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The use of locum doctors in the UK National Health System (NHS): understanding and improving the safety and quality of care

Safe People

Organisation name

University of Manchester

Organisation sector

Academic Institute

Applicant name(s)

Kieran Walshe - Chief Investigator - University of ManchesterChristos Grigoroglou - Corresponding Applicant - University of ManchesterDarren Ashcroft - Collaborator - University of ManchesterEvangelos Kontopantelis - Collaborator - University of ManchesterGemma Stringer - Collaborator - Not from an OrganisationJane Ferguson - Collaborator - University of ManchesterThomas Allen - Collaborator - University of Manchester

Safe Projects

Project ID

CPRD467

Lay summary

The optimal and effective organisation of primary care resources in the NHS requires information on performance and associated costs of the different types of doctors who are employed in the NHS. However, the lack of evidence on performance for particular types of GP doctors has led to concerns among policymakers and professional associations about the quality of provision of primary care services and patient safety. Very little research has been done about how and when locum doctors are used in primary care, or if their use can influence quality and safety.

Technical summary

The aim of the study will be to collect and analyse quantitative data sets to compare the working patterns and performance of locums to those of other GP types in primary care. We will use the Clinical Practice Research Datalink (CPRD) to access anonymised general practice records on all registered patients, including diagnoses, tests, prescribed treatments and referrals. We will obtain data on each patient’s interaction with a health professional and the staff role field will be used to identify GP types (partner, salaried, or locum) involved in any recorded interaction. This will be our key parameter of interest and we will evaluate its association with patient outcomes. A cross sectional analysis will be conducted for each financial year for the period 2015-2021 to explore the associations between staff role and patient outcomes at the patient level. Moreover, our cohort study is eligible for linkage to Hospital Episodes Statistics (HES) data and this will allow us to obtain detailed information on any form of hospital attendance for all patients in the practices that participate in the linkage scheme.

Latest approval date

24/03/2021

Safe Data

Dataset(s) name

2011 Rural-Urban Classification at LSOA level

HES Accident and Emergency

HES Admitted Patient Care

HES Outpatient

ONS Death Registration Data

Patient Level Index of Multiple Deprivation

Practice Level Index of Multiple Deprivation

Safe Setting

Access type

Release