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Gold, incentives and meh

Little evidence that locum GPs pose greater risk to patient safety, study finds

Existing claims that locum GPs present a greater risk of harming patients are unfounded, according to new research.

A study published in the Journal of the Royal Society of Medicine found that there is little evidence that locum doctors, including GPs, have a 'detrimental' impact on patient care delivery.

Researchers from the University of Manchester looked at 42 international papers, including 24 from the UK, on the impact of locum doctors working in various healthcare settings to determine whether this group is more likely to harm patients than permanent doctors. 

Previous reports highlight longstanding and growing concerns about the quality, safety and cost of locum doctors among a range of stakeholders such as policymakers, employers, regulators and professional bodies.

These include locum GPs being less aware of local policies and less familiar with the patient's healthcare history and lacking commitment. 

However, the researchers found there is 'very limited evidence' to support claims that these healthcare professionals deliver lower quality of care than their permanent counterparts. 

They said: 'Overall, there was some limited empirical evidence to suggest that locums may have a detrimental impact on quality and safety.

'This was attributed in part to locum doctors being less likely to be familiar with patients and less aware of local policies and processes, which had a number of consequences, including delays in discharging patients and safety procedures being less likely to be carried out.'

The researchers notes more research is needed to examine the existing differences between the practice and performance of locum and permanent doctors. 

Commenting on the study, BMA sessional GPs committee chair Dr Ben Molyneux said: 'Locum doctors are highly-trained healthcare professionals and undergo the same level, depth, and intensity of training as any permanent doctor.

'In fact, locum doctors often work in a variety of medical disciplines, further broadening their knowledge base and the quality of care they can give to patients.

'Very little research has been done into the quality and safety of locum doctors, as this study suggests, but one thing is clear: doctors will always put the health, wellbeing and most importantly, safety, of their patients first – regardless of whether they are locums or not.'

Lead author Dr Jane Ferguson said: 'There are a number of factors which plausibly may affect the quality and safety of locum practice, many of which are really about the organisations who use locums and the ways in which they are deployed and supported.

'While it is clearly reasonable to expect that locum doctors take personal responsibility for their own professional development, and display the same commitment to the medical profession as other doctors, it seems likely that the quality and safety of locum practice is fundamentally shaped by the organisational context in which they work.'

GPs in North Wales previously warned they were struggling to compete with locum fees offered by NHS-managed practices to try and entice the few numbers of available doctors.

Elsewhere in Scotland, a board meeting report noted that the bill for locum GPs in Shetland in 2018 was responsible for a projected £554,000 - or 12% overspend

Readers' comments (11)

  • Good Job as the vast majority of us at all ages will be doing this godforesaken medical role as locums in the next 5 years.

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  • These articles always imply that locum's are somehow overpaid.... er.. I think you'll find that most GPs are underpaid....... focus on this.... locums are closer to market value. other way still not coming back from Oz to the disaster that is UK General Practice..... even with Profs social prescribing experiment..... wonder why she didnt choose to go to full time to man the barricades in this time of crisis???? We all know the answer to that one....

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  • The headline is misleading, as this is not new research but previous research repackaged.

    Also, research that tells you that grass is blue and the sky green needs more careful examination than the commentators quoted or the Pulse journalist have apparently carried out.

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  • Most GPs are underpaid. Taking on CQC responsibilities, looking and clearing locums blood tests and letters. Not sustainable.

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  • Locums are likely to deliver safe care, but it is likely to cost the NHS more. If locums do not know the patient well, they are more likely to do more tests and make more referrals. Continuity of care is the most cost effective way to deliver health care.

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  • I suspect that locums are not overpaid , but GPs, and Hospital clinicians are grossly underpaid
    30 years ago when I locumed I earned a reasonable amount but partners earned significantly more. Now I suspect a locums sessional rate must be about equal, so years of experience and local knowledge have no value
    I hope HMG doesn't use the study to run the whole service on locums and bank staff!!!

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  • DrRubbishBin

    I'm not going to comment other than to say I'm not going to comment, and I'd like to add after an absolute abomination of a morning clinic in a failing surgery with too many patients and not enough Drs the suggestion that locums are over paid and possibly generally crap (as a locum) has me absolutely fuming and ready to punch someone. Good job i haven't commented then, and i'm not one of the patients booked into your afternoon clinic, because if i was i'd be giving you a gob full even though it's got absolutely nothing to do with you and is not in any way your fault

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  • Lots of evidence that CQC, NHSE, GMC pose greater risk to patient safety and Doctors mental health, no study required

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  • Locums certainly work hard to be at least as safe as permanent staff : what IS harming patients is the management mentality in secondary care that it is OK to have a service run by occasional locum doctors with huge gaps and discontinuity between, such as the majority of mental health services, and several hospital specialties!
    GPs are trying to pick up the pieces!

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  • The main risk to patients is the lack of doctors and nurses and underfunding which is not connected with locums who help underpin a failing service
    If we had lots of clinicians there would be more
    time for navel gazing - sorry I mean research into safety and robust clinical governance

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