Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020

Abstract

Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse. Aim: To identify characteristics, geographical patterns and drivers of GP locum use. Design and setting: Observational study of routine data from general practices in England. Methods: Descriptive analyses of national GP workforce data betwen December 2017-September 2020, to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared to other GP types. We modelled locum FTE using negative binomial regressions and estimated Incidence Rate Ratios (IRRs) for the association between the outcome and practice and population characteristics. Results: In December 2019, locums made up 1,217.9 (3.3%) of 33,996.6 total GP FTE which was fewer than other GP types. Median locum age was 42 years (IQR, 36–51), and the majority were UK qualified (660 of 1,034 total locum FTE), were male (642.6 of 1,178.9 locum FTE), and had long-term employment (834.1 of 1,127.9 total locum FTE). Rurality (IRR=1.250; 95%CI 1.095-1.428), inadequate CQC ratings (IRR=2.108; 95%CI 1.370-3.246) and single-handed practice (IRR=4.611; 95%CI 4.101-5.184), were strong predictors of locum use. There was substantial variation in locum use between regions. Conclusion: GP locum use remained stable over time. Compared to other GPs, locums are younger male GPs, a substantial percentage of whom did not qualify in the UK, who serve underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas.

Use of locum doctors in NHS trusts in England: analysis of routinely collected workforce data 2019–2021

“…Should data on the number of shifts filled by permanent doctors or data on locum FTE become available, this limitation could be addressed. Third, there may also exist variability in locum use between locums of different types (eg, infrequent or long-term locums) or durations apart from the agency/bank categories, which has been observed in general practice 9. Some locums may be employed for several months16 often to cover a vacancy which has not been filled, while others may cover short-term absences such as illness for as little as one or two shifts and we did not have that information.…”

“…The new set of rules for agency staff resulted in a reduction in spending on locum agency doctors from £3.6 billion in 2015/2016 to £2.38 billion in 2019/2020,7 although many hospital trusts have applied for extensions of these price caps to fill their workforce gaps 4. Despite national information on expenditure, little is known about the extent of locum doctors working across NHS trusts, in contrast to general practice where NHS Digital has published workforce data since 2015 8 9. To date, no study has described the scale of locum usage in NHS trusts in England.…”

Improving locum practice in public and Christian Health Association of Malawi hospitals in Malawi

“…It is necessary to maintain accurate records of locum provider assignments, hours worked, and compensation as well as to use data to evaluate locum provider performance and assess the cost-effectiveness of using locum services 4,22 . In conclusion, a well-de ned framework for locum practice in public and CHAM hospitals can help streamline the process of hiring and managing temporary healthcare workers while guaranteeing patient care quality and compliance with relevant regulations.…”

Continuity of care

“…Research in the BJGP showed, against expectations perhaps, that overall locum use in England has changed little in recent years though there was considerable variability in regions. 1 I would be deeply reluctant to attribute any blame to GP colleagues, whether partners, salaried, or locum, for the current crisis in general practice.…”