NIAO flags up locum cost concerns

Locum spending almost trebled between 2011/12 and 2017/18, said the Northern Ireland Audit Office (NIAO). Spending stood at £28.4m in 2011/12 but rose to £83m five years later. This included sharp rises between 2015/16 and 2017/18, with annual costs up by nearly 57%.

Agency doctors accounted for almost 90% (£73.5m) of locum medical expenditure in 2017/18. Most trusts relied increasingly on non-contracted agencies (those without agreed rates). In 2017/18, 29% of total agency spend went to non-contracted agencies.

Comptroller and auditor general Kieran Donnelly (pictured) said the reliance on agencies was becoming unsustainable. ‘Efforts to reduce this dependency have had very limited success,’ he said. ‘To help ensure that patients’ needs are best met and provide better value for money, it is imperative the Department of Health and trusts collectively progress the transformation agenda and formulate strategies for delivering a suitably resourced and sustainable medical workforce.’

The NIAO said clinical negligence costs, including estimated costs of unsettled cases, had risen by 56%.

The overall cost was £252m in the period 2007/08 to 2011/12, but rose to £393.5m in the following five years. Mr Donnelly said steps had been taken to enhance patient safety, but more work was needed.