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Temporary stand-in staff at hospitals are being paid substantial figures by the NHS, yet they could pose a ‘significant risk’ to patient safety.

Liaison, an organisation that advises the NHS on workforce and finance, revealed one in 30 locum doctors earned £120 an hour – said to be the highest rates since pay caps were introduced for agency staff working in the NHS.

In 86 per cent of cases, staff vacancy was the reason for booking a locum doctor, compared to 1.6 per cent for sickness and 0.5 per cent for maternity and paternity leave.

Locum doctors’ average hourly pay has risen by 6% in 2017, after changes that forced doctors who work through limited companies to pay more tax.

New data revealed to The Independent, also showed rates for specialists were more than double the agreed wage cap as the health service struggles to cope with staff shortages.

In December, the head of the health service’s financial regulator, NHS Improvement, warned it was “wrong from a quality, financial and fairness point of view to pay excessive rates for locums when they are working alongside hardworking permanent staff on NHS terms.”

Liaison said the NHS spent £3.7bn on temporary staff supplied by agencies in 2015-16, and on an average day, there are an estimated 3,500 locums working in England and Wales.

Taj Hassan, president of the Royal College of Emergency Medicine, told The Times A&E departments were being forced to “paper over the cracks, which are very big in some systems”.

NHS Improvement said that one hospital regularly paid a locum doctor £360 an hour – £3,600 for a ten-hour shift. The rate is seven times that earned by the most senior full-time staff doctors and far more than a Government cap on locum pay.

But the NHS claims to have cut more than £600m through its crackdown on fees paid to staffing agencies.

One of the problems that comes a reliance on locums is that when things go wrong, it becomes difficult for the hospital or trust, or for the patient’s lawyers,  to investigate if the locum has since moved away, particularly if they have gone abroad.

Locums are not only expensive and sometimes less experienced than permanent staff, but are often unfamiliar with the local procedures, facilities and specialists.  This could pose a significant safety risk to patients if locums are being asked to use instruments and equipment with which they have no experience, or if they do not appreciate local policies and pathways, particularly in acute and emergency situations”, says Pryers Solicitors’ Partner, Richard Starkie.

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