Report on the use of locum doctors by Northern Ireland hospitals : fourth report, together with the minutes of proceedings of the Committee relating to the report and the minutes of evidence

Locum doctors are employed across the Health Service to meet fluctuations in activity levels and to cover vacancies or short-term absences of medical staff. Trusts obtain locums both from within their own substantive staff and from private agencies. Properly managed, locums play an important role in helping hospitals achieve flexibility. Excessive use can be costly, particularly in the case of the Western Trust which is heavily reliant on agency locums, and can have a negative impact on patient care and satisfaction. 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. In the four-year period to March 2011 almost 8 per cent of Trusts' overall medical staffing expenditure related to locums. Payments to external recruitment agencies for locums totalled GBP74 million while payments to substantive staff working over and above their contracted hours (internal locums) totalled just over GBP35 million. The Committee's overall conclusion is that Trusts need better information on the use and costs of locum doctors - particularly on locums drawn from existing staff The Committee's overall conclusion is that Trusts need better information on the use and costs of locum doctors - particularly on locums drawn from existing staff. It also considers that Trusts need to get better at managing the potential risks to patient safety of using locum doctors. They need to be more consistent in the way they screen and induct locums and the way they manage their performance