Northern Devon Healthcare Trust has spent more on agency staff in the last six months than it did in the whole of last year.The healthcare trust spent £6million on agency staff since April, meaning it is close to reaching a national cap on agency spend set by the Department of Health. If the trust spends more than six per cent of its nursing pay budget on agency staff, it could face significant sanctions. A memo sent to staff this week by chief executive Alison Diamond said the trust was very close to a complete ban on the use of agency workers over the remaining five months of the financial year. It said: We wholly support this national direction of travel and have been very public about our concerns of being so heavily reliant on agency staff. However, we also appreciate the very real difficulties it presents us in terms of maintaining the same level of service at a high quality of patient care. The message went on to explain how the trust was using agency staff to prop up its services, but this was placing a huge burden on staff, and was unaffordable. Darryn Allcorn, director of workforce and development, told the Gazette: We are particularly affected by the national shortage of nurses and doctors because of our rurality and the wide geographical area we cover. We are currently working with our clinical teams on recruitment and other plans to comply with the cap while ensuring we maintain safe, high-quality services, he added. There is a possibility we will have to make temporary changes to some services to ensure we have sufficient staff in our core and emergency services ahead of winter. Mr Allcorn emphasised the number one priority was to provide safe, high-quality care for its patients. He said the trust was working hard to ensure staffing levels were maintained at all times. The trust has recently held a number of recruitment days across North and East Devon, and said there were significant numbers of substantive staff starting in September and October. The trust will be placing restrictions on agency bookings and continuing to recruit staff from overseas. It will also be revising its list of approved agencies and putting resources in place to monitor supply concerns. Last year NDHT spent £4.1million on agency staff, and in July last year the Gazette reported it had overspent by £900,000.