Locum GP rates ‘linked to deprivation’, British Medical Association warns

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Patients in the most deprived areas of England face poorer levels of care due to an over-reliance on locum GPs, the British Medical Association has warned.

Data analysis by BBC News found in some parts of the country 18% of the GP workforce was made up of locums compared to a national average of 3.4%.

The BMA warned of an unacceptable “variation in care quality”.

NHS England said it planned to recruit an extra 5,000 doctors to work in general practice by 2020.

The data was collected for the first time by the Health and Social Care Information Centre.

It showed in September 2015 there were 1,321 locum GPs working in practices across England.

A locum doctor is defined by the NHS as being a doctor who is standing in for an absent doctor, or temporarily covering a vacancy.

Analysis found Clinical Commissioning Groups in some of the most deprived parts of the country used a higher percentage of locums.

NHS Bradford City – the most deprived CCG area in the country – had the second highest use of locum doctors with 18% of its of GPs being classed as temporary practitioners in September 2015.

Its clinical chair, Dr Akram Khan, says there have been occasions where some GP practices have been entirely staffed by locum doctors.

“There is a recruitment crisis within this profession,” he said.

“Working in an area like Bradford can be difficult as we have a range socio-economic challenges and lots of patients from different ethnic backgrounds.

“We have to remember doctors are effectively working in a market place, they can choose where to work and therefore many choose to work in areas where the demands are less strenuous”.

In comparison to Bradford, nearby NHS Harrogate in North Yorkshire is one of the most affluent CCG areas in the county. The data shows over the same period just 1% of its GPs were classed as locums.

Dr Richard Vautrey the deputy chair of the BMA General Practitioners Committee, says patients in deprived areas face the prospect of receiving an inferior level of care.

“There is a real risk of a variation in care quality between areas and that is unacceptable.

“There are CCGs that struggle to recruit GPs because there aren’t enough doctors to go round. If practices are reliant on using locum doctors then patients don’t get the continuity of care that they would otherwise get from a full time GP.”

Dr Shazia Ahmed, a newly qualified doctor who has chosen to become a locum practitioner, said she did so in order to choose her hours and look after her six-year old son.

“People shouldn’t think we’re a second class of GP though,” she said.

“We’re just as qualified and my main priority is always patient care and given the pressures the NHS is under I would say locum doctors play a vital role in supporting the work full time GPs do”.

Data about the use of locum doctors in Scotland, Wales and Northern Ireland is either not collected or not comparable.

Furthermore, the BBC has excluded from its analysis data provided by CCGs in the NHS England South (South East) region owing to the data set being incomplete.

NHS England say they acknowledge there is a growing issue with the use of locum doctors and have set out a plan to recruit more full time GPs by the year 2020.

Going forward, NHS England says it will spend an extra £206m on boosting GP recruitment, which will see £20,000 bursaries made available in areas that have found it hard to recruit new GPs.

Locum GP rates ‘linked to deprivation’, British Medical Association warns

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