The use of locum doctors in the NHS: Understanding and improving the safety and quality of care

The numbers of doctors working in temporary positions (known as locums) in the NHS has increased in recent years, and there have been concerns about the quality and safety of locum practice and the way NHS organisations use locum doctors. Our research provides important new information on these issues.

Our research, funded by the National Institute of Health Research and undertaken during 2020-22, examined where locum doctors work in the NHS in England, what kinds of work they do, and how the use of locum doctors is organised. We compared the work of locum and permanent doctors and carried out national surveys to explore locum working in both primary care and in NHS trusts.

We also used detailed case studies in a number of primary and secondary care organisations to explore how the use of locum doctors may affect patient safety and the quality of care, and what NHS organisations can do to try to ensure safe, high-quality care for patients.

NHS organisations need the flexibility and staffing capacity provided by using locum doctors, and our research can help them to understand how best to use locums, and how to ensure that locum doctors can provide safe, high-quality care. The research was supported by NHS England, Health Education England the General Medical Council and other stakeholders.

Project advisory group

Dr Yasmin Khan, Medical Director - System Improvement and Professional Standards, Responsible Officer (Yorkshire and the Humber), NHS England and NHS Improvement (North East and Yorkshire) and Project Advisory Group Chair

Dr Arthur Allison, Responsible Officer and Locum Doctor

Dr Kofi Asante, Locum Doctor
Professor Philip Kalra, Principal Clinical Research Lead, Salford Royal

Dr Ray Field, Regional Medical Revalidation Lead at NHS England
Ailsa Donnelly, Patient and Public Involvement Project Chair

Professor Sheona Macleod, Acting Director of Education and Quality and Executive Medical Director, Health Education England

Irfan Suleman, Head of Commercial Strategy at NHS England and NHS Improvement

Professor Justin Waring, Professor of Medical Sociology & Healthcare Organisation

Dr Ben Molyneux, Chair, Sessional General Practitioners Committee, British Medical Association, Vice Chair City & Hackney Local Medical Committee, Clinical Lead, Unplanned Care Board City & Hackney

Dr Sally Pearson, Responsible Officer and HPAN Lead at NHS Resolution