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Medical locums are necessary to support patient care

Posted on 05/02/2014 by Jamie Horton in Category Healthcare
The recent figures issued by the Labour Party which indicated that spending on locum doctors in A&E departments has risen by 60% in three years generated strong debate in the media.

It isn’t surprising that the figures have sparked concerns given that a staggering 21.8 million patients attended A&E centres in the first 11 months of 2012 -2013, meaning approximately 60,000 people sought urgent and outpatient medical care every day.

The steady increase in medical locum spend in A&E departments is a clear indicator of the continued difficulties the NHS is facing in providing medical cover in the short, medium and long term.

However, the reality is that while using medical locums may appear to be simply placing a band-aid over a gaping wound, it is in fact the only viable option for NHS Trusts right now if they are to ensure they deliver critical care and mitigate risk to patient safety.

It’s important to recognise that the pressure on A&E departments has been largely influenced by an increase in the number of people attending emergency departments, and initiatives such as the introduction of the NHS 111 line and Walk-in centres have not reduced the demand for care. Compounding this are the longstanding difficulties associated with recruiting A&E doctors, as well as a national shortage of appropriately qualified medics. Working Time Regulations require larger numbers of doctors working in A&E departments and, due to the challenging nature of the role, many doctors tend to favour other roles over A&E.

While progress has been made to increase the number of doctors in A&E and to attract more individuals to the profession, it takes six years to train to be an A&E doctor and until the skills shortage is addressed, locums and agency staff will continue to have a valuable role to play in ensuring continuity of service provision to enable Trusts to work more flexibly.

This doesn’t mean more can’t be done to reduce costs. Spend on medical locums is a necessity but needs to be justified by greater visibility and control of spend. This can be done by:

  • Better managing the cost of supply of locum doctors in a way that recognises candidate and skills shortages

  • Better management of the demand for locum doctors through effective control measures to justify expenditure and workforce planning and shift rostering

At a time when the NHS is under enormous financial pressure; widespread tactical reliance on emergency medical locum doctors will continue however the situation can be dramatically improved if NHS Trusts embrace temporary managed services models more commonly found in other areas of the public sector and in local authorities.​