“Staggering” cost of locum psychiatrists

​Figures released through a Freedom of Information request have detailed the exorbitant sum paid to visiting locum psychiatrists, with the annual bill for NHS Western Isles way in excess of many larger health board areas – and at a time when their budgets are facing major pressures.
Health board say the "challenge in terms of the recruitment of psychiatrists is discussed regularly"Health board say the "challenge in terms of the recruitment of psychiatrists is discussed regularly"
Health board say the "challenge in terms of the recruitment of psychiatrists is discussed regularly"

​The FoI was lodged by a mental health campaigner who is concerned by the inadequacies of a service which relies on itinerant professionals.

It comes after a recent industrial tribunal ruled in favour of NHS Western Isles after they dismissed a consultant psychiatrist. The tribunal heard that the national shortage of consultant psychiatrists “puts them in a strong bargaining position”.

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The FoI request was made to each local health board area in Scotland. It shows that for NHS Western Isles they paid £2.7 million in 2023-24, down from £4.7 million the previous year. That is far in excess of Orkney (less than £100,000 a year) and even Highland NHS, with a far larger area and population, at around £2 million a year.

An NHS Western Isles spokesperson said: “The challenge in terms of the recruitment of psychiatrists is discussed regularly at NHS Western Isles Board meetings. There is a national shortage of consultant psychiatrists with around 60 per cent of posts across Scotland currently vacant.

“In terms of local services, there is a requirement to have 24/7 Consultant Psychiatrist provision to cover the Acute Psychiatric Unit at Western Isles Hospital. The minimum rota for this is two Psychiatrists for a 1:2 rota.

"The models in Orkney and Shetland are very different to the model in the Western Isles so are not comparable in terms of provision. Notably, Orkney and Shetland do not have inpatient units.”

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She added: “NHS Western Isles continues to advertise for Psychiatry vacancies and is scheduled to interview prospective candidates in the near future. In the meantime, NHS Western Isles takes every step to ensure that rates are negotiated to ensure the safest and most cost effective option.

Campaigner Peter Todd, who organised the FoI and lives in Thurso, said: “As a patient from the Highlands who attends New Craig's Psychiatric Hosptial in Inverness I'm not in the least bit surprised by these staggering figures.

“For too long those in charge of health boards and the Scottish Government have had scant regard for mental health services which are underfunded and mismanaged, which is part of the reason there is recruitment and retention issues within psychiatry.

“Have those in charge got any idea how traumatic it is having to explain the trauma and abuse they've suffered and witnessed every time they see a different locum psychiatrist?"

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He added: “Whilst NHS boards are being financially crippled by locum costs, patients are being failed, abandoned and re-traumatised by having to see repeated locums.

"All we hear is excuses from those in power, not possible solutions.”