The use of locum doctors in the NHS: understanding and improving the safety and quality of care
The numbers of doctors working in temporary positions (known as locums) in the NHS has increased in recent years, and there have been concerns about the quality and safety of locum practice and the way NHS organisations use locum doctors. Our research provides important new information on these issues.
Our research, funded by the National Institute of Health Research and undertaken during 2020-22, examined where locum doctors work in the NHS in England, what kinds of work they do, and how the use of locum doctors is organised. We compared the work of locum and permanent doctors and carried out national surveys to explore locum working in both primary care and in NHS trusts.
We also used detailed case studies in a number of primary and secondary care organisations to explore how the use of locum doctors may affect patient safety and the quality of care, and what NHS organisations can do to try to ensure safe, high-quality care for patients.
NHS organisations need the flexibility and staffing capacity provided by using locum doctors, and our research can help them to understand how best to use locums, and how to ensure that locum doctors can provide safe, high-quality care. The research was supported by NHS England, Health Education England the General Medical Council and other stakeholders.
Publications and reports
Journal articles
- The quality and safety of locum doctors: a narrative review (Ferguson, J. & Walshe, K., Nov 2019, In: Journal of the Royal Society of Medicine. 112, 11, p. 462-471 10)
- ‘You're just a locum’: professional identity and temporary workers in the medical profession (Ferguson, J., Tazzyman, A., Walshe, K., Bryce, M., Boyd, A., Archer, J., Price, T. & TredinnickâRowe, J., 28 Oct 2020, In: Sociology of Health & Illness. 43, 1, p. 149-166)
- Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020 (Grigoroglou, C., Walshe, K., Kontopantelis, E., Ferguson, J., Stringer, G., Ashcroft, D. M. & Allen, T., 27 Jan 2022, In: The British journal of general practice : the journal of the Royal College of General Practitioners. 72, 715, p. 108-117)
- The use of locum doctors in NHS trusts in England: analysis of routinely collected workforce data 2019 – 2021 (Grigoroglou, C., Walshe, K., Kontopantelis, E., Ferguson, J., Stringer, G. & Ashcroft, D., 25 May 2023, In: BMJ Open)
- Locum doctors in English general practices: evidence from a national survey (Stringer, G., Ferguson, J., Walshe, K., Grigoroglou, C., Allen, T., Kontopantelis, E. & Ashcroft, D., 6 Jul 2023, In: British Journal of General Practice)
- The use of locum doctors in the NHS – results of a national survey of NHS Trusts in England (Stringer, G., Ferguson, J., Walshe, K., Grigoroglou, C., Allen, T., Kontopantelis, E. & Ashcroft, D., 23 Aug 2023, In: BMC Health Services Research)
Reports and media
- Locum doctors in the NHS: Understanding and improving the quality and safety of healthcare (policy report)
- The use of locum doctors in the NHS: Key findings from a national survey of NHS Trusts in England
- The use of locum doctors in the NHS: Key findings from a national survey of general practices in England
- BJGP Interviews podcast episode 057: Locum use in England has remained stable in recent years (Prof K. Walshe and Dr C. Grigorolou)
Project team
- Professor Kieran Walshe (PI)
- Dr Jane Ferguson (CoI)
- Dr Thomas Allen (CoI)
- Professor Evan Kontopantelis (CoI)
- Professor Darren Ashcroft (CoI)
- Gemma Stringer (Research Associate)
Project Details
- Funder: National Institute for Health Research Health Services and Delivery Research Programme
- Duration: April 2020 – December 2022
- Key Contact: Dr Jane Ferguson
If you have any questions or queries, please contact jane.ferguson@manchester.ac.uk
Project Advisory Group
- Dr Yasmin Khan, Medical Director - System Improvement and Professional Standards, Responsible Officer (Yorkshire and the Humber), NHS England and NHS Improvement (North East and Yorkshire) and Project Advisory Group Chair
- Dr Arthur Allison, Responsible Officer and Locum Doctor
- Dr Kofi Asante, Locum Doctor
- Professor Philip Kalra, Principal Clinical Research Lead, Salford Royal
- Dr Ray Field, Regional Medical Revalidation Lead at NHS England
- Ailsa Donnelly, Patient and Public Involvement Project Chair
- Professor Sheona Macleod, Acting Director of Education and Quality and Executive Medical Director, Health Education England
- Irfan Suleman, Head of Commercial Strategy at NHS England and NHS Improvement
- Professor Justin Waring, Professor of Medical Sociology & Healthcare Organisation
- Dr Ben Molyneux, Chair, Sessional General Practitioners Committee, British Medical Association, Vice Chair City & Hackney Local Medical Committee, Clinical Lead, Unplanned Care Board City & Hackney
- Dr Sally Pearson, Responsible Officer and HPAN Lead at NHS Resolution
FAQs
Please view the Project FAQs document (Word doc)