GP mythbuster 50: GP locums

Locums can be employed through locum agencies or chambers, local medical committees (LMCs) or local sessional GP groups, or in some cases through training schemes or out-of-hours organisations. Most GP locums are freelance and find work through local knowledge and contacts.

GP practices commonly engage locums to:

• cover long-term absence due to sick leave, annual leave, maternity leave or sabbaticals
• provide regular sessions while practice-based GPs work outside the practice
• offer specific skills including minor surgery
• increase GP sessions during busy periods in a practice
• Cover recruitment gaps

GP practices have a general obligation to ensure that they only employ individuals – either permanent or temporary – who are fit for their role. The practice is responsible for checking that the locum:

• is a GP
• is registered with the GMC
• is on the Performers List.
• has professional indemnity.

GP locums are covered for core general practice work by the Clinical Negligence Scheme for General Practice (CNSGP) operated by NHS Resolution. This is a state indemnity scheme for general practice in England. It covers clinical negligence liabilities in general practice that relate to incidents which took place on or after 1 April 2019. All providers of NHS primary medical services are covered under the CNSGP. The scheme extends to all GPs and others working in general practice who carry out activities when delivering primary medical services. Cover does not include activities not included in the NHS contract. See further information for details.

When we inspect

We consider how services make sure that all staff have the required skills, knowledge and experience and that they are supervised to deliver effective care, support and treatment. We consider this as part of:

• Regulation 12 (Safe care and treatment)
• Regulation 17 (Good Governance)
• Regulation 19 (Fit and proper persons employed)

and as part of the Safe, Effective and Well Led key questions

To meet Regulation 19 (Fit and proper persons employed) employers must have robust recruitment procedures, including any relevant employment and security checks, to assure themselves about workers they employ to carry out regulated activities, including locums.

Schedule 3 details the information required before a person can carry on a regulated activity, including:

1. 1. Proof of identity including a recent photograph.
2. 2. Satisfactory evidence of conduct in previous employment concerned with providing either:
   • health or social care
   • children or vulnerable adults.
   • 3. Satisfactory documentary evidence of any relevant qualification.
   • 4. A full employment history, together with a satisfactory written explanation of any gaps in employment.

How does a provider show they meet Regulation 19?

Providers must comply with Regulation 19 when employing permanent and temporary individuals, and must be confident that they are able to make available the information listed under Schedule 3. This applies both when the provider directly employs a locum, for example on a casual basis, as well as when a locum is indirectly employed through a locum agency.

In our inspections of GP practices, we assess whether all staff receive appropriate information, training, support, supervision and oversight. Staff must have the skills, knowledge and experience to deliver effective care and treatment. This includes anyone working for the GP practice, including temporary staff. We expect providers to ensure all staff are fit for their roles. This includes checks to show staff are on the NHS performers list and registered with the GMC.

Where a locum is supplied by a locum agency, the agency is covered by the Employment Agencies Act 1973 and the associated Conduct of Employment Agencies and Employment Businesses (Amendment) Regulations 2016. This regulates the conduct of employment agencies that recruit and manage temporary and permanent labour and requires agencies to check that a locum GP is suitable to work in the position the practice seeks to fill. This includes obtaining copies of documents such as relevant qualifications and certificates.

When a GP practice is hiring a locum through an agency, it must consider to what extent it can rely on the checks carried out by the locum agency. This may depend on the nature of the agreement between the practice and the agency and how they would make available the Schedule 3 information if needed. GP practices must be confident that the agency has copies of all the relevant documents as detailed in the regulations. In some cases, providers may ask to see copies of supporting documents before accepting the locum. Either way, we expect GP practices to be assured that all appropriate checks have been carried out, either by themselves or by the agency, and that the person is suitable for the job they are doing.