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 doubled in recent years, and there are concerns about the quality and safety of locum practice and the way NHS organisations use locum doctors.

A group of doctors in scrubs walking along a corridor

There is little empirical evidence on differences in practice or in the quality and safety of care as very little research has been done about locum doctors, so we don’t really know whether or why there are differences in the quality and safety of care between locum and permanent doctors. It is clear that a better understanding of the quality and safety of locum doctors working in the NHS is needed, and could help to find ways to improve the working arrangements for locum doctors and the quality and safety of patient care that they provide.

Our research will find out 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 will compare the work of locum and permanent doctors and survey all NHS organisations and carry out a national survey to explore locum working in both primary and secondary care.

We will be carrying out 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. We are keen to hear from you if you think your organisation would be interested in taking part.

NHS organisations need the flexibility and staffing capacity provided by using locum doctors, and our research will help them to understand how best to use locums, and how to ensure that locum doctors can provide safe, high-quality care.

This research is supported by NHS England and Improvement, Health Education England and the General Medical Council. These organisations are committed to using findings from this research to inform and improve governance and working arrangements for locums.  If you would like to take part, your contributions will help inform future decisions about how locum employment is organised.

Project team

Project Details

  • Funder: National Institute for Health Research Health Services and Delivery Research Programme
  • Duration: April 2020 – April 2022
  • Key Contact: Dr Jane Ferguson 

If you have any questions or queries, please contact

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



Please view the Project FAQs document (Word doc)