Locum doctor conditions are ‘putting sick at risk’
THE way that many stand-in doctors are expected to work in the NHS can pose a risk to patient safety, a study suggests.
The locums, used to fill staffing gaps, said they faced unfamiliar environments, “sometimes with minimal induction and varying levels of support”.
The study’s authors said a lack of familiarity may “be beneficial” as locums can offer fresh perspectives on treatment, management or the culture of organisations – but doctors could also be “stigmatised, marginalised and excluded” by permanent staff.
Some locums felt they were more likely to be made a scapegoat if things went wrong, describing “defensive practices” such as avoiding making high-risk decisions as well as ordering extra tests or referrals.
The authors said the stand-ins recognised that having an NHS run by locums was detrimental and many avoided working for organisations that were “locum dependant”. The authors added in the journal BMJ Quality and Safety: “Our findings show the way in which doctors who worked on a temporary basis were integrated into organisations posed some significant challenges and opportunities for patient safety and quality of care.
“Our findings are a call to action for organisations to take stock of how they engage, support and work with locums, and asks both locums and organisations to reflect on whether their practices support a collective approach to patient safety and quality of care.”
Professor Richard Lilford of the University of Birmingham’s Institute of Applied Health Research said the study suggests locum arrangements “are unkind and unfair, and potentially harmful to patient safety”.
Challenges
The authors interviewed 88 people including locum doctors and agencies as well as permanently employed medics plus patients.
Meanwhile a study by University of Surrey academics in the journal BMJ Open warned that the challenges of retaining skilled staff amid high turnover, early retirements and rising care demands “may jeopardise NHS future functioning”. NHS England was approached for comment.