Locum numbers fall in secondary care but with concurrent rise in permanent doctors

In January 2012 a total of 2279 locum doctors were employed by NHS hospitals and community health services, down 10% from 2534 in January 2011.

However, the number of non-locum doctors rose by a similar number, from 90 382 to 92 280 (2.1%), in the same period.

From January 2010 to January 2011 the number of locums employed in secondary and community care had risen by 1.2%.

In particular, the number of locum trainee doctors fell dramatically in 2011 after a considerable rise in 2010. The number of locum doctors employed at training grades rose by almost a third from 495 to 645 in the 12 months to January 2011 but then fell by more than a quarter to 461 in January 2012.

The number of non-locum registrars rose by 22% in 2010 but by only 1% in 2011.

The fall in the number of locums in secondary care is not surprising given the current pressure on trusts to reduce costs, said Mark Porter, chairman of the BMA’s Central Consultants and Specialists Committee.

“In the NHS as a whole something like two thirds of all costs are staff costs, and the only way to reduce that cost base without making people redundant is to reduce your locum bills,” he said.

The NHS spent an estimated £1.03bn on temporary clinical staff in 2010-11, down from £1.05bn in 2009-10, according to figures published recently by the Daily Telegraph (17 Mar, http://tgr.ph/JUZNqL).

NHS Employers has since September last year been encouraging employers to reduce the sums they spend on temporary agency staff to help the health service meet its target of £20bn worth of efficiency savings by 2014-15.

“Professionally speaking, it may well be very appropriate for an organisation to reduce locum usage, because organising the work so that it can be delivered with the employed workforce is a marker of good organisational practice,” said Porter.

However, reducing the number of locums limits a department’s ability to be flexible when a doctor phones in sick, for example, and puts pressure on other staff to pick up the work that would have been done by a locum, he warned.

“In some places trusts are taking out the expenditure on locums without actually replacing them,” he said. “Increasingly, holes in the rota are being left, and existing doctors have a huge moral and professional responsibility to pick up that work.”