Our white paper on the A&E crisis: The Real Emergency in Emergency Departments released in February 2013 reviewed the driving forces behind this demand. HCL engaged early in the debate, believing that reputable commercial partners play a valuable role in being part of the solution, not the problem.
With reports back as far as 2010* the current A&E crisis is not a new phenomenon. The rising use of medical locums has been driven by demand – following changes to the GP’s Out of Hours contracts in 2004** more people are visiting A&E departments than ever before. Our research indicates that since 2003 the number of people attending A&E has risen by 22%.
It is increasingly clear that without these highly skilled locum doctors supporting NHS rota shortages, the number of A&E department closures would increase significantly. Our report showed that locums account for over a fifth of doctors in emergency units at the weekend – a critical period when shortages are most acute.
The vast majority of medical locum pay rates are in-line with substantive salaries (after the deduction of sick and holiday pay) so the consistent reporting of the exorbitant cost of locum doctors does tend to be the exception rather than the rule.
Additionally HCL’s national data show that professional locum doctors tend to engage with their local communities choosing to work in their local hospital on a regular basis, with nearly 65% of our locums travelling up to 30 miles to their place of work.
The lack of investment in education, the high number of vacant A&E posts nationally and the current immigration restrictions to employ highly skilled A&E doctors from non EU countries are all adding to this issue.
As the world’s fifth largest employer the NHS needs support. We do this by providing on framework and fully compliant locum doctors while also providing support through the provision of full time substantive staff. Over the past three years HCL has seen demand for substantive staff rising, the number of doctors it has placed into permanent roles has almost doubled year on year.
Even if the demand for substantive staff is addressed the need for locum staffing support will continue, HCL urges government and other stakeholders to look at the wider issues affecting this problem.
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