Short-staffed GP practices increasingly unable to hire locums, poll shows

Four in five GP partners say their practice has been unable to recruit a locum doctor when they needed one within the past six months - heaping extra pressure on other staff, a GPonline poll shows.

GP consulting room door ajar
(Photo: monkeybusinessimages/Getty Images)

Nearly two thirds of GPs say use of locums has increased significantly over the past six months at practices where they work, according to a GPonline survey of around 250 GPs - but more than half said it was difficult to hire locums when needed.

Among GP partners who responded, 67% said it was difficult to hire locums when needed - and an overwhelming 80% said they had been unable to recruit a locum GP when they needed one at some point in the past six months.

The findings provide fresh insight into the staffing crisis in general practice at a time when the profession is operating with a full-time equivalent (FTE), fully qualified workforce 350 GPs down compared with a year ago - and around 1,700 below the level in 2015.

GP workforce

Meanwhile, demand on general practice continues to be relentless. Practices delivered an unprecedented 367m appointments in 2021, and in March this year GP appointments specifically are up more than 5% compared to the same month in 2021.

The reduced workforce means that appointments per FTE, fully qualified GP were up more than 6% this March compared with the previous year.

LMCs have warned through the early part of 2022 about practices struggling to cope with staff shortages, with their workforce 'shredded' by COVID-19 absences. LMC monitoring has found that some practices forced to operate with up to half of their workforce stripped out by COVID-19 absences had found it impossible to bring in locum cover.

National Association of Sessional GPs (NASGP) chair Dr Richard Fieldhouse told GPonline: 'The biggest problem the NHS faces is its workforce. These survey figures demonstrate that very well.'

Rising demand

He said general practice had gone into the pandemic 5,000 GPs short of the level it needed, and was now even further behind - while rising demand was compounding the problem.

The NASGP's booking platform had seen an 'exponential increase' in locum bookings in recent months, suggesting huge demand for GP cover, Dr Fieldhouse said.

'People at the moment are barely coping - but in another three to four years there will be even fewer GPs because of stress and burnout driving doctors out,' he warned.

The NASGP estimates that there are as many as 17,000 locum GPs in the UK - and the GMC has cited a figure slightly higher again. However, in addition to factors such as stress and burnout driving doctors out of general practice, Dr Fieldhouse said there were now many more job opportunities for GPs outside of traditional roles in practices.

NHS work

'Often in practices that have lost a partner, they can afford to pay locums. But there are so many other opportunities for those doctors - for example to work for private companies that work with the NHS or not doing NHS work. We need to be better at incentivising GPs to work in the NHS,' he warned.

Many GPs responding to the survey highlighted growing concerns over staff shortages. Some said they had been unable to find locum cover even through agencies charging significant fees.

One GP said: 'Shortage of GPs puts unmanageable demand on the remaining doctors and no one wants to join an underdoctored practice. The poor simply get poorer.'

Another wrote: 'More needs to be done to improve lives for the partners and salarieds doing the day job to entice people working as locums into practice.'

A GP currently working as a locum said: 'I am a full-time locum. Most practices have asked me if I would join them as a salaried. Most practices need more salaried GPs, but until they address the poor deal and pay salaried GPs get, I'm better off financially, mentally and practically to continue as locum.'

The DHSC said this week it remained committed to 'supporting general practice to deliver an extra 50m appointments a year by expanding and diversifying the workforce' - and repeated claims that numbers of 'doctors working in general practice' are growing.

However, the government has been accused of misleading use of data on the GP workforce by quoting figures that include trainees to claim the workforce is growing, while numbers of fully qualified GPs continue to fall. Doubts have also been raised over the government's claim that plans to bring in 26,000 staff through the additional roles reimbursement scheme are 'on track'.

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