BMA Scotland criticises ‘highest spend on agency locums in a decade’
NHS Scotland’s spending on agency locums has reached the highest level in a decade, according to BMA Scotland, which warned of a “crisis” in the workforce.
At the end of the last financial year, NHS Scotland had a record 187,157 headcount, an increase of 17.9% from a decade ago, praised by the Scottish Government as representing “12 consecutive years of growth”.
In the 12 months until March 31, some 18,526 new starters joined NHS Scotland, and 12,546 people left.
During the same timeframe, £129.6 million was spent on agency locums, an increase of 8.3% on the previous year – which the British Medical Association (BMA) said was the highest in a decade, and a 92% increase compared to March 2014 (£67.3 million).
The workforce figures were lauded by health secretary Neil Gray, however they were branded a reflection of the “continued workforce crisis NHS Scotland finds itself in”, by the BMA which urged for pay negotiations to boost staff retention and to compete with salaries south of the border.
In the past year ending March 31, £490 million was spent on bank and agency nursing staff – a 9.5% increase on the previous year.
Dr Alan Robertson, chair of the BMA’s Scottish consultant committee, said that Freedom of Information statistics indicated consultant vacancies could be twice as common as official NHS figures suggested.
He said consultants working in England were put off by less competitive pay, and urged for this to be addressed, alleging that NHS Scotland was losing staff to better-paid jobs in England.
He claimed the headcount did not reflect an increase in waiting times, and that posts which remained vacant for six months were the highest in a decade, citing a “demoralised” workforce facing “moral distress” in NHS Scotland.
There were 40% fewer vacancies than in the year ending March 2023, with 3,382.5 jobs available – totting up to a 39.3% decrease over the past year.
Another 451 consultant jobs have yet to be filled – a decrease of 3.6% – which was described as “stubbornly high” by Dr Robertson.
In the nursing and midwifery sector, there were 77,407 staff employed – a 4% increase in the past year.
In the medical and dental categories, there are 6,634 consultants excluding directors – a 2.5% increase over the past year.
The number of admin workers also increased, with 34,518 staff – a 3.4% increase over the past year.
As of April, the working week became 30 minutes shorter and is now 37 hours.
Dr Robertson said: “We know these figures are failing to show the true extent of gaps in the workforce.
“Our recent FOI found vacancy numbers are twice those being reported. It is of little surprise spending on locums has also reached the highest level in a decade, with an eye-watering £129.6 million being spent last year.
“This is only a sticking plaster approach and not a long-term solution to the crisis – money being spent on locums should instead be put towards staffing. Permanent staff are by far the more cost-effective, they also provide stability and continuity of service that best serves patients.
“The stark reality of these stubbornly high consultant vacancies is reflected in the recent truly dreadful waiting times statistics which are having a terrible impact on patients and their families and seeing many doctors giving up.
“While the Scottish Government likes to point to staffing in the NHS being at a record high, this does not take into account the continued rising demand for services. Addressing pay would improve retention and recruitment in Scotland.
“Consultants in Scotland now earn less than their counterparts south of the border and as a result, we have seen senior doctors leaving Scotland to take up jobs there and consultants in England changing their minds about moving here.
“Medicine is a global market and it is vital Scotland is able to compete especially with its nearest neighbours. Addressing these issues would also help address vacancies and we call on the Scottish Government to start genuine pay negotiations urgently.”
Health secretary Neil Gray said: “I welcome these workforce statistics, which show that the number of people working in Scotland’s NHS is at a record high.
“Whilst our NHS workforce has seen 12 consecutive years of growth, we know that growing the workforce alone does not ensure improved performance or patient safety and experience.
“It is through reform and diversification that we can progressively make better use of our workforce by improving the design of services and giving them the tools, technology and infrastructure they need.”