West Midlands hospitals and ambulance service spend £61m on reserve bank staff wages

The majority of the money went on nurses and clerical staff at sites through the Black Country and Staffordshire.

The biggest outlay was at the Heart of England NHS Trust in Birmingham with £15m, followed by Dudley with £11.9m and the trust that runs Sandwell Hospital with £11.1m.

Critics have said it shows hospitals do not have enough permanent staff and are being forced to call on bank workers, whose wages are often higher.

It comes as hospitals struggle to cope with rocketing numbers of admissions and falling budgets.

West Midlands Ambulance shelled out £1.16 million in 2013/14, including £740,145 on 'additional clinical services' and £139,438 on admin and clerical staff.

Some £11.1m was spent by Sandwell and West Birmingham Hospitals NHS Trust, which runs Sandwell Hospital and City Hospital in Winson Green. The most was spent on qualified nurses at £4.39m, with £2.45m on 'unqualified' nurses such as care assistants, and £2.45m on admin and clerical workers.

A total of £6.1m was spent at Wolverhampton's New Cross Hospital with £4.3m of that going on nurses and care assistants and £909,000 on admin.

South Staffordshire and Shropshire NHS Trust, which providers mental health services including St George's Hospital in Stafford, spent £4.63m on bank staff including £448,000 on clerical workers and the rest on medical staff.

Dudley Group NHS Foundation Trust, which manages Russells Hall Hospital, paid bank workers £11.98m, some £8.37 of which went on nurses and care assistants.

Heart of England NHS Trust in Birmingham shelled out £15m, including £11.5m on nurses and care workers, while Worcestershire Acute Hospitals NHS Trust spent £5.85m in total.

Staffordshire and Stoke-on-Trent Partnership NHS Trust paid £2.94m with £2.4m of that on nurses and care assistants.

Walsall figures were not available.

Paula Clark, chief executive of the Dudley Group, said: "We have to make sure our patients are safe and cared for by appropriately skilled staff at all times and that we meet or exceed the nationally set registered nurse to patient ratio of 1:8.

"We use bank staff across the trust to cover unplanned sickness and short-term vacancies or when we need to open extra beds to cope with peaks in demand.

"We always try and cover vacant shifts first from our own staff bank before employing agency staff."

Sandwell and West Birmingham NHS Trust spokeswoman Tran Vy Tuong said: "We have been working hard over the past year to reduce our use of bank and agency staff and have managed to reduce agency costs by 30 per cent since July 2014.

"There is more to do and in the year ahead we are focussed on tackling short-term sickness levels and filling our vacancies to create fully staffed teams and reduce further the occasions we would need to use temporary staff."