Trust busts locum cap after overspending on GPs

Wirral Community Health Services Trust breached its £1.7m cap and has attributed 70 per cent of its total spending on agency staff to the GP out of hours service.

The trust, which breached its cap by £322,000, has raised concerns that if agency expenditure continues at the same rate this could impact its “level one” rating on NHS Improvement’s “finance and use of resources” metric. This is the highest financial rating a trust can achieve.

However, trust board papers, published last week, said: “Continued spending at our current level will impact our future score, and we need to retain a high score to continue to prove that we can operate as an independent trust.”

The trust is also predicting it will not achieve its agency spending target of £1.7m for 2017-18 but is “confident” of meeting its 2018-19 target.

The papers added: “At the end of 2016-17 the trust exceeded its agency cap. Agency expenditure is closely monitored and approximately 70 per cent is attributable to GP out of hours. GP out of hours have detailed plans currently being implemented to address this issue for 2017-18, however the situation requires close ongoing monitoring.”

In a statement to HSJ, the trust said in 2016-17 it used an average of 660 agency hours per month, for 20 different locum GPs in its out of hours service.

However, it added that a recent recruitment drive had enabled it to reduce its GP agency hours in March by 41 per cent year on year.

The news follows a reduction in funding for the service by 10 per cent by Wirral Clinical Commissioner Group in 2016-17. The CCG is set to reduce this by a further 10 per cent this year.

In response to the reductions, the trust has developed a new service model based around multi-disciplinary teams. The trust said this has allowed it to reduce its GP hours by 18 per cent.

“This has enabled us to deliver a safe and effective service, without any change to the service opening hours and within budget,” the statement said.

Wirral Community Health said it has not had to reduce operation hours for the service after the funding reductions.

As part of this new service model, the trust has recruited to two “paramedic style” roles that it hopes will begin to reduce agency hours from June.