The Auditor General of Northern Ireland said the overreliance on locum doctors is unsustainable after a report from the Northern Ireland Audit Office showed that total spending on locum doctors rose from £28.4 million in 2011-12 to £83 million in 2017-18, an increase of 192.2%.

Auditor General and Comptroller of Northern Ireland Kieran Donnelly commented, “The health and social care sector’s heavy reliance on locum doctors is becoming unsustainable, with rising costs placing local health budgets under huge strain.”

The report showed that both the Northern and Western Trusts in Northern Ireland spent over 22% of their total medical pay bill on locums.

According to the report, Northern Ireland’s Trusts are ‘very heavily reliant’ on locum doctors provided via agency, which are more expensive than using HSC (Health and Social Care) doctors to provide cover.

Total agency spend has risen from £23.1 million in 2011-12 to £73.5 million in 2017-18, and now accounts for 90% of expenditure on locum doctors. The report added that most Trusts are also increasingly reliant on non-contracted agencies, which often charge the highest rates. In 2017-18, £21.3 million (29% of the total agency spend) was paid to non-contracted agencies.

“Efforts taken to reduce this dependency have had very limited success,” Donnelly said. “To help ensure that patients’ needs are best met and provide better value for money, it is now imperative that the Department and Trusts collectively progress the transformation agenda and formulate strategies for delivering a suitably resourced and sustainable medical workforce.”

The report on locum doctors by the Audit Office was part of a wider review into soaring costs in relation to locum doctors and clinical negligence claims which the office said is putting Northern Ireland’s health system under serious financial pressure.