A Daily Telegraph investigation found a sharp rise in payments made via agencies, despite repeated pledges to clamp down on spending on temporary medics. Freedom of Information disclosures reveal that since 2017, 16 trusts have paid more than £3,000 a shift for agency and bank doctors. The steep rise follows changes in tax rules which means rising numbers of medics are cutting their NHS hours. The investigation showed that the payments covered not just the hours worked, but time doctors spent on call – including when they were sleeping. The highest sum was paid by Barking, Havering and Redbridge University Hospitals trust, which this year spent £3,893 covering one 24 hour shift for a gastroenterologist on a bank holiday weekend.  The crisis is compounded by shortages of medics in many specialties, with almost half of advertised consultant posts going unfilled, and one in four senior doctors working part-time. 

The NHS had been steadily reducing spending on agency staff since setting caps on its rates in 2015, when the bill for locum workers fuelled the biggest NHS deficit on record.  But official figures show that, since 2017/18, it has failed to make any progress, with spending of £2.4 billion, £200 million more than the target set.  In August of last year, the head of the NHS watchdog urged trusts to only use locum medics “as a last resort” as it set new targets, urging them to cut costs.