This report outlines the findings of follow-up examinations on two key areas within the HSC sector (locum doctors and patient safety) which have previously been the subject of reviews by the Northern Ireland Audit Office (NIAO) and the Public Accounts Committee (PAC). NIAO reported on locum doctors in July 2011 and on patient safety in November 2012, with PAC publishing its reports in March 2012 and February 2013 respectively. Our primary focus is to measure the degree to which key PAC recommendations for improvement have been implemented in practice.
Our review of locum doctors assesses: recent trends in respect of the extent of reliance on locum doctors and expenditure associated with this; the current extent of reliance on agency supplied locums (the most unsuitable form of provision); and the degree to which risks to patient safety associated with the employment of locum doctors are being better managed.
In the area of patient safety, we have reviewed: whether a more open culture of reporting and investigating adverse incidents which create patient safety risks has been established; whether procedures for learning from patient safety incidents have been strengthened and if learning is being disseminated across local hospitals; recent trends for expenditure on clinical negligence claims, and of the length of time taken to settle these cases.