Two-thirds of the spending on locum doctors employed in NHS trusts is being driven by the need to fill vacancies, analysis shared exclusively with HSJ reveals.

  • Data shared with HSJ shows majority of trusts use locum doctors to cover vacancies
  • Analysis also finds consultant pay rates exceed national framework agreement
  • Regional disparity, with North West and South West paying the highest hourly rates

The report by financial and workforce management company Liaison also shows average locum consultant pay rates have soared to 46 per cent higher than national framework rates, which are designed to set a level of pay for temporary staff.

It also highlights substantial hikes in rates of pay for some posts, including hourly rates more than three times the recommended levels.

Health secretary Jeremy Hunt is due to unveil proposals to cap agency spending in the NHS today, following concerns the increased costs are driving the provider sector into a deepening deficit.

Liaison’s report for quarter three of 2014-15 looks at locum spending across 40 NHS trusts, covering staff supplied by 67 agencies.

It found the biggest single reason for needing to employ a locum doctor was to cover vacant roles, with 66 per cent of booked hours caused by an unfilled post.

The report says: “Pay rates continue to exceed recommended national framework agreement rates. For example, consultant rates were on average 46 per cent higher than the average [framework] rate.

“Whilst commission rates show a marginal decrease overall, the maximum rates paid indicate continued overcharging by some agencies. For example, the average hourly commission rate paid for an ST3 [registrar] was £6.63, relative to the maximum commission paid by one trust for an ST3 of £25.27 per hour.”

It found the average pay rate for a general medical locum was static at £59.20 per hour, but in one example a trust paid £133 per hour for the same role.


London pays the lowest rates for general medical consultants compared to other regions of the country

Hourly pay rates for consultants average £90.40 per hour but reached as high as £140 an hour, or £1,680 for a 12 hour shift.

Analysis of the 10 highest paid locums across the first three quarters of 2014-15 revealed they were set to earn just under £3m in the financial year, with commission to the supplying agencies reaching £218,000.

The highest paid general medical consultant was set to earn £450,000 in 2014-15 for an average 80 hour week.

The data also shows a north/south divide, with London paying the lowest rates for general medical consultants compared to the other regions. The North West and South West paid the highest hourly pay rates. The South East Coast paid the highest commission - 79 per cent more than the East of England for a consultant role.

Andy Armitage, managing director of Liaison, which produced the report based on anonymised data, told HSJ there was evidence of trusts paying over the odds.

“Some trusts are paying more than they should be for a variety of reasons,” he said.

“What we are seeing is trusts not being able to fill some of their substantive positions, which is creating ongoing demand for filling those vacancies.

“Trusts are having to pay more to attract those doctors into certain positions and what it boils down to is a supply and demand equation. Doctors know they can select these jobs and trusts know that they have to fill the vacancies.”


Exclusive: Vacancies fuel agency overspending by NHS trusts