NHS Paid £3,258 For One Doctor's A&E Shift

An NHS hospital paid more than £3,200 for a locum doctor to cover a single 24-hour A&E shift over the Christmas and New Year crisis, a Sky News investigation has found.

So short staffed were some trusts between Christmas Eve and New Year's Day that more than half the shifts in their emergency departments were worked by locum medics, often at huge expense .

Figures obtained by Sky News show that four hospitals paid more than £2,000 for A&E consultants to work a shift, with the highest bill being the £3,258 paid by United Lincolnshire NHS Trust for a doctor to work for 24 hours.

Leeds Teaching Hospitals NHS Trust paid the equivalent of more than £230 an hour for one doctor.

Three hospitals paid more than £1,700 for nurses on single shifts.

At Royal Berkshire, one agency was paid £1,875 for a nurse to work 12 hours on New Year's Day, the equivalent of £156.25 an hour.

Derby Hospitals NHS Foundation Trust paid £156 an hour for a nurse and North Bristol NHS Trust paid £144.

At Airedale NHS Foundation Trust almost three quarters - 71% - of the shifts over that period were covered by a locum doctor.

Some 58% of shifts were filled by locums at Heart of England NHS Foundation Trust and 52% at Royal Bolton Hospital.

Walsall Healthcare NHS Trust had to find agency nurses for 43% of shifts, King's College Hospital NHS Foundation Trust used them for 32% of shifts and Heart of England NHS Foundation Trust for 25%.

The figures were obtained by a Freedom of Information request.

Some 75 out of the 140 trusts replied to questions about how their emergency departments were staffed between 24 December 2014 and 1 January.

In February this year, MPs on the Public Accounts Committee claimed senior A&E doctors were profiting from staff shortages by working for locum agencies.

Experts said that competition between hospitals to fill shifts during what was the busiest Christmas period on record meant that the prices being charged by locum agencies soared.

Dr Clifford Mann, president of the Royal College of Emergency Medicine, said: "Market forces really are quite extreme currently, with the lack of permanent people to employ.

"It means hospitals are desperate to try to find people to fill these slots and are having to pay super premium rates for that to happen.

"It can be very demoralising to be working alongside somebody with much less experience, much more junior, who is earning a multiple income compared to you in terms of the pounds paid per hour."

Mick Corti, of the London Procurement Partnership which negotiates on behalf of the capital's hospitals to drive costs down, said that agencies were sometimes collecting fees of up to £100 an hour before paying the doctors and nurses themselves.

"There is almost competition on what you are able to pay and by paying more you think you can increase the supply of the agency nurse or doctor, but you are not - you are pinching that nurse or doctor from wherever else they might have worked and then they have a problem.

"You get an inflationary spiral where one trust is competing against another, and that is what the NHS needs to move away from and try to hold firm. Pay appropriate rates and stick to it."

:: Top Five Doctor Payments:

United Lincolnshire NHS Trust -- £3,257

Royal Cornwall Hospitals NHS Trust -- £2,142

Leeds Teaching Hospitals NHS Trust -- £2,099

Croydon Health Services -- £2,000

University Hospital South Manchester -- £1,625

:: Top Five Nurse Payments:

Royal Berkshire NHS Foundation Trust -- £1,875

Derby Hospitals NHS Foundation Trust -- £1,798

North Bristol NHS Trust -- £1,728

West Middlesex University Hospital -- £1,462

University Hospitals of Leicester -- £1,416