RT Journal Article
SR Electronic
T1 Use of locum doctors in NHS trusts in England: analysis of routinely collected workforce data 2019–2021
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e065803
DO 10.1136/bmjopen-2022-065803
VO 13
IS 6
A1 Christos Grigoroglou
A1 Kieran Walshe
A1 Evangelos Kontopantelis
A1 Jane Ferguson
A1 Gemma Stringer
A1 Darren Ashcroft
A1 Thomas Allen
YR 2023
UL http://bmjopen.bmj.com/content/13/6/e065803.abstract
AB 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.Data may be obtained from a third party and are not publicly available. Data can be obtained from NHS Improvement under a special license and are not freely available.