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Figures obtained by The Telegraph show that Barts Health NHS Trust in London spent most heavily on agency staff, with an £81 million bill in 2014-15.

It was followed by King’s College Hospital foundation trust and Royal Free London NHS trust, which each spent more than £60 million.

The trusts blame their reliance on temporary staff on a lack of qualified nurses.

Many have tried to employ more nurses in the wake of the Mid Staffs scandal, but struggled to find permanent workers, causing the agency bill to spiral.

Critics say the problem has been caused by underinvestment in training, a lack of any effective cap on the rates that agencies charge and a failure to recruit enough staff.

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