No checks as agency

Health bosses handed over cash to pri­vate con­trac­tors with­out ex­am­in­ing rel­e­vant pa­per­work

The Sunday Post (Inverness) - - Nhs Staffing Crisis -

The damn­ing find­ings are in a n Au d i t Scot­land re p o r t , re­leased to The Sun­day Post un­der free­dom of in­for­ma­tion laws, which crit­ics claim raises se­ri­ous ques­tions for the en­tire cash-strapped health ser­vice.

The public spend­ing watch­dog launched a probe into NHS Greater Glas­gow and Clyde af­ter the health board blamed agency costs for much of a £ 9.4m over­spend last year.

Au­di­tors spot- checked some of the lu­cra­tive pay­ments to locum agen­cies and con­cluded health chiefs “rely largely on the as­sump­tion that cor­rect in­for­ma­tion is p r ov i d e d from sup­pli­ers”.

In one case in­voices were set­tled with­out timesheets for l ocum med­i­cal staff be­ing sub­mit­ted and in an­other ex­am­ple the con­trac­tor had put down a higher pay­ment rate than the agreed amount but still got paid.

NHS Greater Glas­gow and Clyde last night said it had tight­ened up pro­ce­dures since this re­port was pub­lished.

But cam­paign­ers have raised fears that such slack fi­nan­fi­nan­cial man­age­mentnt could be di­vert­ing fundsds away from front­line med­i­cal care across NHS Scot­land.

Mar­garet Watt,att, pic-pic­tured, chair­wom­anoman of Scot­land Pa t i e n t s’ As­so­ci­a­tion, THERE are now more than 400 va­cant con­sul­tant posts across NHS Scot­land.

Con­sul­tant va­can­cies are con­tin­u­ing to rise and al­most half of th­ese have been va­cant for more than six months.

This is mir­rored in gen­eral prac­tice where 26% of prac­tices that re­sponded to a re­cent sur­vey had at least one GP va­cancy.

The BMA has been warn­ing the Scot­tish Gov­ern­ment for some time that the NHS in Scot­land is fac­ing se­ri­ous dif­fi­cul­ties in re­cruit­ment and re­ten­tion and said: “This raises se­ri­ous ques­tions about whether this is hap­pen­ing all over Scot­land.

“There are huge sums of money in­volved here and ev­ery penny wasted is a penny de­nied to where it is needed in the NHS.

“What baf­fles me is if a com­pany tried to get paid in the busi­ness world with­out hand­ing over the right pa­per­work it would get told to think again, so why does this hap­pen in the NHS?

“The prob­lem of agency doc­tors and nurses is spi­ralling out of con­trol and it’s time we took a step back and worked out why we are do­ing this, why is it so ex­pen­sive and why can’t we do it a bet­ter way.”

NHS Greater Glas­gow and Clyde makes around 800 to 900 med­i­cal agency locum book­ings a month, which cost a to­tal of £19.1m in 2015/16.

Spend­ing watch­dog Au­dit Scot­land car­ried out spot checks on 20 agency in­voices sub­mit­ted and found that no checks had been made to con­firm the agreed pay rates and spec­i­fi­ca­tion of the role for each pay­ment.

In two in­stances the rates quoted on the in­voice did not match the agreed sup­plier rates.

This re­sulted in an over­pay­ment of £1,070 and £210 re­spec­tively. An­other test found that one agency, whichw had banked around £600,000 in the pre­vi­ousvi­ous 12 months, had not pro­vided copies of locums’ timesheet­stimeshee along with its in­voices.

Au d i t Scot­land con­cluded: “The in­voice

check­ingche pro­ce­dures that we are long past the point at which ac­tion must be taken.

Ev­ery va­cant post puts more pres­sure on an al­ready over­bur­dened med­i­cal work­force and leaves health boards at­tempt­ing to plug gaps by try­ing to se­cure tem­po­rary locum cover.

Un­less we tackle the un­der­ly­ing causes of th­ese gaps in our work­force then our re­liance on locums will only in­crease. for agency pay­ments are not suf­fi­ciently ro­bust and rely largely on the as­sump­tion that cor­rect in­for­ma­tion is pro­vided from sup­pli­ers.

“There is a risk that the board is be­ing over­charged for ser­vices, if proper au­tho­ri­sa­tion and check­ing of timesheets is not rig­or­ously car­ried out.”

The Au­dit Scot­land re­port points out that it had high­lighted the same con­cerns the year be­fore.

Scot­tish Lib­eral Demo­crat health spokesman Alex Cole- Hamil­ton said: “It is deeply con­cern­ing that spot checks sug­gest firms are get­ting away with not sub­mit­ting the cor­rect pa­per­work, es­pe­cially given the size of the NHS locum bill.

“There are ob­vi­ously sit­u­a­tions where locums can play a valu­able part in cov­er­ing short term gaps in the work­force but this re­port will do noth­ing to re­as­sure mem­bers of the public that NHS re­sources are be­ing pru­dently man­aged.”

The NHS has long been crit­i­cised for not keep­ing a close eye on costs. An un­der-fire IT sys­tem for health call cen­tre NHS 24 went £ 131.2m over- bud­get, while it costs more than £500,000 a year for the NHS to dis­pose of un­used medicines.

A spokes­woman for NHS Greater Glas­gow and Clyde said: “Since this re­port was pub­lished we have been work­ing on ini­tia­tives to re­duce our use of agency and bank staff.

“The new sys­tem en­sures that agency sup­pli­ers will only be paid the pay rate and hours agreed.”

There al­ways has been and al­ways will be a need for locum staff to cover short-term ab­sences, sick leave and ma­ter­nity leave, amongst other things.

The use of locums is, how­ever, a tem­po­rary so­lu­tion and does not pro­vide long-term sta­bil­ity in the case of a long-term va­cancy.

The only way to re­duce the use of locums in the health ser­vice is by fill­ing va­cant posts on a per­ma­nent ba­sis.

Se­ri­ous ques­tions need to be asked as to why Scot­land is un­able to at­tract and re­tain an

Protests against NHS cuts – like this one last year out­side Glas­gow’s NHS work­force. In some spe­cial­i­ties, de­spite re­peated ad­ver­tis­ing, posts are not prov­ing at­trac­tive and are re­main­ing un­filled.

With va­can­cies in­creas­ing and de­mand ris­ing faster than re­sources, an on­go­ing sig­nif­i­cant short­fall in doc­tors will in­evitably have a neg­a­tive im­pact on our abil­ity to con­tinue to de­liver a high qual­ity and sus­tain­able health ser­vice.

It is im­per­a­tive that the Scot­tish Gov­ern­ment builds on ini­tial work they have done with BMA Scot­land’s GPs and work to find so­lu­tions to th­ese chal­lenges across both pri­mary and sec­ondary care. We need pos­i­tive ac­tion to demon­strate to all med­i­cal staff that they are val­ued, mak­ing posts at­trac­tive so that we can con­tinue to pro­vide the kind of health ser­vice that our pa­tients de­serve.

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