NHS Trusts have come under fire following fresh revelations that billions of pounds of public money are still being spent on agency staff pay, despite centrally imposed pay caps introduced in November 2015.

Locum doctors’ remuneration is under scrutiny on this occasion after workforce management company Liaison released figures showing that some Trusts have used locums continuously for more than three years. Each locum doctor is paid more than £300,000 per year.

While the latest emphasis has been on locum doctors, chronic and endemic staff shortages have also forced Trusts to rely on agency nurses and non-clinical staff, many of whom are contracting in the NHS as Umbrella Company Employees.

As reported in The International Business Times, the CEO of campaign group The TaxPayers’ Alliance, John O’Connell, accused NHS Trusts of slack and unorganised with taxpayers’ cash.

The need for agency cover could be reduced considerably, he claimed, with proper management of staff time.

However, the Trusts maintain that they have been unable to recruit and retain doctors in needed roles. Serious staffing shortages have forced them to draft in short-term cover.

The pay caps were put in place by the standards body, NHS Improvement, and were intended to prevent agency staff from being paid no more than 55 per cent above the rate for equivalent permanent staff. The aim was to reduce the NHS’s annual agency staff bill of £3.6bn. However, the caps have not had this effect, as the figure remains the same more than a year after they were introduced.

NHS Improvement’s CEO, Jim Mackey, laid the blame on the locum doctors themselves, insisting that their pay was unfair to the permanent staff working alongside them.

However, the President of the Royal College of Emergency Medicine, Taj Hassan, described Mr Mackey’s proposed solution – further caps on locum pay – as “very unlikely to solve the problem.”

What is needed, he countered, is a job plan that recognises the pressure of working out of hours and gives doctors the opportunity to recuperate and recover.

In April 2016, REC Chief Executive Kevin Green denounced the pay caps as ill-conceived and myopic, adding: “All the evidence suggests the cap is exacerbating the skills shortage crisis rather than alleviating it, and NHS Improvement has so far failed to produce evidence to the contrary.”

During the previous month, the House of Commons Committee of Public Accounts stated that “the NHS will not solve the problem of reliance on agency staff until it solves its wider workforce planning issues.”

It seems that until the workforce planning issues have been resolved, the NHS will have little option but to draft in skilled clinical and non-clinical staff to maintain vital services.

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