Unified Hospital SMO (and RMO) strategy

Although there is a theoretical standardisation through MECAs, some hospitals/districts are using alternative mechanisms to induce clinicians to come to their region. This occurs in both recruitment of permanent staff, and also attracting locum coverage. This is resulting in an "arms race" where some districts are spending increasing amounts to fill gaps, but resulting in a weaker overall system, and disadvantages those hospitals/districts that are "playing by the rules."

In addition, unofficially increased locum rates that some hospitals/districts are prepared to offfer are an additional inducement to make it feasible to work solely as a locum. It is also makes it more attractive for permanent employees to use their annual leave to work as a locum in another part of Te Whatu Ora. There are then situations where an outside locum is being paid to fill a gap created by a permanent staff member working as a locum elsewhere.

It should be reasonably achievable for Te Whatu Ora to have a unified approach to matters of recruitment, conditions and signing-on offers.

It should also be reasonably achievable to have a clear proposal for managing employees working in one district doing locums in another district. Although not ideal, allowing employees to use their leave to do locums in their own roles would be preferable to shifting to a different work environment. There would be less friction in learning new systems. Over the medium term, it would be ideal to phase out permanent employees doing locums within Te Whatu Ora, as this not utilising annual leave to rest and recover will have knock on effects on staff well-being and health.

At present, disunity across the motu has been a contributing factor to SMO workforce strategies.

Smaller regions that are choosing to stick to the agreed rules are losing out on prospective employees resulting a very stretched and stressed SMO workforce.

The power is substantially in the hands of individuals choosing to make a career as a locum. Shortages and need to fill gaps have resulted in needing to lower standards in assessing which locums will be appointed to fill in critical gaps. 

Additionally, it effects morale of permanent SMO staff that locums (who are often not fully vocationally registered and are not invested in the service) are getting paid substantially more.

Finding locums to back-fill permanent employees doing work as a locum elsewhere is especially disheartening, and highly inefficient.