27.07.16
‘Standardised’ contract needed to stop consultant overspend
Revelations about the high rates some NHS trusts are spending to get consultants to cover shifts show the need for contract reform, the chief executive of NHS Employers has said.
Freedom of Information requests from the BBC to 114 NHS trusts found that spending on high-cost overtime has risen from £125m in 2013-14 to £168m in 2015-16.
The average amount was £13,356 for every consultant, and one in four trusts paid at least one consultant more than £100,000, with the highest amount being £374,999 to a consultant at Lancashire Teaching Hospitals FT.
Danny Mortimer, CEO at NHS Employers, said: “There is a variety of reasons why we are seeing the costs rising – patient demand and supply of doctors are two important factors. Clearly the information obtained challenges NHS organisations and teams about what arrangements they have in place. What it doesn’t show however is that there are a greater number of doctors doing overtime within the terms of their contract and being paid in line with that or not being paid at all.
“The BMA and the NHS have accepted that the contract needs to be improved in relation to how we plan and reward work at evenings, nights and weekends. When our negotiations conclude, I am hopeful that this will provide a more standardised basis for new arrangements going forward.
“What we need is a system that can be applied fairly across all doctors. We want to move to a situation where there is a standardised base line nationally for all doctors.”
A spokesperson for the Department of Health said that consultants should be “properly rewarded” for their work, but that the statistics showed why the evening and weekend ‘opt-out’ in the existing contract should be abolished.
“This will allow us all to promise patients urgent and emergency care of a consistently high standard across the week, and – as the hospitals themselves say – make better use of operating theatres while reducing big overtime bills,” they added.
NHS trusts are suffering from high rates of staff shortages, which a recent Public Accounts Committee report said are caused partly by the government’s mismanagement of the workforce.
Dr Keith Brent, chair of the British Medical Association consultants’ committee, said the figures lay bare the extent of consultant shortages in many areas.
“The fact is there simply aren’t enough consultants to meet the level of demand on services,” he added. “Consultants are routinely working 4-6 hours of overtime on standard rates, as well as several unpaid hours each week. The payments we are seeing here is for even more work on top of that.
“It is important to point out that large payments only happen in a very small number of cases, usually where hospitals are struggling to meet government targets in an understaffed and pressurised environment. However, trusts paying the higher individual figures should consider why such large numbers are being paid to one person and whether that money could be better spent on hiring more staff, for example.”
He said the BMA was keen to work with the government to develop “a long-term strategy” to manage the workforce challenges in the NHS.
(Image c. NHS England)
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