Nursing shortages are allowing “profiteering” staffing agencies to triple their rates, care leaders have warned, raising the risk of vulnerable patients being forced to move care homes and increasing the burden on the NHS.

The crisis is forcing some nursing homes to become standard residential care homes without support for people with chronic diseases.

The shortage also makes it harder for NHS hospitals to discharge patients. Some hospitals have redeployed their own staff into nursing homes to free beds in hospitals. In other places, NHS trusts are competing for staff with care providers.

Geoff Butcher, director of Blackadder Corporation, which runs six homes in the West Midlands, said that he paid nurses about £19.50 an hour, slightly higher than the NHS rate of £16.52. “Two of our nurses resigned recently and they’ve gone to an agency for £35 an hour,” he said. “And that agency then came to us and said we can have these staff back at £52 an hour. They want £95 an hour for those nurses on a bank holiday nightshift. It’s utterly unaffordable.

The latest data from NHS Digital show that 2.45 million patients waited between 15 and 21 days in October to see a GP or other practice clinician, which was 8.3% of the total number of appointments, compared with 8% in October 2018.

Another 1.69 million waited between 22 and 28 days for a GP appointment while 1.66 million waited more than 28 days.

In both cases there was an increase in the percentage of patients affected compared to October last year.

The overall number of appointments increased to 30.8 million in October 2019 from 29.7 million in the same month the year before.

The Conservative manifesto pledges to add 50,000 nurses to the workforce in England by 2024-25.

How realistic is this target, particularly given that nurse numbers have gone up by only about 5,000 since 2010?

Workforce is one of the main concerns for the NHS in England right now. Health employers talk of difficulties filling rotas and worries about how future staff can be recruited at a time of rising patient demand.

In an attempt to address that, the Conservatives have said that if re-elected they would take action to address the problem.

This will be achieved, according to the party, by training more staff, international recruitment and better retention of existing nurses.

Boris Johnson’s plans to charge foreign staff who help save British lives £625 a year to use the NHS will worsen its staffing crisis, doctors’ and nurses’ leaders have warned.

They have reacted with dismay over the prime minister’s proposal to increase the so-called health surcharge payable by non-EU staff for the third time in four years and demand it should be scrapped completely. 

The Conservative party announced on Sunday it was going to increase the surcharge from £400 to £625 a year for all non-EU migrant workers and extend it to all EU citizens who migrate to the UK after Brexit.

The fee is payable for each member of a family migrating, meaning nurses from popular recruitment spots such as the Philippines and India who come to Britain with a spouse and two children will have to pay the government £2,500 a year for the privilege of working in the NHS.

More than eight out of 10 care home beds are provided by profit-driven companies, including more than 50,000 by large operators owned by private equity firms, research reveals.

Private companies now own and run 84% of beds in care homes in England used by older people, as local councils have almost totally withdrawn from a key area of social care they used to dominate.

The disclosure of the private sector’s huge market share has raised concerns because some of the biggest operators have large debts, are alleged to use tax avoidance schemes and drive down staff pay. The Care Quality Commission (CQC) watchdog has said inadequate staffing levels at care homes can lead to elderly residents receiving poor-quality care.

For-profit companies own 381,524 (83.6%) of England’s 456,545 care home beds, research by the IPPR thinktank (in partnership with Future Care Capital) has found, based on analysis of data from the CQC and Companies House, an increase on the 82% in 2015.

“The state has abdicated its responsibility for providing care over recent decades. The private sector may have filled this gap but it consistently puts profits before people,” said Harry Quilter-Pinner, a senior research fellow at the IPPR and co-author of the report.

One of the country’s biggest providers of agency health workers has been accused of “profiteering” after trying to charge care homes up to £2,700 to supply a staff member for a single shift.

The Guardian can reveal that Newcross Healthcare, already exposed for fining workers £50 when they call in sick, quoted the sky-high charges in a price list sent out to homes looking for cover over Christmas.

Newcross – which supplies thousands of agency health workers to care homes, many of whose residents have their fees paid by local councils – stated that it would be charging triple its normal Sunday day rates to supply staff on Christmas Day and Boxing Day.

According to a price list seen by the Guardian, the firm normally charges £76.84 an hour to supply a head of care, also known as a matron, for a Sunday day shift. At triple rates of £230.52 an hour, this would cost a care home £2,766 for a 12-hour shift.

The company also charges £59.12 an hour to supply a nurse for a Sunday day shift. At a triple rate of £177.36 an hour, it would mean a 12-hour shift for a nurse would cost a care home £2,128.

A normal Sunday rate for a senior carer is £30.12, the document states.

So why is so much being spent on agencies?

Monitor found that overspend on agency staff arose from a need to “cover vacancies and unplanned demand”. Foundation trusts have consistently cited recruitment difficulties, particularly in qualified nursing and medical staff and in accident and emergency, the regulator said.