’ healthcare systems are increasingly unaffordable and that this will mean a squeeze on contingent labour costs, increased focus on international staffing and increase in demand for lower cost healthcare delivery.”

It said it was looking to mitigate risks to its UK business, historically the group’s main market, by “diversifying into new territories”.

Acacium’s CEO Mike Barnard told HSJ: “We are seeing health systems adopt a more varied approach to commissioning support from the independent sector, with a strong focus on enhancing productivity.

“Whilst we have seen a reduction in contingent workforce requirements in some of our staffing businesses, our services offer has seen increased demand. 

He added: “Looking ahead, we believe that partnership is the best way to ensure value for money, better patient care and improved productivity.”

An NHSE spokesman said that despite industrial action, it had reduced agency staff spend in absolute terms and as a proportion of 2023-24 spending.

But they added: “More progress still needs to be made, however, and the NHS will continue to reduce reliance on agencies by training more staff domestically and retaining more existing staff as part of the NHS Long Term Workforce Plan.”