Audit identifies substantial spend on non-framework agency doctor suppliers 

There was significant spending on medical agency staff with non-framework suppliers, according to a HSE audit conducted in 2022.

The objective of the audit was to assess the HSE’s level of compliance with the terms of a 2017 multi-supplier framework agreement and subsequent agreements for the provision of temporary agency medical staff.

Another objective was to identify the extent to which non-framework agencies were utilised, the reasons for such use, and the effectiveness of controls over these agencies.

In relation to the Hospital Groups analysed, 89 per cent (€55.2 million) of the €62.5 million total spend on agency doctors in 2022 was with framework suppliers.

Two Hospital Groups – Children’s Health Ireland and RCSI Hospital Group – failed to supply details to HSE Internal Audit to enable review.

For the nine Community Healthcare Organisations audited, only 55 per cent (€20.7 million) of the €37 million total spend was with suppliers listed on the framework.

“The low spend identified with two of the five framework suppliers would indicate an inability to supply the necessary resources, in turn leading to widespread usage of non-framework suppliers across all areas,” according to the HSE internal audit activity report for the third quarter of 2023.

The report was presented to the audit and risk committee in November and was obtained by the Medical Independent (MI) through Freedom of Information law.

The activity report underlined how the use of non-framework suppliers on terms not covered by the framework agreement may result in value for money not being achieved by the HSE.

“Use of non-framework agencies has been observed by Internal Audit to lead to issues, such as not having contracts in place with them, and/or contractual obligations which apply to the framework agencies not being applied to non-framework agencies (eg, medical clearance and vetting of agency staff),” according to the report.

When asked by MI how the HSE responded to the issues identified in the audit, a spokesperson said HSE Procurement recently ran a new tender for the provision of short-term agency doctors, which came into effect on 15 December 2023.

“The revised strategy within the new tender sought to address the issues raised in the audit, which the HSE was already aware of, by increasing the number of contracted agencies on the agreements to maximise access to available doctors,” according to the spokesperson.