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NHS spend on covering doctor staffing gaps increases

NHS spend on covering doctor staffing gaps increases

NHS spending on hiring temporary doctors to cover staffing gaps in Scottish hospitals has risen sharply.

The cost of hiring medical locums was about 29m during 2008/9, according to figures issued by the Scottish government.

But this increased to about 36m last year, BBC Scotland can reveal.
The government has now set up a group to examine establishing an NHS medical staff bank, to reduce the need to use locums from expensive private agencies.

Dr Alan Robertson, a member of the group and of BMA Scotland's junior doctors' committee, said part of the rise in costs was due to locums being used to fill gaps in rotas.

One reason for this was recent changes in the recruitment process for trainee medics, he said.

Dr Robertson added: "People tend to be on longer-term jobs for maybe a couple of years, when it used to sometimes be six-monthly jobs.
"If a gap comes up then it may take longer to try and fill, as you have to wait for the next recruitment round which only happens once a year."
Changes to immigration rules had also reduced the number of available doctors, Mr Robertson said.

Short notice
He said the implementation of the European Working Time Directive over the past decade, which limits the hours medics can work, is also likely to have had an impact on rotas.

"Perhaps before you could have had eight or nine doctors, now you need 10 or 11 to get the average hours down correctly," he added.

However, he said the cost of hiring locum medics from external agencies could be more than double the NHS rate for extra shifts.

NHS nursing banks provide a internal pool of staff who can be called on at short notice to cover both planned and unplanned absences.
A letter sent to NHS boards by the Scottish government's health department said their use has helped to reduce the cost of hiring nurse locums from 30m in 2003/4 to 10.39m in 2008/9.

It states: "The experience with nurse agency suggests that there are potentially significant benefits to be obtained from taking a similar approach with other staff groups within the NHS, and more widely across the public sector."

Patient safety
A study on medical locums is due to be published by next month by Audit Scotland, which is the first major examination of the issue in more than a decade.

The watchdog body will assess whether NHS Scotland is using temporary medical staff in the most efficient way.
It will also consider whether health boards have "sound arrangements" for ensuring patient safety when using locums.

A Scottish government spokeswoman said the working group on temporary medical staff was due to conclude its work by the end of summer.
She said: "In light of the benefits from the creation of nurse banks, we are currently exploring the possibility of establishing a similar arrangement for temporary medical staff.

"The group will also produce guidance for boards setting out the key issues and solutions in relation to the employment of temporary medical staff."


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