NHSi top priority: reduce agency spend


Medical locum spend has recently been in the spotlight with the media, hospital executives, the government and NHS bodies all weighing in.

The NHS spends around £3billion a year on temporary medical and nursing staff and there are reports of locum doctors earning salaries above that of substantive staff - many think it’s all very excessive. Whilst we share some of this sentiment, let’s not forget that significant numbers of hospitals and emergency care providers simply would not be able to safely treat patients without locum cover.

That’s not to say that we shouldn’t try and reduce our spending on locum cover. Much of the recoverable cost relates to the Locum agencies, private companies that coordinate between hospitals and doctors. The Health Secretary described agencies as a ‘rip off’. Lord Carter described agency work and time-sheet fraud as a ‘leakage’. We feel the same; agencies earn an estimated £350million commission per year, charged as a percentage fee on the hourly wage of the locum.

Jim Mackey, the CEO of NHS Improvement, has recently taken a step in the right direction with a letter, made available in the Nursing Times, to the CEOs of NHS Trusts. In his letter, he advises hospitals to:

  • a) employ locums through their PAYE mechanisms,
  • b) incorporate as many of them as possible in their Staff Banks,
  • c) collaborate with their neighbouring Trusts and
  • d) be more transparent in their data collection and reporting.

These measures can save money, while ensuring the limited pool of staff is used more effectively.

Since going live, the Locum’s Nest app has helped a number of hospitals work towards these targets, with demonstrable improvements in staff utilisation and cost. Locum’s Nest is developed and run by doctors. Together with our partner hospitals, we are addressing the staffing challenges with respect towards the professionals who help keep the NHS alive.

Nicholas Andreou