Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate he has made of the potential additional annual cost to the public purse of using locum rather than directly employed doctors in the NHS.

In 2020/21, expenditure on agency doctors was £918,879,984 or 6.6% of the substantive spending on doctors that year. Maximum hourly rates for agency staff are governed by NHS England’s price cap which is calculated at 55% above substantive rates. For agency medical consultants, this is £80.61 or £107.47 for unsocial hours, defined as those outside of 7am to 7pm, Monday to Friday and bank holidays. Exceptions exist, including for circumstances concerning patient safety. The suitable rates for extra-contractual working hours are agreed locally. The agency rates include worker pay, holiday pay, National Insurance and pension contributions and an agency fee.

For doctors employed on nationally agreed terms and conditions, the highest hourly pay is for a medical consultant. The hourly basic pay rate based on 40 hours per week for a consultant at the maximum of the pay scale is £57.12 per hour. This does not include enhancements for working unsocial hours or National Insurance and pension contributions. Locum medical staff provide a flexible resource when demand is high or during times of sickness or other absences. We are reducing the cost of flexible staffing through price caps, procurement frameworks, expenditure ceilings and working with National Health Service trusts to develop staff banks.