THE continued widespread use of locum consultants at the Hospital remains a “red” risk, threatening the continuity of care, members of a health board have been told.
At the Health Advisory Board’s December meeting yesterday, members of the board expressed concerns that while locum staff were well-qualified and provided good care, significant progress needed to be made in the recruitment of permanent staff.
The Health Department has been reviewed by the Royal College of Physicians, leading to a series of recommendations which were analysed at the meeting.
In a report presented by Adrian Noon, chief of service medicine, it was stated that “virtually all our ward-based care is provided by locum consultants, who, although they are providing an excellent service, are not invested in the long-term future of the care group and can leave at short notice, causing disruption to rotas and patient care.
“This has been well documented across internal and external reviews and the need to recruit substantively to allow for consultant care to be resilient.”
The report classed the use of locums as having a “high” red risk level.
Board chair Professor Hugo Mascie-Taylor said that consistently good care would not be provided unless permanent members of staff were in place.
While recognising that it would not be possible to recruit new consultants quickly, Prof Mascie-Taylor asked that the board be provided with a clear picture of the extent of the problem in time for its meeting on 25 January.
Julie Garbutt, chief officer at Health until 2018 and newly appointed as a non-executive director of the board, said the issue arose because there were far more specialist consultants, rather than generalists who could cover a wider range of areas.
“There’s been an inability to find a sustainable business model and we won’t be able to respond unless we change the model,” she said. “It will be expensive [to achieve that change], but it would be a major and necessary investment.”
Professor Simon Mackenzie, medical lead for the change team, said that a move back towards more general care would require “quite a major cultural change” that would not be welcomed by everyone in the organisation.
A total of 26 recommendations were made, with eight of these listed as having achieved significant progress and four having been completed.
The report presented to the board concluded: “If the service is not improved, then clinical risk will remain. Failure to address this would leave [Health] vulnerable to reputational and financial risk in the event of proven harm to a patient.”
