Health trusts spend over £100m covering doctor shortage

Locums or temporary doctors are used to fill gaps in staff rotas

Local health trusts have spent over £100m in the past four years covering the shortage of doctors in hospitals.

A report by the Northern Ireland Audit office (NIAO) into the use of locum doctors says annual savings of up to £5m could be made if the system was managed better.

Locums are doctors who provide temporary staffing cover in hospitals.

They are in demand due to changes to immigration law and European legislation on working hours.

Hospital managers have said that sometimes they have no other choice but to turn to agency cover to ensure patients are managed safely.

Such practice is, however, landing the health service with an excessive bill.

According to the NIAO, more than £100m was paid out to locums in the past four years in order to fill gaps in hospital rotas.

Last year alone, £22.5m was spent - 8% of the total spend on medical staff.

The Western and Northern Health Trusts are singled out for their spends which are 11% and 17% respectively.

The report notes that annual savings of around £5m could be made if all trusts managed the process more efficiently, including paying the same hourly rate.

It also highlighted variations in how the trusts managed their information which makes it difficult to obtain an accurate and overall picture of locum activity across all five health trusts.

The report recommends that trusts should work together. This would generate greater efficiency savings and help reduce the clinical risk posed to patients.

It is also suggested that the system should provide suitable training and inductions for locums who should be assessed regularly.

Patient safety

While the report acknowledges that such systems are in place - it says the audit has identified several instances where checks to ensure the competence of locum doctors has not been undertaken.

Patient safety is a running theme throughout the report. Auditors say there are no safeguards in place to enable a trust to identify whether a locum doctor has exceeded the safe level of working hours.

As a result of the European Working Time Directive, doctors are now restricted on the number of hours they can work.

The report acknowledges that often managers have no other choice but to pay existing staff for extra hours worked, recruit temporary staff or, as a last resort, use agency staff.

According to the NIAO, an increasing number of females are choosing medicine as a career.

This will place further pressure on trusts where cover is required for maternity leave.