A quarter more spent on locums

NHS Shetland spending on locums and agency nurses rocketed this year, according to a new report by Audit Scotland.

It revealed that the health board spent 24 per cent more on temporary medical staff in 2014/15 than in 2013/14, and there was an 84 per cent increase in spending on agency nursing staff.

Shetland MSP Tavish Scott raised this at Wednesday’s public audit committee meeting in the Scottish parliament.


Speaking before the meeting he said: “This increase of 24 per cent spent on temporary doctors and an increase of 84 per cent on agency nursing staff is a big impact on NHS Shetland’s budget.

“Permanent appointments will not only be better value for money but will contribute to an improved standard of care. My recent health survey which 900 residents responded to, showed that while most residents never have to wait long for an appointment, many expressed dissatisfaction that they were often unable to see their preferred doctor. Just this week a constituent told me that she would wait until January to see her GP at the Lerwick Health Centre.

“Shetland needs the Scottish government to accept the Audit Scotland findings on recruitment and retention of key medical staff.”

Mr Scott added that the Scottish government had only managed to add 35 new GPs to the workforce between 2009 and 2013, and called for the situation, which affects much of Scotland, to be tackled.

He said: “We need to see urgent action to help address the recruitment crisis and new resources to support primary care in Scotland. GPs are the first point of contact in our health service and every person has the right to quick and quality treatment. I was very impressed by a recent visit to the Scalloway Health Centre. I listened carefully to the views of medical staff and GPs.

“Audit Scotland also indicate the financial pressure NHS boards are under. That includes Shetland and I have every sympathy for them. So it will be important that when the Scottish government decides its budget before Christmas, they make a serious investment in the primary care so many people depend on.”

Mr Scott called on the government to ensure that NHS Shetland received its “fair share” of government funding and repeated his assertion that the organisation was underfunded.

He said: “At present NHS Shetland is currently underfunded to the tune of nearly £900,000 by the government’s own formula. It is vital that this shortage is addressed to enable NHS Shetland to recruit more permanent staff.”

In response, NHS Shetland chief executive Ralph Roberts said the health board was aware of the issues raised and was already working to address them.

He said: “We recognise that the costs have increased in the last year and we are making every attempt to reduce our use of agency and locum staff. This is not only because of the financial cost but because we understand the impact a high turnover of temporary staff can have on our service and the remaining staff.

“We have, however, also been fortunate to have a number of very committed locum staff who have made a long term commitment to supporting services in Shetland and we are grateful to them for this support, that is often done at financial rates lower than they might have earned in other places.”

He said that although the overall cost of locum and agency staff was £1.57 million in 2014/15, this was lower than in 2011/12 (£1.61 million) and 2013/14 (£1.59 million), so it was important not to draw simple conclusions from one year’s figures.

The increase in nursing agency also represented a “very low overall figure” of only £21,000.
He said: “It is also important to emphasise that locum or agency staff are only used to cover essential services. Therefore in the past year we have used medical locums to cover vacancies in some GP practices such as Lerwick, Yell and Whalsay or in the obstetric service at the Gilbert Bain Hospital.

“We are making every effort to recruit to these posts on a permanent basis because we agree with Mr Scott that this is better in the long term for our patients.”

However, Mr Roberts disputed Mr Scott’s claim that NHS Shetland was being underfunded.

He said: “In relation to Mr Scott’s comments in relation to underfunding of the health board, we are on record as having previously explained this situation. The most recent publication of the health service allocation formula indicates that NHS Shetland is within one per cent of our “fair share” of NHS resources and we are not therefore expecting any additional funding as a result of this formula.

“We continue, however to discuss with the Scottish government our finances and make the case for a recognition of the additional costs of providing healthcare in Shetland.”


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