Reliance on Locum GPs Linked to ‘Unacceptable’ Care Variation

According to information released by the British Medical Association (BMA), many less affluent areas of the country now experience significant difficulty in recruiting permanent GPs in some of their most at-need locations, forcing them to rely on Locum – or temporary – doctors.

This reliance on locum GPs could be linked to an “unacceptable” level of care variation and may, in some cases, increase the potential for clinical negligence or late / misdiagnosis.

18% of GPs are Locum Doctors

According to data originally collected by the Health and Social Care Information Centre, some areas of the UK now staff as much as 18% of their GP roster with Locum doctors, compared to a national average of 3.4%. Those areas with the highest rates of locum doctors were Bradford City (18.1%), Sandwell and West Birmingham (11.8%), Barking and Dagenham (9%) and North Manchester (6.4%). Bradford City’s clinical chair, Dr Akram Khan, indicated that there have even been occasions where some practices were entirely staffed by locum doctors. Even some more affluent areas such as North East Hampshire and Farnham (4.1%) and Windsor, Ascot and Maidenhead (3.9%) were observed to have exceeded the national average, indicating that this is not an isolated problem. Overall, the BMA’s report indicates that as of September 2015, there were 1,321 locum GPs working in practices across England. All of this is of concern as, according to Dr Richard Vautrey; deputy chair of the BMA General Practitioners Committee:

“There is a real risk of a variation in care quality between areas and that is unacceptable… If practices are reliant on using locum doctors then patients don’t get the continuity of care that they would otherwise get from a full time GP.”

Essentially, if doctors are not permanently assigned to a community or set of patients, they cannot be expected to become as familiar with the symptoms and complaints presented to them from regular patients. This means they may be less likely to recognise abnormal trends or developments in a patient’s health, potentially increasing the risk of misdiagnosis and delaying diagnosis of the correct condition.

NHS Recruitment Crisis Cause of Care Variation

Doctors in those regions with the highest rates of locums indicate that a recruitment crisis in the NHS is to blame for the variance in care across surgeries / practices, with many prospective GPs perturbed by socioeconomic problems associated with particularly deprived areas. Nonetheless, until NHS England can make good on its plans to invest in these areas and tackle the problem, some of the UK’s most at risk-patients will continue to face the prospect of variable care delivered by unfamiliar GPs.

Our Thoughts on NHS Recruitment Issues

Commenting on the news, Jason Brady, clinical negligence solicitor at Blackwater Law said:

“Whilst locum doctors may be just as experienced as their full time counterparts, they will not have the tacit knowledge of a patient’s health and welfare that a full time GP, who has seen the same patient several times, would have. Of course, GP practices have records of patients’ health but these may be brief or lack substance. It may be difficult for a locum doctor to fully grasp a patients full medical background from a file, particularly if they do not have time to study this prior to an appointment. Ultimately, this may impact on the quality care and advice delivered.”