Agency Staff Draining Anaesthetic Department Budgets, Warn RCoA

Dawn O'Shea

December 03, 2021

The Royal College of Anaesthetists (RCoA) says that the need for agency staff to cover staff shortages arising from chronic workforce gaps and absences due to COVID-19 is draining anaesthetic departments' budgets.

RCoA says departments are being faced with considerable agency bills to meet service demands and is calling for an urgent increase in higher anaesthetic training places to support the recovery of elective activity.

While acknowledging that agency anaesthetists are a useful resource to offer short-term cover, some Clinical Directors for anaesthesia have told the RCA that they have had to spend hundreds of thousands of pounds on agency locums to make up for the workforce shortfall in their departments.

"These staffing gaps endanger emergency cover and can lead to cancellations of more routine procedures at short notice," the RCoA said in a statement.

"Without a plan to fill the current gap of 1400 senior anaesthetists, the elective recovery is in jeopardy, so the College is calling for an increase of 100 higher anaesthetic training places a year over the next 4 years.

"Anaesthetists in higher training have already completed up to 9 years of medical training and, under the supervision of fully qualified staff, provide care for patients needing emergency and planned services, while also gaining the skills they need to contribute to the NHS for many years to come. This will go some way to providing a stable workforce for the future."

The RCoA 2020 Medical Workforce Census Report reported that more than 90% of anaesthetic department in the UK had at least one consultant vacancy. In total, there were 680 vacant consultant posts and 243 vacant SAS doctor posts across the country. There were 380 consultant locums and 100 SAS doctor locums.

One clinical director told the College that their department had one agency locum working 4 days a week for about a year and estimated that the agency bill for this one locum for one year amount to about £316,800.

Another department had incurred an estimated cost of £733,920 for locum consultant cover 417 days from April 2020 to August 2021.

Commenting on the current crisis, Dr Fiona Donald, RCoA President, said: "The NHS workforce is at a critical junction, with numerous staff leaving or retiring and higher training places not available to many, hospitals often have no other option than to employ expensive locums as a temporary fix. However, papering over the capacity cracks with costly short-term staff is not the answer and will ultimately be to the detriment of the NHS’s sustainability, and their bottom line.

"We have to remember that this isn't just about dealing with the immediate backlog of operations, it’s also about building back a better NHS. With so many anaesthetists in training eager and qualified to apply for higher anaesthetic places it is simply not logical for the government to delay the investment we are calling for, especially when Clinical Directors are telling us they are spending upwards of £300,000 for just one locum. An extra 400 training places over 4 years could go a long way, not only to reducing agency staff costs, but to also providing additional capacity, now and in the years to come.

"The Secretary of State said last week that he is serious about tackling the elective waiting list and recovering the NHS. We are saying that his plans must include investment in the anaesthetic workforce.

"With anaesthetic services so critical to the recovery and the future of the NHS, anything less than what we are calling for will harm the building back of healthcare services and ultimately cost the government significantly more money," Dr Donald said.

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