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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

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