Mon, 19 March 2012

The chief executive of an agency supplying locum doctors to the NHS says that the NHS got “a jolly good deal” when it paid an agency £20k for a single shift.

According to an article in yesterday’s Sunday Telegraph, in one week North Cumbria University Hospitals paid an unnamed agency £20k for a medic who, in one week, worked for 56 hours and was on call for 112.

North Cumbria University Hospitals was one of 28 hospitals and trusts listed by the Sunday Telegraph as paying the most per shift between April 2009 and December 2011.

They included Mid Staffordshire NHS Foundation, Christie Foundation, Stockport Foundation, all of whom paid more than £4.5k for a shift that varied in length from 56 hours (plus 112 on call) to 24.

Salim Shahul, chief executive of dr-Locums, tells Recruiter that working back from the £120k annual salary of employing “a random consultant in the NHS”, which works out at £88.80 a hour, the equivalent hourly rate for the temporary consultant works out at £106 an hour, excluding VAT. Thus the sum paid by the trust “doesn’t look so bad”. Looked at it in this way, Shahul says the NHS got “a jolly good deal”.

He adds that the NHS would have needed to employ four and a half staff each working 36 hours a week to cover the 168 hours.

In a statement, North Cumbria University Hospitals tells Recruiter: “With changes to legislation around the European Working Time Directive, NHS Trusts across the country have experienced pressures regarding medical staff rotas. In order to support delivery of Working Time Directive compliant rotas and with the difficulties of running two district general hospitals in one of the most rural locations in England, the Trust has employed locum medical staff when recruitment to permanent posts has proved difficult.”

The spokesperson adds that temporary appointments were made in advance of opening up a new cardiology service in December 2011: “The Trust has now recruited four cardiology consultants, and developments within this service are continuing.

“The Trust continues to work actively to reduce spending on locums, by converting these to permanent posts and as the figures show, spending in this area decreased in 2011-12.”

The medical director of an NHS Trust, which was also listed in the Telegraph article as paying almost £6k to an agency for one medical locum shift in A&E, says that the trust is obliged to “pay the going rate”. Manjit Obhral says the trust has taken steps to reduce its reliance on agency staff.

Obhral, medical director of Mid Staffordshire NHS Foundation Trust, says: “The wellbeing and safety of our patients remains our top priority. On occasions, and in common with all Trusts, we sometimes have to employ locum medical staff through agencies.

“In these circumstances we always put patient safety above cost. This means that we have to pay the going rate for those staff who are available to cover, sometimes at short notice – these costs are often extremely high, due to the agencies’ fees.

“We have reduced our reliance on agency staff, particularly for nursing staff, by increasing our own bank of nursing staff, whom we can call on, and by recruiting permanently to posts.”

The article attributes much of the use of temporary agency staff in the NHS to the introduction of the European Working Time Directive in August 2009, which limits the number of hours that medics can work to 56 hours a week.

Tom Hadley, director of policy & professional services at the Recruitment & Employment Confederation (REC), says:“The reality is that the overall agency spend has diminished over recent years and costings are, in the vast majority of cases, tightly controlled by the framework contracts that agencies sign up to.

“Locum doctors and other temporary workers cover absences, help to meet spikes in demand and deliver crucial front line services to patients. There are examples of high rates paid for particularly hard-to-fill shifts but these are not the norm.

“The ability to bring in specialist staff when there is a need – rather than increasing headcount – is a feature of cost-effective resourcing models in both the private and public sector. Recruitment agencies make this happen by sourcing, vetting and placing highly skilled flexible workers at short notice and on a 24/7 basis.”