£7.9m spike in locum spend in Western Trust during COVID-19

The cost of expensive locum and agency staff in the Western Trust spiked by £7,988,724 to £50,542,932 between 2019/20 and 2021/22, according to figures released by the Department of Health.
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The hike was part of a wider trend that saw a five-fold increase in agency spending across the entire health service in the North from £68 million to £320 million between 2012/13 and 2021/22.

Figures released to Foyle SDLP MLA Mark H. Durkan show that during the COVID-19 period (2019/20 to 2021/22) the spending on agencies increased from £42,554,198 to £50,542,932 in the Western Trust.

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Across the North agency expenditure increased by £65,682,197 from £254,730,859 to £320,413,056 during the same period.

Agency costs have increased substantially over the last 10 years, from £68m in 2012/13 to £320m in 2021/22.Agency costs have increased substantially over the last 10 years, from £68m in 2012/13 to £320m in 2021/22.
Agency costs have increased substantially over the last 10 years, from £68m in 2012/13 to £320m in 2021/22.

Mr. Durkan said: “This is an eye-watering spend on what is essentially a temporary fix to a deepening crisis within the health service. Clearly this band-aid approach to the gaping wound of resourcing issues is not only ineffective but also proving extremely expensive.

“Costs for agency and locum staff is increasing substantially year on year in an effort to plug workforce gaps. It’s now a case of not being able to put the genie back in the bottle.

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“This situation wasn’t unforeseen. Warning after warning from expert panel reports of stark increases in locum expenditure went unheeded. The failure to deliver long overdue transformation within the health service has led us to this juncture.”

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Peter May, Permanent Secretary at the Department of Health, releasing the information in a letter to Mr. Durkan, stated: “HSC Trusts employ locum staff for several reasons, for example, cover for sickness and maternity/paternity leave; cover for existing vacancies; and when demand increases over the winter months.

"The primary aim of this is to ensure that safe and effective services are sustained at all times for patients and clients. Whilst these agency costs have increased substantially over the last 10 years, from £68m in 2012/13 to £320m in 2021/22, it is concerning the impact this is having on the Health & Social Care budget and the Department recognises that this is not sustainable, particularly at a time of serious financial pressures right across the public sector.

"This is why transformation of health and social care in Northern Ireland is such a priority.”

Mr. May said the Department is ‘examining all potential options and the implications, in conjunction with the Trade Unions, as to how to address the issues of rising locum expenditure’.

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He added: “The Bengoa expert panel report warned of ‘stark increases in costs associated with locum and agency staff to provide a safe service where it is not possible to recruit to permanent positions’.

"The report made clear that rising locum and agency costs are due to the current configuration of services and that ‘changing the model of care’ is the only solution.”

Mr. Durkan said: “Agency staff spend is almost five times what it was ten years ago. That’s hundreds of millions of pounds which would be better spent investing in a health workforce and providing a decent liveable wage.

"A £320 million spend on temporary cover for 2021/22, at a time when health staff have been forced to take to the picket lines for fair pay, is mindboggling."