Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020

C. Grigoroglou; K. Walshe; E. Kontopanteli; J. Ferguson; G. Stringer; D. M. Ashcroft; T. Allen

doi:10.3399/BJGP.2021.0311

Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020

C. Grigoroglou^*
, K. Walshe
, E. Kontopanteli
, J. Ferguson
, G. Stringer
, D. M. Ashcroft
, T. Allen

^*Corresponding author for this work

Health Services Management Centre

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

33 Downloads (Pure)

Abstract

Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse.

Aim: To identify characteristics, geographical patterns, and drivers of GP locum use.

Design and setting: Observational study of routine data from general practices in England.

Method: Descriptive analyses of national GP workforce data between December 2017 and September 2020 were conducted to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared with other GP types. Locum full-time equivalent (FTE) was modelled using negative binomial regression and estimated incidence rate ratios (IRRs) for associations between outcome and characteristics of practices and population.

Results: In December 2019, total locum FTE was 1217.9 compared with 33 996.6 for total GP FTE. Locums represented 3.3% of total GP FTE, which was fewer than other GP types. Median locum age was 42 years (interquartile range [IQR] 36 to 51) FTE and the majority were UK qualified (660 of 1034 [63.8%] total locum FTE), were male (642.6 of 1178.9 [54.5%] total locum FTE), and had long-term employment (834.1 of 1127.9 [74.0%]) total locum FTE. Rurality (IRR 1.250 [95% CI = 1.095 to 1.428]), inadequate Care Quality Commission ratings (IRR 2.108 [95% CI = 1.370 to 3.246), and single-handed practice (IRR 4.611 [95% CI = 4.101 to 5.184) were strong predictors of locum use. There was substantial variation in locum use between regions.

Conclusion: GP locum use remained stable over time. Compared with other GPs, locums were younger male GPs, a substantial percentage of whom did not qualify in the UK, and those who served underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas and can provide a greater understanding of general practice workforce challenges in England.

Original language	English
Pages (from-to)	e108-e117
Number of pages	10
Journal	British Journal of General Practice
Volume	72
Issue number	715
Early online date	27 Jan 2022
DOIs	https://doi.org/10.3399/BJGP.2021.0311
Publication status	Published - Feb 2022

Bibliographical note

Funding Information:
This study was funded by the National Institute for Health Research (NIHR) Health Service and Delivery Research programme (project reference number: NIHR128349). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
©The Authors

Keywords

Employment
General practice
GP locums
Health workforce
Numerical data
Regional variation
Statistics

ASJC Scopus subject areas

Family Practice

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Cite this

@article{a5f32824892d4710827edfd8956a0fc5,

title = "Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020",

abstract = "Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse. Aim: To identify characteristics, geographical patterns, and drivers of GP locum use. Design and setting: Observational study of routine data from general practices in England. Method: Descriptive analyses of national GP workforce data between December 2017 and September 2020 were conducted to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared with other GP types. Locum full-time equivalent (FTE) was modelled using negative binomial regression and estimated incidence rate ratios (IRRs) for associations between outcome and characteristics of practices and population. Results: In December 2019, total locum FTE was 1217.9 compared with 33 996.6 for total GP FTE. Locums represented 3.3\% of total GP FTE, which was fewer than other GP types. Median locum age was 42 years (interquartile range [IQR] 36 to 51) FTE and the majority were UK qualified (660 of 1034 [63.8\%] total locum FTE), were male (642.6 of 1178.9 [54.5\%] total locum FTE), and had long-term employment (834.1 of 1127.9 [74.0\%]) total locum FTE. Rurality (IRR 1.250 [95\% CI = 1.095 to 1.428]), inadequate Care Quality Commission ratings (IRR 2.108 [95\% CI = 1.370 to 3.246), and single-handed practice (IRR 4.611 [95\% CI = 4.101 to 5.184) were strong predictors of locum use. There was substantial variation in locum use between regions. Conclusion: GP locum use remained stable over time. Compared with other GPs, locums were younger male GPs, a substantial percentage of whom did not qualify in the UK, and those who served underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas and can provide a greater understanding of general practice workforce challenges in England.",

keywords = "Employment, General practice, GP locums, Health workforce, Numerical data, Regional variation, Statistics",

author = "C. Grigoroglou and K. Walshe and E. Kontopanteli and J. Ferguson and G. Stringer and Ashcroft, \{D. M.\} and T. Allen",

note = "Funding Information: This study was funded by the National Institute for Health Research (NIHR) Health Service and Delivery Research programme (project reference number: NIHR128349). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: {\textcopyright}The Authors",

year = "2022",

month = feb,

doi = "10.3399/BJGP.2021.0311",

language = "English",

volume = "72",

pages = "e108--e117",

journal = "British Journal of General Practice",

issn = "0960-1643",

publisher = "Royal College of General Practitioners",

number = "715",

}

TY - JOUR

T1 - Locum doctor use in English general practice

T2 - analysis of routinely collected workforce data 2017–2020

AU - Grigoroglou, C.

