Locum doctors in English general practices: evidence from a national survey.
general practice
locum doctors
national survey
patient safety
quality of care
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
19
01
2023
accepted:
16
05
2023
medline:
4
9
2023
pubmed:
22
8
2023
entrez:
21
8
2023
Statut:
epublish
Résumé
Locum doctors give practices flexibility to deliver patient services but there are concerns about the impact of locum working on continuity of care, patient safety, team function, and cost. To explore locum working in English general practices, and understand why and where locum doctors were needed and how they were engaged, supported, perceived, and managed. An online survey was sent to 3745 practices. Quantitative responses were analysed using frequency tables, In total, 605 (16.2%) responses were returned between June and December 2021. Practices made frequent use of locums, preferring regular locums familiar with processes and patients. Disadvantages of agency locums included cost, lack of patient familiarity, and impact on continuity of care. Care provided by locums was generally viewed as the same but sometimes worse compared with permanent GPs. Some practices reported that locums did not always perform the full range of duties, resulting in increased workload for other staff. Practices were largely unfamiliar with national guidance for organisations engaging locums, and, although processes such as verifying documentation were conducted, far fewer responders reported providing feedback, support for revalidation, or professional development. Locum working is an essential part of English general practice, but this research raises some concerns about the robustness of arrangements for locum working and the impact on quality and safety of care. Further research is needed about the clinical practice and performance of locums, and to explore how locum working can be organised in ways that assure safe and high-quality care.
Sections du résumé
BACKGROUND
Locum doctors give practices flexibility to deliver patient services but there are concerns about the impact of locum working on continuity of care, patient safety, team function, and cost.
AIM
To explore locum working in English general practices, and understand why and where locum doctors were needed and how they were engaged, supported, perceived, and managed.
DESIGN AND SETTING
An online survey was sent to 3745 practices.
METHOD
Quantitative responses were analysed using frequency tables,
RESULTS
In total, 605 (16.2%) responses were returned between June and December 2021. Practices made frequent use of locums, preferring regular locums familiar with processes and patients. Disadvantages of agency locums included cost, lack of patient familiarity, and impact on continuity of care. Care provided by locums was generally viewed as the same but sometimes worse compared with permanent GPs. Some practices reported that locums did not always perform the full range of duties, resulting in increased workload for other staff. Practices were largely unfamiliar with national guidance for organisations engaging locums, and, although processes such as verifying documentation were conducted, far fewer responders reported providing feedback, support for revalidation, or professional development.
CONCLUSION
Locum working is an essential part of English general practice, but this research raises some concerns about the robustness of arrangements for locum working and the impact on quality and safety of care. Further research is needed about the clinical practice and performance of locums, and to explore how locum working can be organised in ways that assure safe and high-quality care.
Identifiants
pubmed: 37604697
pii: BJGP.2023.0039
doi: 10.3399/BJGP.2023.0039
pmc: PMC10471140
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e667-e676Informations de copyright
© The Authors.
Références
J Occup Health Psychol. 2017 Jul;22(3):273-285
pubmed: 27732008
BMJ Open. 2023 Feb 22;13(2):e061531
pubmed: 36813497
Br J Gen Pract. 2016 Aug;66(649):396-7
pubmed: 27481958
BMC Med Res Methodol. 2011 Sep 05;11:126
pubmed: 21888678
Br J Gen Pract. 2022 Jan 27;72(715):e148-e160
pubmed: 34844920
J R Soc Med. 2019 Nov;112(11):462-471
pubmed: 31710823
Br J Gen Pract. 2019 Dec 26;70(690):e64-e70
pubmed: 31594773
BMJ. 2016 Nov 24;355:i6207
pubmed: 27884887
Br J Gen Pract. 2020 Aug 27;70(698):e676-e683
pubmed: 32784221
Br J Gen Pract. 1999 Jul;49(444):519-21
pubmed: 10621983
Br J Gen Pract. 2021 May 27;71(707):e432-e440
pubmed: 33947666
Br J Gen Pract. 2018 Jun;68(671):e420-e426
pubmed: 29739778
Br J Gen Pract. 2022 Apr 28;72(718):204-205
pubmed: 35483948
Med Educ. 2021 Sep;55(9):995-1010
pubmed: 33772829
J Med Internet Res. 2004 Sep 29;6(3):e34
pubmed: 15471760
J Interprof Care. 2020 May-Jun;34(3):324-331
pubmed: 31390903
Sociol Health Illn. 2021 Jan;43(1):149-166
pubmed: 33112436
Br J Gen Pract. 2022 Jan 27;72(715):e118-e127
pubmed: 34990397
BMJ. 2022 Jun 14;377:o1458
pubmed: 35700985
Br J Gen Pract. 2022 Jan 27;72(715):e108-e117
pubmed: 34990386
BMJ. 2021 Jun 8;373:n1461
pubmed: 34103332