Use of locum doctors in NHS trusts in England: Analysis of routinely collected workforce data 2019-2021

Christos Grigoroglou*, Kieran Walshe, Evangelos Kontopantelis, Jane Ferguson, Gemma Stringer, Darren Ashcroft, Thomas Allen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objectives: Temporary doctors, known as locum doctors, play an important role in the delivery of care in the National Health Service (NHS); however, little is known about the extent of locum use in NHS trusts. This study aimed to quantify and describe locum use for all NHS trusts in England in 2019-2021.

Setting: Descriptive analyses of data on locum shifts from all NHS trusts in England in 2019-2021. Weekly data were available for the number of shifts filled by agency and bank staff and the number of shifts requested by each trust. Negative binomial models were used to investigate the association between the proportion of medical staffing provided by locums and NHS trust characteristics.

Results: In 2019, on average 4.4% of total medical staffing was provided by locums, but this varied substantially across trusts (25th-75th centile=2.2%-6.2%). Over time, on average two-thirds of locum shifts were filled by locum agencies and a third by trusts' staff banks. On average, 11.3% of shifts requested were left unfilled. In 2019-2021, the mean number of weekly shifts per trust increased by 19% (175.2-208.6) and the mean number of weekly unfilled shifts per trust increased by 54% (32.7 to 50.4). Trusts rated by the Care Quality Commission (CQC) as inadequate or requiring improvement (incidence rate ratio=1.495; 95% CI 1.191 to 1.877), and smaller trusts had a higher use of locums. Large variability was observed across regions for use of locums, proportion of shifts filled by locum agencies and unfilled shifts.

Conclusions: There were large variations in the demand for and use of locum doctors in NHS trusts. Trusts with poor CQC ratings and smaller trusts appear to use locum doctors more intensively compared with other trust types. Unfilled shifts were at a 3-year high at the end of 2021 suggesting increased demand which may result from growing workforce shortages in NHS trusts.

Original languageEnglish
Article numbere065803
Number of pages9
JournalBMJ open
Volume13
Issue number6
DOIs
Publication statusPublished - 25 May 2023

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).

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.

Keywords

  • Health policy
  • Human resource management
  • Organisation of health services

ASJC Scopus subject areas

  • General Medicine

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