The issue of locum GPs can be controversial. Some people think locums are taking advantage of the NHS to enjoy unfairly inflated pay. On the other hand, some argue that locum work comes with (broadly unacknowledged) challenges and stress, that it’s hardly an easy path.
Working closely with GP surgeries as we do, we can say that locums form an integral part of primary care, so we want to address the controversy, assess the stigma that we know is unfair, and explain why locums are so important to general practice.
The locum stigma
It’s not only in the media that locums face stigma. A paper in the journal ‘Sociology of Health and Illness’ gathered data and interviews on ‘Professional identity and temporary workers in the medical profession’. One locum interviewee reported:
“…you are treated with suspicion. You’re slightly policed. I think they look at your outcomes more scrupulously. It doesn’t feel good. Sometimes… you can see how you might feel a wee bit got at or a lesser being. It’s not good for morale really, is it? … You don’t feel quite so comfortable in your skin if they’re looking at you as though you’re some kind of numpty.”
The advantages of using locums in general practice
Let’s consider the other perspective. Let’s look at the benefits that locums and locum work can offer.
Locum work improves workforce retention
Locums aren’t NHS employees, but they do perform work for the NHS (among other healthcare providers of course).
If doctors leave their GP practices to start performing locum work exclusively, then formally speaking that is staff turnover. However, even though a locum isn’t formally employed by the health service, their work is still available to the NHS. From that point of view, the NHS has retained the workforce.
That consideration matters, because some doctors simply couldn’t continue to practice if locum work weren’t an option.
“It was making me ill actually…I sort of think back and think, maybe the fact that I've just had a coronary artery bypass grafting has something to do with ten years of extreme stress at work.”
• Locum interviewee, ‘Professional identity and temporary workers in the medical profession’.
Some doctors are extremely stressed, burned out, or even working themselves into poor health. If they only had the opportunity to work full time, employed by a practice, then they would very likely stop practising altogether.
Locum work can help keep waiting times down and maintain positive health outcomes
74% of locums are used to cover long-term vacancies, like sick leave or parental leave.
The way to cover those absent GPs and make sure that the surgery keeps up with demand is to hire a doctor temporarily. It’s obviously not practical to hire a permanent member of staff because that can take a long time, and you’ll have surplus staff when the absent team member returns.
If you also consider the stress of the doctors working full time, that is hardly positive for patients. When doctors’ mental and physical health is poor, it’s not likely that they’ll deliver the best care that they can. That means worse health outcomes, a poorer patient experience, and more complaints from patients.
On the topic of complaints more generally, the data suggests that patient dissatisfaction with locums is no worse than with full-time GPs. The General Medical Council found that 3.6%-3.8% of locum GPs encounter complaints. Non-locum GPs see a 4.9%-5.2% complaint rate (2013-2016).
Locum work diversifies the talent pool for primary care
A permanent, full-time working arrangement doesn’t work for some people. Many people need the flexibility that locum work provides, and it means the system is open to a more diverse pool of healthcare workers.
For example, those who have dependents might need to provide care on an unpredictable schedule, or at times that aren’t compatible with shifts or rotas that they are handed. You can see, for example, in the 30-39 age bracket (statistically the most likely to have young children) across all types of practice 25% of female doctors work as locums, and 20% of men do. Women are still more likely to be the primary caregiver, so more flexible work allows them to practice more, and makes more talent available to GP practices and the profession more generally.
When health services encounter high demand, locum work means primary care practices can access additional talent pools, like doctors of retirement age. 25% of practising male doctors over 70 years old work as locums, and those who have retired can be available on a locum basis if there’s a sudden or unexpected need for doctors.
Locums as a primary care staffing strategy
Considered thoroughly, locums are more than the solution to bridging a time gap between permanent members of staff or filling in for short-notice absences. They are also vital to a long-term staffing strategy, and an important building block of the healthcare system. Every practice needs to be able to call on locums that they know will deliver the best care for their patients.
MCG Healthcare is the leading partner for healthcare providers who need the most exceptional and reliable talent, and for doctors who want to find their perfect role.
If you are a practice manager, get in touch with us to quickly fill your locum positions with dependable, compliant healthcare workers. We will find you the best match, even at short notice.
hello@mcghealthcare.co.uk or call 0330 024 1345.
