New Medical and Dental Agency Framework launched
Date published:
The Health Minister today welcomed the launch of a new Agency Framework for Medical and Dental locum staff.
This follows the introduction of the Nursing, Midwifery and Support Workers Framework in May 2023.
Commenting Health Minister Mike Nesbitt said: “My predecessor, Robin Swann established the HSC Regional Agency Reduction Implementation Group (ARIG) in March 2020 and today represents another very significant step in our continuing efforts to reduce the use of agency/locum staffing.
“We expect that this new Medical and Dental Agency Framework will very significantly reduce the number of doctors supplied by off framework suppliers and paid at off framework rates.
“Similar to the approach for the registered Nursing, Midwifery and Support Workers Framework, a “price cap” has been introduced for the first time into the Medical and Dental framework. This should enable Trusts to secure better value and reduce locum spend. It is anticipated that it will also support stabilisation of the medical workforce through some doctors taking up substantive posts with Trusts.
Workforce stabilisation is the core purpose of the work being taken forward across HSC to reduce the use of and expenditure on Medical and Dental Locums. This will bring with it significant additional benefits in terms of improved governance and quality of care, financial sustainability, increased morale in teams and improvements in operational performance.
The first actions of the ARIG naturally focused on the use of nursing and midwifery agency staffing as this was by far the largest area of expenditure. In addition to a new agency nursing and midwifery framework, the cessation of the use of off-contract agency for that professional group, further investment in and recruitment of the core HSC nursing/midwifery workforce and ongoing work to reform and modernise the HSC Nursing bank, has seen total spend for registered nurses and midwives reduce by 22.3% between 2022/23 and 2024/25 and the near total elimination of off-contract agency use.
In addition to the success in Nursing, there has also been significant progress across other professions. In Spring 2023, the Chief Social Worker and Executive Directors of Social Work agreed that they would no longer utilise any social work agency within HSC organisations. Off framework agency utilisation ceased on 31 March 2023 and the remaining agency usage in social work ceased entirely on 30 June 2023. In the period 2022/23 to 2024/25 there has also been a 9% reduction in admin and clerical agency and a 7% reduction is support services agency spend.
Commenting the Minister said: “Tackling the high levels of use and the associated costs of Agency staffing is a complex and challenging piece of work. I am encouraged by the fact that Trusts have worked collaboratively across HSC to address this problem and welcome the progress made to date in reducing our agency spend on Nursing and other staff groups and completely eliminating our use of agency staffing in Social Work.”
Notes to editors:
1. Introduction of a new Medical and Dental Agency Framework alone will not deliver the workforce stabilisation or the financial savings that HSC is targeting. In addition to the new Framework and the work being progressed in relation to other professions, a M&D Agency Reduction Group, co-chaired by Neil Guckian and Professor Lourda Geoghegan, Deputy CMO has developed a comprehensive action plan with 16 individual workstreams that will be progressed over the next 12 months to compliment the new framework and underpin the objective of reducing the use of and expenditure on medical and dental locums across the HSC.
This work includes:
- establishing new rates for E-locums (rates paid for additional locum shifts to our core HSC workforce) recognising, that competitive E-Locum rates, sitting alongside the new M&D framework, are an important component of the solution to reducing reliance on outside agency locums across HSC and will hopefully see temporary shifts filled by HSC staff rather than Agency staff;
- reviewing vulnerable specialties and considering steps to support stabilisation of these services and giving consideration to telemedicine, digital innovation to support regional working and the development of regional rather than individual Trust cover for particular advisory specialties;
- reviewing our medical workforce and looking ahead to identify key areas of risk to identify the numbers of doctors required in each of the specialist training programmes to develop the medical workforce or the future and reviewing our historic allocations of doctors in training across the region to reduce the reliance on resident doctor locums across Trusts.
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