AU - Walshe, K.

AU - Kontopanteli, E.

AU - Ferguson, J.

AU - Stringer, G.

AU - Ashcroft, D. M.

AU - Allen, T.

N1 - Funding Information: This study was funded by the National Institute for Health Research (NIHR) Health Service and Delivery Research programme (project reference number: NIHR128349). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: ©The Authors

PY - 2022/2

Y1 - 2022/2

N2 - Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse. Aim: To identify characteristics, geographical patterns, and drivers of GP locum use. Design and setting: Observational study of routine data from general practices in England. Method: Descriptive analyses of national GP workforce data between December 2017 and September 2020 were conducted to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared with other GP types. Locum full-time equivalent (FTE) was modelled using negative binomial regression and estimated incidence rate ratios (IRRs) for associations between outcome and characteristics of practices and population. Results: In December 2019, total locum FTE was 1217.9 compared with 33 996.6 for total GP FTE. Locums represented 3.3% of total GP FTE, which was fewer than other GP types. Median locum age was 42 years (interquartile range [IQR] 36 to 51) FTE and the majority were UK qualified (660 of 1034 [63.8%] total locum FTE), were male (642.6 of 1178.9 [54.5%] total locum FTE), and had long-term employment (834.1 of 1127.9 [74.0%]) total locum FTE. Rurality (IRR 1.250 [95% CI = 1.095 to 1.428]), inadequate Care Quality Commission ratings (IRR 2.108 [95% CI = 1.370 to 3.246), and single-handed practice (IRR 4.611 [95% CI = 4.101 to 5.184) were strong predictors of locum use. There was substantial variation in locum use between regions. Conclusion: GP locum use remained stable over time. Compared with other GPs, locums were younger male GPs, a substantial percentage of whom did not qualify in the UK, and those who served underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas and can provide a greater understanding of general practice workforce challenges in England.

AB - Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the scale and scope of the locum workforce in general practice is sparse. Aim: To identify characteristics, geographical patterns, and drivers of GP locum use. Design and setting: Observational study of routine data from general practices in England. Method: Descriptive analyses of national GP workforce data between December 2017 and September 2020 were conducted to determine the volume and geographical distribution of locum use and examine the characteristics of locums compared with other GP types. Locum full-time equivalent (FTE) was modelled using negative binomial regression and estimated incidence rate ratios (IRRs) for associations between outcome and characteristics of practices and population. Results: In December 2019, total locum FTE was 1217.9 compared with 33 996.6 for total GP FTE. Locums represented 3.3% of total GP FTE, which was fewer than other GP types. Median locum age was 42 years (interquartile range [IQR] 36 to 51) FTE and the majority were UK qualified (660 of 1034 [63.8%] total locum FTE), were male (642.6 of 1178.9 [54.5%] total locum FTE), and had long-term employment (834.1 of 1127.9 [74.0%]) total locum FTE. Rurality (IRR 1.250 [95% CI = 1.095 to 1.428]), inadequate Care Quality Commission ratings (IRR 2.108 [95% CI = 1.370 to 3.246), and single-handed practice (IRR 4.611 [95% CI = 4.101 to 5.184) were strong predictors of locum use. There was substantial variation in locum use between regions. Conclusion: GP locum use remained stable over time. Compared with other GPs, locums were younger male GPs, a substantial percentage of whom did not qualify in the UK, and those who served underperforming practices in rural areas. This is likely to reflect recruitment or high turnover challenges in these practices/areas and can provide a greater understanding of general practice workforce challenges in England.

KW - Employment

KW - General practice

KW - GP locums

KW - Health workforce

KW - Numerical data

KW - Regional variation

KW - Statistics

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DO - 10.3399/BJGP.2021.0311

M3 - Article

C2 - 34990386

AN - SCOPUS:85123901267

SN - 0960-1643

VL - 72

SP - e108-e117

JO - British Journal of General Practice

JF - British Journal of General Practice

IS - 715

ER -

Locum doctor use in English general practice: analysis of routinely collected workforce data 2017–2020

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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