Taking the Temperature Report |Quarter 4 2017-18

Locum pay per hour decreases and commission rates fall in last quarter

Our latest Taking the Temperature report offers an insight into NHS agency spend across 63 trusts utilising Liaison Workforce’s service and highlights show that the average locum pay per hour decreased and commission rates fell during last quarter.

Figures released in the Q4 2017/18 Taking the Temperature report compare results with the last quarter, as well as by type and region. The analysis in our latest report is based on processed timesheets for 2,800 doctors representing some 489,265 hours worked and £38 million in pay and commission fees.

If we look at the split amongst the trusts up and down the country then 23 clients trusts in the North had a total pay and commission spend of £14m totalling 181,560 hours. The 12 client trusts in the Midlands total pay and commission spend was £8m with total hours of 112,623.  In the South, 28 client trusts spent £15m with total hours of 195,084 in Q4.

Liaison Workforce currently works with 160 agencies supplying staff through our STAFFflow and TempRE workforce services.  Of the 63 trusts using Liaison Workforce services, 47 are acute hospitals and 13 are mental health trusts and three are community trusts.

Our independent support provides NHS trusts and boards with a technology enabled service that offers transparency, guidelines and benchmarking to help them track performance, identify areas of necessary improvement and enable significant movement towards control of agency staffing spend.

Overall, average locum hourly pay and commission rates have fallen and we’re continuing to work with trusts and boards to reduce high expense buying habits and encourage collaborative banks to keep locums working within the system. The management information and data we are able to provide is continuing to give trusts visibility and greater control over pay rates across the four main grades as well as bring down commission rates.

Total hours worked saw a decline across all four grades of ST3, FY2, Consultant and Staff. The largest drop in the number of hours worked was a reduction of almost a fifth (40,822) at Consultant grade falling from 207,963 in Q3 to 167, 141 in Q4.

The predominant reason for bookings continues to be for trust vacancies which fell from 82.3% in Q3 to 75% in Q4 with clashes or gaps in rotas and a marginal increase in bookings due to service pressure following behind at 16.5% and 4.2% respectively. This tells us that demonstrating workforce planning remains a challenge faced by a number of trusts.

Almost two thirds (65.2%) of pay rates overridden during Q4 were due to the need for specialist locums, suggesting a shortage of specially trained staff is forcing trusts to pay higher rates.  In almost a fifth of these cases agencies agreed to lower their commission rates to accommodate these overrides.  With trusts now required to seek chief executive sign off on all total hourly rates exceeding £120 per hour, 8% of locums in our sample were paid overrides during Q4 compared to 5% in Q3.

Across the top ten highest earning locums during Q4, the projected annual cost to the NHS is £3.76m for the equivalent of almost 16 WTEs.  Of these top ten locums, nine have worked consecutively for six months or more, whilst two have been in their posts for more than a year.

Regionally, NHS South West Consultant GM pay and commission rates continue to be the highest at £119 and NHS London the lowest at £110 per hour, compared to a UK average hourly rate of £116. NHS South West also pays the highest ST3 GM pay and commission rates per hour at £83 with NHS South Central paying the lowest hourly rate of £67, set against a UK average of £74.

Hourly pay rates rose in all grades this quarter but hourly commission rates reduced for both consultants and SR3s by -0.1% and -0.6% respectively.

Continued rises in pay rates make tough reading again this quarter but, as our annual Taking the Temperature report shows, it’s promising to see hours booked through agencies declining as bank bookings, at typically lower pay rates, have increased in the year delivering better value for money for the NHS.

Liaison Workforce is currently working with over 25% of English NHS trusts to help better control, manage and reduce the costs of its temporary staffing. The anonymised data in this TTT report is drawn from temporary staffing spend activity from these client trusts.