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Locum health practitioner expenses in NI ‘unsustainable’

NI fitness trusts have nearly trebled the amount spent protecting the shortage of medical doctors in hospitals in six years.
A Northern Ireland Audit Office (NIAO) document indicates overall expenditure soared from £28.4m in 2011/12 to £83m in 2017/18 – an increase of 192%.
Locums are doctors who offer temporary staffing cowl in hospitals.
Auditor General Kieran Donnelly stated the reliance on locums became “unsustainable” and rising prices placing “huge pressure” on budgets.
In the Northern and Western Trusts, almost 1 / 4 (22%) in their overall clinical pay bill is spent on locum cowl.
The use of locum medical doctors is vital inside the shipping of healthcare in hospitals, but, they value considerably more than completely-hired docs.
£3m invoice for Daisy Hill locum docs
Western Trust spends £27m on locum and enterprise personnel
The report reveals that their use has the “capacity to growth dangers to patient safety”.
While reliance on locum medical doctors has long past up extensively throughout the board, their use inside the Northern and Western Trusts is singled out via the report.
‘Significant pressure.’
The report notes that the amount being spent to fill gaps in clinic rotas to keep services is “placing an extensive pressure on already stretched budgets”.
It found that trusts are very closely reliant on locums who come through a corporation, and they fee extra than locums who’re without delay employed using the health service.
In reality, the whole business enterprise spend has risen from over £23m in 2011/ 2012 to £seventy three.5m in 2017-18.

According to the Audit Office, “the branch and the trusts have made no tangible progress implementing effective solutions” to reduce the heavy reliance on locums.
It said that until recently there is “little development growing group of workers planning answers to become aware of the superior quantity of local doctor places required”.
Medical negligence claims
Better team of workers planning, it says, may want to help inside a long time to reduce down reliance on locums.
Mr Donnelly said that “to assist ensure that sufferers’ desires are the first-rate met and provide higher fee for money it’s miles now imperative that the department and trusts together progress the transformation agenda and formulate techniques for handing over a certainly resourced and sustainable clinical team of workers”.
A separate file by using the Audit Office into affected person safety stated that the expenses of settling medical negligence claims and the anticipated charges for unsettled cases had risen substantially, from more than £252m in 2007/eight to 2011/12 to £393m for 2012/thirteen to 2016/17.
That is an increase of fifty-six %.
Mr Donnelly described the rise in settling negligence claims as “regarding”.
‘Scarce sources.’
“These charges divert scarce sources far from frontline services and doubtlessly bring about patients ready longer for treatment,” he stated.
The evaluation finds that a few headways have been made in a few regions of affected person protection such as better degrees of reporting of unfavourable incidents, better public reporting on patient protection performance using trusts and greater patient involvement in SAI (Serious Adverse Investigations).
But it additionally finds there can also nonetheless be below-reporting of SAI’s and says the department wishes to reflect consideration on why staff do no longer assume that unusual incidents might be nicely investigated and why they do now not consider data is being shared nicely.
“While steps have been taken to try and decorate nearby affected person protection requirements and proof suggests that extra incidents are being suggested, similarly work required to embed a strong protection culture across the fitness and social care region,” said Mr Donnelly.