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Good practice guide

Using locum doctors in hospitals

Self-assessment checklist for NHS boards

Case Study 1 – The efficient use of locum doctors – NHS Borders

NHS Borders’ Appointment of locum medical staff: Procedure and protocol sets out guidelines for deciding the need for locum doctors with the aim of minimising their use. The policy is based on good practice guidlines, including the 1998 Accounts Commission report, Doing the rounds and the national Code of practice in the appointment and employment of locum doctors.

The policy aims to provide management and medical managers with a
clearer understanding of how and when suitable arrangements should be
put in place in the event of planned or unplanned absence of medical staff
of all grades.

Actions set out in the policy aimed at ensuring locum doctors are used only when necessary include:

  • All medical staff should give six weeks’ notice of leave therefore
    providing sufficient notice to consider cover arrangements other
    than locums.
  • When planning for leave and responding to urgent unplanned absence situations, consultants and other medical staff are asked to:
    • review ongoing commitments and consider rescheduling
      non-urgent work
    • reallocate work to other available colleagues
    • redistribute available resource within the clinical team to avoid cancellation of ‘essential workload’
  • In general, locums will not be appointed to cover planned / predictable leave. This includes prospective cover leave for holidays, exams and study leave.
  • Where longer notice is given, eg maternity leave, locums will be appointed by open advertisement. The Medical Staffing team should be informed at least 12 weeks before the expected date of leave to ensure the recruitment process can be managed within the timescales.
  • Internal cover is encouraged as much as possible where this will not cause a breach in the contractual working arrangements for the doctor providing the cover.

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