Locum doctors accused of 'organised campaign' to hold NHS to ransom

Laura Donnelly
NHS watchdogs suggested some locum doctors were colluding to inflate pay in ways which should see them struck off  - PA

Locum doctors have been accused of running an “organised campaign” to hold the NHS to ransom after dozens demanded pay boosts of up to 50 per cent.

NHS watchdogs said medics employed via agencies are refusing to work at the last minute, leaving dangerous gaps in medical cover, as pressures on hospitals mount.

Jim Mackey, chief executive of NHS Improvement, accused doctors of colluding to try to get pay boosts in ways which could see some struck off.

He spoke out as it emerged that a string of hospitals have been pushed to the brink of crisis, by agency doctors withdrawing from shifts, after their pay demands were resisted.

The crisis stems from new rules - introduced this week - which attempt to clamp down on tax avoidance.

Health regulators say some locum doctors are abandoning shifts when pay demands have been refused - knowing that the NHS is braced for a surge in pressures over the long Easter weekend.

Mr Mackey accused doctors of a “very organised campaign” as it emerged that:

  • One A&E in Lincolnshire was “just hours from closure” in recent days after locum consultants pulled out of agreed shifts with little notice;

  • Doctors at a hospital in Derby may be referred to the General Medical Council (GMC) for cancelling shifts for the same reason;

  • Eleven locum doctors failed to turn up for work at one Midlands trust, while 14 in Blackpool rejected their shifts;

  • Medics in the South West told hospital chiefs they would only fill shifts if pay was boosted by 56 per cent.

One finance director likened the situation facing the NHS to a “Mexican standoff”, with doctors attempting to take advantage of an expected surge in pressures as Easter approaches.

The new Revenue and Customers IR35 regulations mean trusts must subtract tax and national insurance from workers’ pay packets at source, instead of using personal service companies, used by some to minimise tax.

Some workers estimate they could lose more than 20 per cent of take-home pay as a result of the changes, introduced this week. 

NHS finance directors said some doctors were attempting to negotiate pay boosts far beyond what they might lose from the tax changes - and threatening to otherwise immediately withdraw labour.

Mr Mackey said a number of NHS trusts had now warned of difficulties trying to cover shifts in the coming weeks, if they did not give in to the demands.

He told Health Service Journal: “We are trying to hold our nerve and not blink, but safety will drive the decisions.

Behaviour reported by trusts in recent days suggested a number of medics working together, to collectively withdraw labour at the last minute, in an attempt to force up pay.

“There was an example over the weekend where there was a very organised campaign amongst the doctors to say let’s make this really hurt and threaten very hard and see if we can break it,” Mr Mackey said.

“I don’t know how they’re on the register as doctors,” he said, saying NHS managers were pleading with the regulator to “hold the line” and not give in to demands.

Senior NHS managers said  United Lincolnshire Hospitals Trust’s Accident & Emergency department was left just hours from closure, after locums pullled out of shifts, leaving no A&E consultants on duty, before medics were found elsewhere.

Watchdogs confirmed they had brokered a conference call between hospitals across four counties in order to find emergency help for the A&E.

In other cases, 11 A&E “middle grade” locum doctors failed to turn up at University Hospitals North Midlands trust, with more senior medics roped in to cover the shifts.  In Blackpool, NHS chiefs pleaded with consultants to step in after 14 temporary doctors rejected planned shifts.

And an email to hospital bosses in the South West said three locums were demanding pay increases of more than 56 per cent. 

Derby Teaching Hospitals Foundation Trust is considering whether to refer two A&E locum doctors to the GMC after they cancelled their shifts with only two days’ notice.

Medical director Nigel Sturrock said the doctors had requested a pay increase to compensate for the tax changes, which the trust refused.

The doctors’ decision had put “patient safety at risk and breaking the GMC’s own guidelines on good medical practice”, Dr Sturrock said.

“As a result we are discussing referring these individuals to the GMC. Patient safety is central to our ethos at Derby Teaching Hospitals and locums who put this at risk will be dealt with accordingly.”

One hospital medical director said: “Some individuals and agencies are playing games. Locums will play trusts off against each other and some of these people are quite prepared to travel long distances. The first two weeks in April will be crucial. If the NHS can hold the line, then we might see a change in the market.

“But if one trust breaks the cap for one doctor in one ward then it will fail. We need to all hold the line on this.”

The watchdog has been attempting to clamp down on rates of agency pay, introducing a cap on pay after spending on locums rose from £1.8bn to £3.3bn in three years.

Yesterday Mr Mackey also admitted that hospitals are unlikely to break even in the current financial year, which has only just begun.

Estimates of a combined trust deficit of around £600m by next March were “not miles out,” he said.

 

 

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