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15% could be saved on locums in Scotland

The NHS in Scotland could save almost 15% of the money it spends on hospital locums – or £6m a year – through better planning and procurement.

An Audit Scotland report, Using locum doctors in hospitals, says health boards spend around £47m a year on locums. This spending has doubled in the past decade but, in many cases, health boards are not always clear about why locum doctors are being hired and how long they are using them for.

Auditor general for Scotland, Robert Black, said: “Locum doctors have an important role in ensuring hospitals are adequately staffed and provide good quality patient care around the clock. In recent years, the demand for locum doctors has risen due to workforce issues such as increased difficulty in filling vacancies and the impact of European legislation governing working hours.

“Health boards need better information about why and when they use locum doctors; the grades and specialties of doctors they are hiring as locums; and whether locum doctors are existing employees or from agencies. With better information, boards could improve their workforce planning and use locum doctors more cost-effectively.”

The report also says the NHS needs to get better at managing the potential risks to patient safety of using locums. This is particularly important for locums hired through private agencies as they may be unknown to the board and unfamiliar with the hospital in which they are working.

Health boards across Scotland need to be consistent in the way they screen and induct locum doctors and the way they manage their performance. For example, pre-employment checks are not always formalised, induction arrangements are variable across different health boards, and feedback on locums’ performance is mainly verbal, with few written assessments or records. There are no formal systems for sharing information about individual locum doctors between boards.

Read the full report.

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