The cost of hiring locum or temporary doctors for NHS hospitals in England has increased to more than £3/4 billion a year since the introduction of EU regulations to reduce doctors’ hours, the Royal College of Surgeons has reported.
Figures obtained under the Freedom of Information Act show that annual spending on all hospital locum doctors has increased by almost £200 m in the past year alone and has almost doubled since 2007. For surgical locums, the spend is almost £1⁄4 bn per year. The RCS said that the increases have arisen as Trusts try to address hospital rota gaps created by the introduction of the European Working Time Regulations (EWTR). The RCS estimates that, since introducing the 48-hour working limits in UK hospitals, the NHS loses more than 400,000 hours of surgical time a month while still managing the same workload. The RCS commented that the effect of the EWTR has been particularly damaging for units providing 24-hour acute care where staffing requirements are high and complex. As a result, Trusts are forced to employ staff already working in their Trust in order to fill gaps (so-called “internal locums”). A survey carried out by the RCS earlier this year revealed that around half of surgeons are covering rota gaps in their own hospitals, regularly working beyond 48 hours. However, the largest increase has been in the amount paid to external locum agencies as the NHS is forced to seek doctors from all over the world on highly paid short-term contracts, as the supply of available UK doctors runs dry. Spending on external agencies has increased by almost £200 m in the past year to almost £1⁄2 bn in 2009/10. The RCS has voiced concerns about the impact on patient care as hospitals choose between running on skeleton staff or with doctors with no prior knowledge of the hospital they are working in, the patients they are treating, or the colleagues they are working with. John Black, president of RCS, said: “It seems ridiculous that, at a time of economic crisis, we are seeing astronomical sums of money being thrown at locum doctors in order to prop up services that are only falling apart because of an ill-conceived European law. “Unless hours for doctors working in 24-hour acute care medicine are relaxed to a sensible level, the pool of good, safe doctors will dry up and we will see more units close. The coalition Government has promised to deal with the issue, but the question is when?”
