Nearly one in five GPs (19%) said the proportion of shifts at the practice or practices where they work had increased significantly over the past 12 months, with a further 34% reporting a slight increase.
Just 15% of the 413 GPs who responded said reliance on locums had dropped over the past year - with the rest reporting no change. Among GP partners, 23% said the proportion of shifts filled by locums had increased significantly over the past year, the survey found.
Previous polling by GPonline has found a rise in shifts filled by locums in both 2017 and 2018. The trend comes as numbers of GPs in partnership roles continues to fall - and locum rates continue to rise.
Demand for locums
Responses to the survey suggested that despite rising use of locums, demand was such that practices would have brought in more if they had been able to find available doctors.
One GP responding to the latest survey said: 'We would have had more locums if we could get them. They are like unicorn poo in rural Wiltshire.'
Several other respondents also commented on the need for more locums and the struggle to recruit. One said: 'There are no locums available to fill slots, if there were we would use a lot more.'
BMA GP committee chair Dr Richard Vautrey said: 'Practices value the support they receive from GP locums as they do their best to meet patients' needs, but the increased use is a sign of the pressures practices are under, not least to recruit and retain GPs.
'Patients benefit from continuity of care but it's harder to offer that without the necessary workforce. We are still waiting for a formal government response to the partnership review and as part of that they need to commit to the recommendations so that we can provide more support to practices and their patients.'
Continuity of care
Several respondents expressed gratitude for the support offered by locums at their practices, with some highlighting the use of regular locums as a way to maintain continuity of care.
But some partners highlighted the impact on their workload and costs of rising reliance on locums. One pointed out that working longer hours to reduce locum costs could leave them falling foul of heavy tax on pension contributions: 'We have worked hard to reduce locum usage, as the cost is unsustainable, but it means we have to work harder to get tax penalties - how is this sustainable?'
Another said: 'I am a partner and having to use locums means I am doing more on-call, with less regular appointment availability, but having to try to see more patients because of following up some of them from the on-call sessions, plus handling excessive paperwork which is not done by the locums. I am regularly seeing over 45 patients a day and I don't know how sustainable this is.'
GP workforce data published earlier this year showed that general practice is currently losing around 100 partners a month, and that the number of partners in England has slumped by more than 3,000 since late 2015.
More than half of GPs now believe locum work is the most attractive career option - with only one in seven saying they would choose to work as a partner as their first preference, GPonline reported in August.
Meanwhile, average hourly rates paid to locums have risen over the past year, according to our sister website Medeconomics.