Spending on premium-rate overtime by hospitals across the UK has risen by more than a third in the past two years, a freedom of information request has revealed.
Hospitals can pay consultants a higher-than-normal rate for extra shifts. Some hospitals have paid up to £1,000 for four hours’ work, research by the BBC found, while rates of £600 a shift are common – three or four times consultants’ normal rate of pay.
The average amount paid in high-cost overtime last year was £13,356 per consultant. One doctor at Lancashire teaching hospitals NHS foundation trust made £375,000 on top of their salary from the shifts.
Figures from 114 of the 186 trusts and health boards show the amount hospitals spend on high-cost overtime is increasing. In 2015-16, £168m was spent, up from £125m in 2013-14. Not all hospitals pay overtime at higher rates. Wrightington, Wigan and Leigh NHS foundation trust stopped paying premium rates in 2010.
Andrew Foster, the trust’s chief executive, told the BBC: “I don’t think it is very defensible to pay a huge premium to one group of staff and not to other groups of staff.”
Danny Mortimer, chief executive of NHS Employers, conceded that the figures revealed “challenges in some parts of the country” where trusts are “finding it difficult to recruit doctors to certain specialities”.
But speaking on BBC Radio 4’s Today programme he said: “We don’t believe that in every circumstance these extra payments are generated by shortages. Half of doctors receive these additional payments and half don’t. There are doctors who are working regularly at nights and weekends who aren’t attracting the same rates of additional pay.”
Mortimer said the NHS was working on new standardised arrangements for pay and overtime.
He said: “What we need is a system that can be applied fairly across all doctors, that recognises the extra work they do and pays them an overtime rate when they are working nights and weekends, but does that in a way that is consistent and rewards the doctors that work the most onerous working patterns.
“There are situations where there are shortages. But payments are being made in specialities in departments where there are enough doctors. It’s about the system that we apply and the pressure that people are under to try and provide services.”
The British Medical Association (BMA) said the payments were a sign of doctor shortages. Keith Brent, the BMA consultants’ leader, said: “These payments are made because there simply are not enough doctors and hospitals are under pressure to meet waiting time targets.”
The Department of Health said the NHS would have over 11,000 more doctors by 2020. A spokesman said: “Consultants do a vital job and should be properly rewarded, but this analysis shows why we are working with the BMA to replace a unique evening and weekend ‘opt-out’ in the existing contract.
“This will allow us all to promise patients urgent and emergency care of a consistently high standard across the week, and – as the hospitals themselves say – make better use of operating theatres while reducing big overtime bills.”
Hospitals" premium-rate overtime payments soar
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