Most practices have increased use of locum GPs to tackle workload pressures

More than half of GP practices have been forced to increase their use of locums in the past six months to deal with growing workload pressures, a GPonline poll reveals.

(Photo: sturti/Getty Images)
(Photo: sturti/Getty Images)

The survey of 270 GP partners from across the UK found that 26% of practices had significantly increased their use of locums during the previous six months, and a further 27% had somewhat increased the number of locum sessions they booked.

Just 18% of practices said their locum use had decreased, while the remaining 29% said it had remained the same.

The poll comes as the National Association of Sessional GPs (NASGP) said that it had seen a 26% month-on-month increase in locum bookings through its LocumDeck platform, which connects practices with locum GPs, for the last six months in a row.

The findings highlight a marked change in locum GPs' work during the pandemic. During the early months of the pandemic last year many locum GPs had sessions cancelled and faced financial hardship as practices switched to remote consultations and permanent staff cancelled annual leave.

Workload pressures

However, workload in general practice has soared in recent months. RCGP data from the start of June showed that GP practices were delivering more appointments each week compared with 2019 and clinical administrative work had increased by a third. Alongside this rise in demand, practice teams have administered tens of millions of COVID-19 vaccinations since the start of the year.

Meanwhile, the GP workforce is in decline – the number of fully-qualified, full-time equivalent GPs per patient in England dropped by 10% over the past five years, according to data from March.

Partners responding to GPonline's poll indicated that the rise in workload meant that they were becoming increasing reliant on locum GPs and that this would ultimately hit practice profits.

'As workload has increased we no longer have the capacity to just work a bit harder when someone is off, and are using more locums as a result,' one partner said.

Another added: 'Higher workload means more locums are regularly needed, which negatively impacts practice profits.'

'We could not have managed without massive increase in locum use since the pandemic,' one GP said. 'We used to be able to manage with three quarters of normal access when a partner was off. Now patients have such easy access to us the demand is unmanageable.'

Locum in demand

Many partners responding to the poll reported that it was becoming increasingly difficult to secure locum GPs to fill sessions because they were so in demand. Others suggested that locum GPs were becoming unaffordable as rates increased.

'We have been struggling with immense sickness amongst clinical staff and the staff remaining are now on their knees trying to keep everything held together. We have tried to find locums to cover shortfall but seem to have struggled,' one partner said.

'We are short staffed but there aren't any locums to be had. We have been trying to recruit or use locum GPs for the last year, but to no avail. Instead we are losing colleagues who are finding it too busy,' one partner said.

'Locums are so expensive and you can't find any, so there is no choice but to pay top price or you get no break from work,' another GP said.

One GP partner suggested that locum rates needed to be capped because fees were 'extortionate'. They added: 'Experienced partners are taking pay cuts to fund expensive locums'.

Locum GP pay rates

However NASGP chair Dr Richard Fieldhouse said rates charged by locum GPs had remained relatively stable. He said that bookings through the association's LocumDeck platform suggested that fees had not increased.

'But these are all self-employed locum GPs or chambers' GPs,' he added. 'It could be agency fees that are increasing what practices are paying if they employ via an agency.'

Dr Fieldhouse pointed out that locum GPs often worked for lower rates at practices where they felt fully supported, were treated as a key part of the team and paid promptly.

In May, NHS England announced further funding to complete the rollout of 'flexible pools' of locum and salaried GPs across England. The pools, which are being set up by integrated care systems, aim to boost general practice capacity by making it easier for surgeries to access temporary staff.

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