NHS Ayrshire splash £3m on locums for stroke and elderly service

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A WHISTLEBLOWING medic has called on Scotland’s public spending watchdog to investigate why NHS Ayrshire and Arran has spent £3 million in two years on locum stroke doctors.

The spend includes a single locum consultant, continuously employed since 2016, who is earning £500-550,000 per year – five times a normal consultant’s salary.

Data obtained under freedom of information by experienced stroke specialist, Dr Sukhomoy Das, shows that the locum cost for NHS Ayrshire’s elderly medicine and stroke service over the course of 2017/18 and 2018/19 is vastly higher than any other health board, at £2.96m.

It ranges from zero at NHS Fife and NHS Highland, to £1.17m at NHS Lanarkshire, £887,000 at NHS Grampian, and £774,000 at NHS Greater Glasgow and Clyde.

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Dr Das, who worked at NHS A&A from 2000 to 2009, previously raised safety concerns with management in 2006 in relation to agency locums who he said lacked stroke training and were misdiagnosing patients.

He said he was subsequently bullied and passed over for promotion as a result of this whistleblowing, and eventually quit his job.

The health board insist his concerns were probed at the time and no issues were found.

However, Dr Das says his repeated requests to see any investigation report came to nothing, and he went on to be the only whistleblower from Scotland invited to give evidence to England’s Francis Inquiry – a probe into how a culture of NHS cover-ups can cost patient lives.

Dr Das, who lives in Ochiltree, Ayrshire, said he could have been doing the job of the locum for a fraction of the cost but believes he has been “blacklisted” as a whistleblower.

He said: “I would expect Audit Scotland to scrutinise this. I was a ‘troublemaker’. I challenged them before and they didn’t want me back.

“But by victimising me, they are really victimising the taxpayer – and patients. Locums come and go.”

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In 2011, Dr Das reached an out-of-court settlement for victimisation with NHS A&A after they first failed to shortlist him, then scored him adversely at interview, for a post nearly identical to the one he had previously done for nine years. The post was offered to a junior medic, who turned it down.

The health board was then forced to pay Dr Das a further £8,600 in 2014 when an employment tribunal ruled it had victimised him by dropping a subsequent recruitment drive for a stroke specialist after he emerged as the only shortlisted candidate.

At the time the health board claimed it was instigating a service review with the aim of hiring consultants instead – yet no permanent stroke consultant has ever been hired. It currently has one permanent stroke specialist acting as a consultant.

Dr Das, 54, insists that is the type of role he could fulfil to help cut locum costs. Although not a consultant, he is currently the clinical lead for rehabilitation of major trauma for the East Scotland Trauma Centre, based at Ninewells Hospital in Dundee. Until recently, he also worked as a stroke specialist at Ninewells Hospital and teaches at Dundee Medical School.

He spends his working week living in rental accommodation in Dundee, only returning to the Ayrshire home he shares with his wife and daughter at weekends, and would prefer to work in his own community.

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The situation is all the more baffling since, in a presentation to Audit Scotland in 2015, NHS A&A justified spending £5m – at that time – on locums across the whole health board because Specialty Doctor posts were “difficult to fill”.

“Yet I am a Specialty Doctor who wants to work there and they won’t have me,” said Dr Das. “Instead they use this ‘veil’ that they are seeking consultants, because they know I am not a consultant.”

Dr Das said the unit has a reputation for bullying that deters potential recruits.

He said: “Information filters out among doctors that this is not somewhere you want to go.”

In a statement, Patricia Leiser, NHS A&A’s human resources director, said the department had been highly rated in the recently Stroke Care Audit, and that its current permanent workforce within Care of the Elderly also includes consultant geriatricians, an elderly mental health consultant and trainee doctors.

Ms Leiser added: “We remain short of our substantive consultant geriatrician workforce, and have taken all actions to substantively appoint to our consultant vacancies including participating in international campaigns to recruit to the NHS in Scotland.

“We have taken decisions to secure locum doctors with the relevant knowledge and expertise required to ensure that we continue to provide a safe and effective Care of the Elderly Service to the citizens of Ayrshire and Arran.

“The total cost of this locum provision, across the entire service in 2017/18 and 2018/19 was £1.65million and £1.31million respectively.

“We are fully aware of the cost associated with locum provision, a proportion of which can be offset against our vacancies.

“We are committed to actions to reduce our expenditure on locum provision while balancing this with the provision for high quality services for patients.”

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