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GP practices employing ‘as many locums as ever’ despite employment crisis

GP practices employing ‘as many locums as ever’ despite employment crisis

GP practices are in no way ‘cutting back’ on employing locums despite reports of a scarcity of work, according to the National Association of Sessional GPs (NASGP).

NASGP chair Dr Richard Fieldhouse told Pulse that locums are ‘still being booked at ever-increasing rates’ and practices are ‘using just as many locums’ as ever. 

He said that the reports around locum GPs struggling to find work is more likely caused by an increase in the number of locum GPs.

It comes after BMA’s England GP committee chair Dr Katie Bramall-Stainer said general practice has gone from a recruitment to an employment crisis, with younger colleagues concerned about being ‘frozen out’ of locum roles.

She also said some practices were ‘forced’ into choosing Additional Roles Reimbursement Scheme (ARRS) roles because their funding has been ‘squeezed’.  

But Dr Fieldhouse, whose membership body developed LocumDeck to help locums book work, said January was a ‘record month for bookings’ on the platform, with December ‘not far behind’. 

‘The practices are using just as many locums as they’ve ever done. They are not in any way cutting back on the number of locums, it’s that the number of people working as locums has increased,’ he told Pulse.

The NASGP estimates there are around 21,100 licensed GPs in England who are not partners or salaried GPs, which represents a 30% increase – around 5,000 – on figures from five years ago, which they say suggests more GPs taking on locum shifts.

The latest full NHS England figures on GP workforce, which are based on practices recording shifts, found that in October 2023 there were around 4,000 locums who had worked in practices either regularly or taking on ad hoc shifts.

In November, a Pulse survey revealed that around half of GP locums have seen a decrease in their sessions worked over the past year due to a lack of work available. 

GP partners responding to the Pulse survey said the cost of living has meant they cannot afford to pay locum rates. 

Dr Fieldhouse said affordability of locums has always been an issue for practices, but this has not become any more pronounced over recent months, and added that this is a ‘different perspective’ to reports from GP leaders.

He said that demand for locum shifts is so high that some practice managers have stopped posting to WhatsApp to fill shifts because they become ‘inundated’ with responses, whereas in the past they would receive ‘hardly any’ replies. 

‘Practices have always, always looked at me in the face and said “we can’t afford locums”. But then they still book them. And we do know that practices are effectively much poorer than they used to be, but we can see from the platform that locums are still being booked at ever-increasing rates,’ Dr Fieldhouse told Pulse. 

He did however suggest that practices are experiencing issues with estates and that when asked why they are not booking locums, some practices say their consulting room space is being used up by phlebotomists or physiotherapists. 

‘They want to book the locum, they can afford to book the locum. But they’ve just got nowhere to put them.’

In October, an agency advised GP locums to consider reducing their expected hourly rates, in part due to the increase in ARRS staff.

And there have been similar concerns around salaried roles, with one practice in Surrey making three GPs redundant due to ‘new ways of working’, including virtual appointments and the use of ARRS staff.



Please note, only GPs are permitted to add comments to articles

David Church 20 February, 2024 1:57 pm

It is certainly a very complex situation.
Some Practices have definitely reduced locum or salaried GP useage for financial reasons, but this has just been a gradually worsening situation for over 5 years.
Some have been unable to find GPs to employ as sessoinal or locum!
Some locums are fully booked some way in advance, and others are struggling, and there is huge regional variation also.
Some have filled vacancies, and some have lost Partners for various reasons.
One commonality is need for more resources to GP, and less uneccessary work-burden caused by failures to resource other services.

Fox Mulder 20 February, 2024 2:04 pm


Fox Mulder 20 February, 2024 2:05 pm

Richard is clearly living in his own world. Absolute nonsense.

Prometheus Unbound 20 February, 2024 2:16 pm

I am not sure what planet Richard is on. Yes there was a flurry of Xmas holiday locum requests, but that was all.

I work as a locum and talk with other locums and the agencies. ALL the agencies I have spoken to tell me the work has evaporated. I am not getting agency calls for any work outside of the school holiday breaks.

Deborah White 20 February, 2024 2:23 pm

Richard Fieldhouse and the NASGP represent a certain slice of locums organising their work in a certain way – this assessment above is by no means generalisable. As has been said, it is a complex picture. I have worked as a locum for over a decade, and have never used LocumDeck or come across local locum colleagues or PMs who do.

