Hospitals are being forced to routinely flout new rules to limit their spending on agency workers because of a recruitment crisis in the NHS.
NHS trusts are on course to overspend on temporary workers by millions of pounds this year after struggling to recruit enough permanent members of staff.
Yorkshire hospitals breached the agency cap 58,000 times in seven months - and some are breaking the rules hundreds of times a day.
Overspending on agency workers is leading to multi-milllion budget deficits at NHS organisations and fears they will miss targets to reign in their spending between now and the end of the year.
Mid Yorkshire Hospitals breached the pay limits on 23,500 occasions between November and May and is forecast to fork out almost £23m on agency workers in 2016-17.
The organisation, which runs Pinderfields, Pontefract and Dewsbury hospitals, must slash £8m from its agency staff bill between now and next March to meet its savings targets.
Trust bosses said the number of breaches had reduced and they were encouraging staff who wanted to work on a temporary basis to do so through the NHS Bank, which is controlled by the health service.
Director of nursing David Melia said: “We acknowledge that there is still a way to go and as such are continuing to look at alternative ways of working so we can have a more flexible workforce.
“There’s no doubt that these additional staff members are a valuable resource to the NHS but we need to do all we can to attract more permanent clinical staff into the organisation.”
Calderdale and Huddersfield NHS Foundation Trust breached the agency cap 13,615 times in the seven-month period.
The trust, which runs hospitals in Halifax and Huddersfield, has been breaking the agency rules 700 times a week - spending £500,000 more than its limit for agency costs every month.
The trust has an “agency ceiling” of £14.95m for this year, but will spend almost £23m, based on current forecasts.
Chief operating officer Helen Barker said: “We are doing everything we can to reduce the amount we spend on agency staff both through our ongoing recruitment drive to substantive posts and through a senior level review of our use of agency staffing.”
A report to Calderdale and Huddersfield’s last board meeting said the trust must slash millions of pounds from the agency bill or risk losing out on extra NHS funding made available to help trusts re-organise services.
The report said: “Agency spend must be reduced considerably if the trust is to deliver the financial plan, not exceed the ceiling and secure the Strategic Transformation Funding.
“This provides a significant risk for the trust.”
Latest figures show the trust had 490 staff vacancies, with the highest number of staff shortages in patient-facing departments.
The report said: “In order to quell the unaffordable use of agency staff recruitment to these posts must be a priority.”
Leeds Teaching Hospitals NHS Trust breached caps almost 3,000 times in the seven months, although its figures only related to medical staff, nurses and allied health professionals.
The organisation has a target to spend £26m on agency staff this year but is on course to exceed that amount by £1.6m.
A report to the trust board said: “The final stage of significant nurse investment in September of this year is expected to reduce the trust’s reliance on agency nurses, and as such, there is an anticipated reduction in planned expenditure from September onwards.
“At the end of April the total agency budget was £2.5m, with expenditure of £2.3m resulting in a favourable variance of £0.2m.”
The government has been criticised for introducing the agency cap instead of doing more to provide fund training places for nurses. Dewsbury and Mirfield MP Paula Sherriff said: “Greater focus needs to be given to helping the trust overcome the longer-term staffing crisis.” The Royal College of Nursing’s Karl Norwood added: “The only solution to this problem is a long-term and properly funded plan to increase the nursing workforce at a national level.”