19.12.16
Mackey calls for crackdown on ‘excessive’ locum pay
Locum doctors are demanding “excessive” pay rates from trusts, placing even more strain on financially vulnerable and understaffed services, NHS Improvement (NHSI) has warned.
Analysis undertaken by the NHS’s financial regulator revealed that some doctors are earning up to £155 an hour for covering shifts in hospitals with serious staff shortages or in particular medical specialties.
The staff shortage across the country is now so acute that one trust in the north of England recently paid £10,000 a week for three consultants in order to maintain a normal service for patients.
NHS Improvement’s chief executive Jim Mackey said that not only are high-earning locums unfair on permanent staff who earn less, they also risk affecting patients’ quality of care.
“There are circumstances where locums are necessary to fill short-term gaps and we recognise that the supply of doctors needs to improve,” Mackey said to the Observer yesterday.
“However, it is wrong from a quality, financial and fairness point of view to pay excessive rates for locums when they are working alongside hard working permanent staff on NHS terms.”
NHSI’s caps last year on the amount that temporary staff can be paid has not yet yielded the savings expected, as locums still accounted for over a third of the NHS’s total £3.6bn bill last year for agency staff.
In the first seven months of this financial year between April and October 2016 NHS trusts in England spent £616m on locum doctors, 35% of all of trusts spending during that period, leaving hospitals on course to spend £1.056bn on stand-ins this year.
While this would still be almost 20% less than the £1.3bn given out by trusts in 2015-16, trusts have found locum doctors’ rates harder to reduce than those of nurses, with the average costs of locum doctors only 13% lower compared to 18% lower for agency nurses.
“[We hope that] locum use, eventually, is seen as a rare, short-term event, and the costs are brought into line with substantive employment,” Mackey said.
However, the British Medical Association warned that cutting the rates that hospitals are allowed to pay may leave units struggling to cope even further, as medics already working as locums to boost their pay will not be sufficiently attracted to work the shifts.
“Increasingly, locums are employed because hospitals can’t attract staff to take up full-time posts. Caps do not address the root causes of the recruitment and retention problems in many parts of the NHS, especially emergency medicine, and the government’s plan to simply name and shame trusts or individuals will not address the underlying issues causing an over-reliance on agency workers,” said the BMA’s chair of council Dr Mark Porter.
Dr Porter suggested that a better solution to bring down agency costs would be to improve working conditions for permanent NHS medical staff, for example by introducing more flexible shift patterns.
At the NHS Providers conference last month, health secretary Jeremy Hunt said that the NHS should place a new focus on ‘e-rostering’ in order to counter rigid shifts for permanent NHS staff. ‘E-rostering’ was recently recommended by Lord Carter as part of his report into hospital inefficiency.
At the same conference, NHS England’s chief executive Simon Stevens urged trusts with “completely unaffordable” clinical locums to contact NHSI so that they can be helped to end the practice, arguing that the NHS cannot continue to sustain locums under its current model.
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