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Huge rise in locum use in A&E units in England

Spending on locums rises by 60% in three years

Jo Carlowe

Tuesday, 14 January 2014

Spending on locums in A&E units has risen by 60% in three years, new figures show.

According to data, obtained under the Freedom of Information Act by Labour, some £83.3m was spent last year on employing locum doctors (up from £52m in 2009-10).

Shadow Health Secretary, Andy Burnham has blamed the rise in spending on the Coalition government’s shake-up of NHS services. 

He accused the government of being guilty of ‘gross mismanagement of the NHS’.

“They are paying more for an A&E service which is getting worse by the week,” he said. 

The figures are based on data received from 108 of the 145 hospital trusts in England questioned under the Freedom of Information Act. 

Dr Mark Porter, Chair of the BMA Council, said:

"Doctors in the NHS face increasingly challenging, high pressured and stressful work environments, often with limited resources and gruelling workloads across both weekdays and weekends. In some specialties, such as emergency medicine, this has contributed to a recruitment crisis and means that because existing doctors are working flat out to meet rising demand an increasing number of locums are being used.

"Whilst locums have always been an integral part of the NHS workforce when there are periods of high demand or staff absences, they should not be used as a long term solution to gaps in the NHS workforce. As these figures suggest, they can be more expensive to employ than permanent staff, resulting in additional costs for an NHS that is already struggling with declining budgets.

"To stem this problem the government urgently needs to address issues around workload pressures, resourcing and work-life balance. Only by making working practices and environments safe and sustainable will the NHS be able attract and retain the required number and mix of doctors.”

NHS England says it acknowledges the problem exists.

Professor Keith Willett, Director for Acute Care at NHS England, told OnMedica: “We do recognise the issues around senior medical staffing in the Emergency Medicine specialty. Local Trusts are responsible for ensuring that they have the right staffing to provide a safe and effective service for their patients. Patient safety is the primary consideration, but achieving the best value for tax payers’ money is clearly an important factor we must also consider.

“Health Education England and the College of Emergency Medicine recently published a report on developing the Emergency Medicine workforce and we are working in partnership to implement proposals. An important factor in this is doing all we can to make Emergency Medicine an attractive career choice for trainee doctors.”

According to The College of Emergency Medicine changes to training and funding may improve the situation.

Dr Clifford Mann, the College’s president said: “The College of Emergency Medicine has for some time been calling for better use of the resources currently being spent on Locums in Emergency Departments. We recognise that the difficultly here is that this spend has been hard to reduce because there simply haven’t been enough Emergency Medicine Doctors and Consultants coming through training to fill the gaps we have in the system.”

He added: “Recently some real changes to how Emergency Medicine Doctors are trained has been announced, also new funding from Health Education England to increase numbers of trainee doctors and changes to the Medical Training Initiative to encourage more trainee doctors from overseas are a real step forward towards solving this issue.

There is more to do and the College has set out the changes we are working to achieve in our 10 Priorities Document. These changes will be self-funding as the locum spend can be much better used to increase capacity in the medium term in our Emergency Departments.”

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