World-class medical talent is snubbing NHS Tayside, prompting a massive surge in agency costs.
High-level posts including some in childcare have been vacant for years, with the health board unable to secure full-time staff.
As a result, the board’s spending on expensive agency staff has rocketed by 42% and concerns have been raised it could potentially wreck the budget.
If the spending cannot be brought under control, there have been warnings it could impact upon the board’s ability to make £22 million in budget savings.
NHS Tayside has admitted a number of posts have proved “difficult to fill” and some have been empty for up to 24 months.
Director of finance Ian McDonald has admitted there is “concern”, as he told a meeting of NHS Tayside’s finance and resources committee that agency staff are being used to fill vacancies that are proving difficult to fill otherwise.
The health board’s agency staffing levels rose by 12% last year, which resulted in the health board seeing its spending on agency staff rising by 42%.
Mr McDonald said he recognised the impact of hard-to-fill medical posts and nursing roster gaps for theatres and critical care is part of the reason for the high numbers of agency staff. His report detailed the rise in agency costs as £765,000 for nursing staff (104% increase) including pressures in theatres and clinical care, as well as £391,000 for medical staff (22% increased) from April 2013 to December 2014.
As well as the spiralling costs of agency staff, concern has also been raised around increased drug trials and a huge backlog of staffing payments.
The meeting also learned of a £695,000 overspend in prescribing medicines, which was largely attributed to “cost pressures”.
Mr McDonald gave his financial update at a time when the health board is expected to make efficiency savings of £22m in the year 2014/15. The committee heard the level of efficiency savings currently stands at £19.6m.
In a joint report, the director of finance said the financial situation is “challenging”. He said: “Delivering a break-even position for 2014/15 at this time recognises some significant challenges.
“Contributing factors are the early forecast costs of unsocial hours at £4.5m, as well as spend patterns on hepatitis C medicines which are predicted to be in excess of £1.2m above the earmarked level.”
Jenny Marra MSP, Scottish Labour’s shadow cabinet secretary for health, said: “The SNP needs to look at staffing problems in NHS Tayside and across the country quickly.
“The Government is forking out far too much money on agency staff when it makes much more economic sense to solve the recruitment problem and have contracted staff paid directly from our health service.”
A spokesperson for NHS Tayside said: “Additional bank and agency staffing provide NHS Tayside with a valuable resource so we can cover planned gaps in our staffing such as annual leave and unavoidable occurrences where there are sudden, unexpected vacancies.
“This ensures we can continue to deliver effective patient care and treatment, as bank nurses and agency staff are equipped with the competencies and skills to deliver health services wherever we need to deploy them.
“NHS Tayside, like all other health boards, has experienced difficulty in recruiting to certain specialities, such as psychiatry, anaesthetics and neurosurgery, due to a national shortage in these areas.”
Perth councillor Alexander Stewart said: “NHS Tayside spent just under £10m last year on recruiting temporary staff to cover shifts.
“Perth Royal Infirmary and cottage and community hospitals in rural Perthshire were affected by these pressures and this is unsustainable.
“These pressures may result in the loss of facilities and services to communities across Perthshire. Therefore it is important that staff are given a fair deal and supported.”