Academic Journal
Locum doctor working and quality and safety: a qualitative study in English primary and secondary care: A qualitative study in English primary and secondary care
| Title: | Locum doctor working and quality and safety: a qualitative study in English primary and secondary care: A qualitative study in English primary and secondary care |
|---|---|
| Authors: | Jane Ferguson, Gemma Stringer, Kieran Walshe, Thomas Allen, Christos Grigoroglou, Darren M Ashcroft, Evangelos Kontopantelis |
| Source: | BMJ Qual Saf Ferguson, J, Stringer, G, Walshe, K, Allen, T, Grigoroglou, C, Ashcroft, D & Kontopantelis, E 2024, 'Locum doctor working and quality and safety: a qualitative study in English primary and secondary care', BMJ Quality and Safety. https://doi.org/10.1136/bmjqs-2023-016699 |
| Publisher Information: | BMJ, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | Male, Primary Health Care/organization & administration, Secondary Care, State Medicine, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Qualitative research, Physicians/psychology, Physicians, Health services research, Humans, Quality improvement, State Medicine/organization & administration, Qualitative Research, Original Research, Quality of Health Care, Governance, Primary Health Care, Focus Groups, Quality Improvement, 3. Good health, Patient safety, England, Female, Health Services Research, Patient Safety, 0305 other medical science |
| Description: | Background The use of temporary doctors, known as locums, has been common practice for managing staffing shortages and maintaining service delivery internationally. However, there has been little empirical research on the implications of locum working for quality and safety. This study aimed to investigate the implications of locum working for quality and safety. Methods Qualitative semi-structured interviews and focus groups were conducted with 130 participants, including locums, patients, permanently employed doctors, nurses and other healthcare professionals with governance and recruitment responsibilities for locums across primary and secondary healthcare organisations in the English NHS. Data were collected between March 2021 and April 2022. Data were analysed using reflexive thematic analysis and abductive analysis. Results Participants described the implications of locum working for quality and safety across five themes: (1) ‘familiarity’ with an organisation and its patients and staff was essential to delivering safe care; (2) ‘balance and stability’ of services reliant on locums were seen as at risk of destabilisation and lacking leadership for quality improvement; (3) ‘discrimination and exclusion’ experienced by locums had negative implications for morale, retention and patient outcomes; (4) ‘defensive practice’ by locums as a result of perceptions of increased vulnerability and decreased support; (5) clinical governance arrangements, which often did not adequately cover locum doctors. Conclusion Locum working and how locums were integrated into organisations posed some significant challenges and opportunities for patient safety and quality of care. Organisations should take stock of how they work with the locum workforce to improve not only quality and safety but also locum experience and retention. |
| Document Type: | Article Other literature type |
| Language: | English |
| ISSN: | 2044-5423 2044-5415 |
| DOI: | 10.1136/bmjqs-2023-016699 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/38627099 https://research.manchester.ac.uk/en/publications/2b698759-d8f6-4555-896a-14604842ee7c https://doi.org/10.1136/bmjqs-2023-016699 |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: http://creativecommons.org/licenses/by/4.0/. |
| Accession Number: | edsair.doi.dedup.....fee52ef2e6a5f802c8ef8d3f8c803361 |
| Database: | OpenAIRE |
| ISSN: | 20445423 20445415 |
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| DOI: | 10.1136/bmjqs-2023-016699 |