NHS Professionals’ report calls for trusts to address the underlying causes of high levels of locum spend
Trusts are failing to grapple with the real causes of locum spend reveals a report by NHS Professionals.

The report contends that trusts are only dealing with ‘one tenth of the problem’ with uncoordinated approaches to managing agencies, staffing and finances.

NHS Professionals calls for trusts to urgently undertake an entire strategic and operational review of locum management to meet QIPP targets, reduce spend and avoid putting patients at risk.

The report, ‘Medical locum expenditure: treating the disease, not the symptoms’, results from a round table of senior NHS managers and medical staff, chaired by Professor Chris Ham of The King’s Fund, with delegates concluding that the complex failure to manage locum doctors goes to the heart of NHS workforce planning.

Failure to apply locum placements strategically is attributed to an absence of management information which could help senior managers identify whether there are short or long term gaps that need to be filled, whether they can be covered by other staff or professions, or even if they need to be filled at all.

The report states that: “Workforce planning should be driven by service demand rather than the current workforce profile. Too few trusts have a medical workforce strategy that is fully integrated with the business planning process, specialist knowledge and resource allocation to respond to staffing needs.”

Weaknesses around locum management, as well as resorting to ‘off framework’ agencies, is also putting patients at risk, with inductions being highlighted as one particular area of concern.

Exacerbating these issues is a disconnect between workforce planning and medical education, with deaneries failing to communicate effectively and make timely changes. On a practical level, many of the commentators complained of the gaps left in junior doctor rotations exposing trusts to costly locum placements to meet staffing levels.

Stephen Dangerfield, chief executive of NHS Professionals, comments: “Trusts may struggle to meet their QIPP targets if they continue to focus on the peripheral reasons for high locum spend. In the context of NHS reforms, it’s absolutely essential that the usage of locums has a clear purpose within a trust, is managed in a planned and systemic way, and that the trust builds positive and productive relationships with locums, agencies, deaneries and other trusts to get the best results from this valuable workforce.”