I would be very interested to hear more about the absolute numbers to which Richard Fieldhouse is referring, and how they are distributed geographically.

So the bird flew away 20 February, 2024 2:27 pm

Around here, ARRS roles are taking over the work.
Dr Fieldhouse gets in a plug for his website, as usual. But, according to it, Nasgp membership is about 3000 locum GPs, ie <10% of total locum GPs. So what's he talking out of? Hat or ARRS?

John Graham Munro 20 February, 2024 2:53 pm

The problem has ALWAYS been ——–practices feel they are entitled to a locum for free

Mo Anon 20 February, 2024 3:42 pm

From My own experience and colleagues they are definitely A LOT less locum posts. Most jobs being replaced by ARRS roles.

Deborah Owers 20 February, 2024 3:48 pm

Wrong! I work as a locum in a chambers group. Many of our practices come to us first when they need a locum so I know our sudden drop in bookings since the summer is not due to an excess of new locums joining the force. They have told us it is financial. One of our regular practices had to cancel a pile of advanced bookings which has never happened before.

Rupen Kulkarni 20 February, 2024 5:41 pm

I agree with all the above comments about a lot of Locum work disapperaing into thin air. Most Practices are having to employ PAs , clinical pharmacists under the ARRS and cant afford Locums although there is a dire need. The real issue is, you don’t get the same quality & number of patient consultations in the same time from any other professionals but GPs. The only reason it cant chnage at the moment is, the money ear-marked for ARRS cant be used to employ locums. Therein ise the crunch as money for Locums has been diverted – and done so deliberately. Richard needs to talk to GPs outside the NASGP cocoon.

Fox Mulder 20 February, 2024 6:10 pm

Why are we even comparing ARRS roles such as pharmacists, paramedics and PAs with a GP? None of the above are doctors! You wouldn’t replace pilots with a fake pilot or a pilot ‘associate’ with only 20% of the training would you? & yes GPs are being replaced – ARRS roles are not ‘additional’ in a vast majority of cases.
Finally, are there 21,100 GP vacancies out there to accommodate for these doctors who are effectively unemployed now? You will struggle to find 10% of that figure – the larger cities in the midlands and north are particularly hard hit vs rural/coastal parts – and that’s before even accounting for the record number of new GPs qualifying this summer (c.4,000). Tens of thousands of GPs struggling to find work is unprecedented and yet all we hear is there’s a mass shortage of GPs – a huge distortion of the actual facts and frankly ridiculous.

Nick Mann 20 February, 2024 7:29 pm

Uncannily different perspective from nasgp. A strange one.

Adeyemi Akinlade 20 February, 2024 8:37 pm

I have joined Locum Deck since January and not a single job offer has come . There is a danger of over-generalisation about availability of locum post. Most agencies have said similar things and surgeries has cut down due to finances and lack inclusion of GPs in the ARRS fund. The reality is fewer Locum opportunity is currently available unless something changes about funding.

Burnt out Out 20 February, 2024 8:52 pm


Adil Suleman 21 February, 2024 10:53 am

Dr Fieldhouse is living on another plant.
He clearly has a conflict of interest with running his own locum agency.
All locums I know report a significant reduction in work.
Locum agencies have confirmed taht Practices are using fewer locums.

Finola ONeill 21 February, 2024 3:16 pm

yes; conflict of interest; why are pulse even reporting on his comments; he employs less than 10% locums and has conflict of interest.
not appropriate to ask or quote him.
I’ve done locums for 10 yrs. always had plenty of work locally; now mainly driving 2 hrs either way for shifts. hotels overnight; don’t mind; not got kids so it’s not an issue; waiting for change of govt with career shift under development. don’t care for myself.
care that general practice is collapsing due to this and thus NHS will collapse plus patients getting terrible service because no continuity and in some places can’t see GP only ARRS with substandard service.
Anyway; not our remit. I can look after my friends and relatives and sorry for all the patients out there who are getting a terrible service./ sorry and don’t vote tory ever again; what can I say?
the label was on the tin with these jokers; it’s called a democracy; better than the alternative ie an autocracy but depends on population’s choice of vote

Gary Heron 22 February, 2024 6:56 pm

I think some of these criticisms of Dr Fieldhouse are unfair. Remember that it was Dr Fieldhouse who got locums the NHS pension. Before his advocacy, locum sessions were not superannuated. He is a great advocate for sessional GPs

A B 25 February, 2024 2:37 pm