Spending on temporary doctors has tripled despite warning of risk to patients' safety
Spending on locum doctors has almost trebled in the last six years - despite warnings that it is expensive and a risk to patient safety. The annual cost is now more than £80m.
In two health trusts, locums account for almost a quarter of the total pay bill. The annual cost of employing an agency locum doctor can be up to £242,000 for a trainee or middle ranking doctor, and £376,000 for a consultant.
The figures are detailed in a report by the Northern Ireland Audit Office.
Auditor General Kieran Donnelly said: "The health and social care sector's heavy reliance on locum doctors is becoming unsustainable, with rising costs placing local health budgets under huge strain.
"Efforts taken to reduce this dependency have had very limited success.
"To help ensure that patients' needs are best met and provide better value for money, it is now imperative that the Department (of Health) and trusts collectively progress the transformation agenda and formulate strategies for delivering a suitably resourced and sustainable medical workforce."
Today's report notes the use of locum doctors is expensive and potentially increases the risks to patient safety.
It found total expenditure on locums has risen by over 190% - from £28.4m in 2010/11 to £83m in 2017/18.
Reliance on locums has increased significantly across all trusts, but particularly in the Northern and Western Trusts, where it now accounts for over 22% of the total medical pay bill.
The review found that trusts are very heavily reliant on locum doctors provided via agencies, which are more expensive than using health service doctors to provide cover.
The report notes how £314m (86%) of the total £363m expenditure on locum doctors between 2011/12 and 2017/18 was paid to agencies. Over this period, spending on agency locums increased significantly. The ratio of spend on agency locums exceeded 80% in all trusts, with the Western Trust (95%) having the highest dependence on this sector. Most trusts are also increasingly reliant on non-contracted agencies, which often charge the highest rates.
In 2017/18, £21.3m (29% of the total agency spend) was paid to non-contracted agencies.
Auditors found the Department of Health and health trusts have made no tangible progress in implementing effective solutions to reduce the heavy reliance on locums.
The report calls for action to address the rising expenditure.
It states: "The department and trusts must seek to find more effective long-term workforce planning solutions, which can help reduce reliance on locums through providing a sustainable and recurrent workforce.
"In tandem with policy development, the department should consider re-establishing short, medium and longer-term targets aimed at reducing the trusts' current level of reliance on locum doctors."