No checks as agency
Health bosses handed over cash to private contractors without examining relevant paperwork
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.