GP locum clinical practice ‘not systematically different’

5th April 2024 by NASGP

GP locum clinical practice ‘not systematically different’

new study from researchers at Manchester University has found that the clinical practice and performance of GP locums does not appear to be ‘systematically different’ from that of ‘permanent’ GPs.

The study, published last week, found that consultations with a GP locum were 12% less likely to lead to a practice revisit within seven days, 4% less likely to involve a prescription for a hypnotic, 15% less likely to involve a referral and 19% less likely to involve a test. Researchers found no evidence that emergency admissions, ambulatory care sensitive conditions admissions and eight out of the eleven prescribing safety indicators were different between the two cohorts.

Differences included that consultations with a GP locum were 22% more likely to involve a prescription for an antibiotic, 8% more likely to involve a prescription for a strong opioid, 4% more likely to be followed by an A&E visit on the same day and 5% more likely to be followed by an A&E visit within one to seven days.

The study examined electronic health records for 3.5 million patients from the Clinical Practice Research Datalink’s GOLD database, from practices using Vision software.

“There is little evidence in our findings to suggest that systemic differences exist in practice or performance between locum and permanent GPs,” researchers concluded. “Rather, it seems likely that the performance of both locum and permanent GPs is shaped by the wider organisational context in which they practice — the quality of induction, supervision, communication, and practice management being obvious likely determinants.”

Lead author Dr Christos Grigoroglou said: “The study did not find any evidence that GP locums are less clinically competent or practice less safely than permanent doctors. Some differences in practice and performance of locum and permanent GPs were found, however they are likely to be shaped by the organisational setting and systems within which locum doctors work.

“There have been some past high profile examples of poor quality care by locum doctors, though the same could likely be said for permanent doctors. Indeed our qualitative research suggests that some patients actually welcome the opportunity to see a locum GP because they get a fresh perspective on their condition.”

Dr Richard Fieldhouse, NASGP chair, said: “This study reaffirms the vital role GP locums play in caring for patients, dispelling the stigma we sometimes experience from colleagues and the national press. It highlights that locum and permanent GPs provide equally high-quality care, demonstrating our effectiveness across various settings.

“Key findings, like locums’ lower rates of practice revisits and referrals, showcase our efficient patient care approach. This challenges outdated narratives, and is a call to action for healthcare systems to continue to better integrate GP locums, ensuring we have the support and resources to excel.

“Ultimately, the study emphasises the importance of a supportive organisational framework for all GPs. By enhancing induction and communication, we can ensure GP locums continue to make significant contributions to patient care.”

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