Staff shortages at Oxfordshire's major hospitals cost managers £6m in the last three months of 2004.

Although bosses at the Oxford Radcliffe Hospitals have pledged to end the need for agency staff by the autumn, the bill for temporary workers between October and December reached £4.44m.

According to a workforce report by Thames Valley Health Authority, the ORH also spent £1.56m on overtime pay for permanent staff - more than any other hospital trust in the Thames Valley area of Oxfordshire, Berkshire and Buckinghamshire.

Managers at the ORH, which oversees Oxford's John Radcliffe Hospital, Churchill Hospital and Radcliffe Infirmary, and the Horton, Banbury, admitted they had a long way to go to end their reliance on agency workers.

They want to stamp out temporary staff within the next 12 months by launching strategies to improve recruitment at the four sites.

The TVHA report shows almost one in every five staff working for the ORH - 18 per cent - left in 2004.

Report author and head of workforce planning and information Barbara Noakes said: "The Chartered Institute of Personnel and Development estimates that the average cost of turnover per leaver is £4,500, taking into account recruitment costs, training and the impact on staff morale and patient service.

"Achieving even a one per cent reduction in turnover has the potential therefore to reduce workforce spend considerably."

Last year ORH chief nurse Julie Hartley-Jones said she was confident managers could reduce vacancies by "thinking creatively".

Following the report, she said their work would still start to have an impact by the autumn.

She said the £4.44m quoted by TVHA included medics and admin and clerical agency costs.

Although the ORH spent the most on temporary staff within Thames Valley, its £619 per head was lower than the £972 per head spent by Heatherwood and Wexham Park Hospitals in Berkshire, the £709 per head cost at the Royal Berkshire and Battle hospitals in Reading, and the £659 at Milton Keynes General Hospital.

She said: "The goal is to have no agency staff by March 2006, and we should start to see a real impact by the autumn.

"Our biggest problem is vacancy rates, and reducing agency spend relies on recruitment.

"As a specialist centre, we have to hire expensive specialist agency staff. We're now employing innovative ways of recruiting, and seeing if that makes a difference."

The trust is about to start recruiting nurses from Spain, Canada and India, and is also enticing workers with extra pay, to compensate for Oxfordshire's high cost of living."