Abstract
Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This is particularly so in hospitals where core clinical services are run by a small number of permanently appointed consultants. The problems associated with locum employment are underestimated and little attention has been directed towards addressing the issue in the rural general hospitals of Scotland. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. Data were extracted from the Human Resources Department of NHS Western Isles' list of locum consultants for most weeks from the beginning of January 2002 to the end of December 2009. The Western Isles Hospital in Stornoway has an establishment of 17 permanent consultants. During the 8 year study period 239 different consultants were employed, 20 held substantive permanent positions, 31 were long-term locums (employed >3 months) and 188 were short-term locums. The short-term locums worked for 535 different locum episodes. The pattern of usage varied according to service configuration. Study data revealed the alarming scope of the locum tenens issue, which will increase unless action is taken. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants.
Highlights
Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs
The June 2010 report Using locum doctors in hospitals[1] from Audit Scotland highlights the NHS spending on locums and suggests that £6 million per year could be saved by reducing locum tenens usage to the national average
For NHS Western Isles attention was drawn to the fact that 36% of the medical staffing budget is spent on locums, rural and island NHS Boards have difficulty recruiting, and that 97% of the locum expenditure was on consultant locums
Summary
Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants. The June 2010 report Using locum doctors in hospitals[1] from Audit Scotland (the body that provides the Auditor General and the Accounts Commission with the services they need to check that public money is spent properly, efficiently and effectively) highlights the NHS spending on locums and suggests that £6 million per year could be saved by reducing locum tenens usage to the national average.
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