Background: Numbers of GP locums in the NHS have grown in recent years, yet evidence on the
scale and scope of the locum workforce in general practice is sparse.
Aim: To identify characteristics, geographical patterns and drivers of GP locum use.
Design and setting: Observational study of routine data from general practices in England.
Methods: Descriptive analyses of national GP workforce data betwen December 2017-
September 2020, to determine the volume and geographical distribution of locum use and
examine the characteristics of locums compared to other GP types. We modelled locum FTE
using negative binomial regressions and estimated Incidence Rate Ratios (IRRs) for the
association between the outcome and practice and population characteristics.
Results: In December 2019, locums made up 1,217.9 (3.3%) of 33,996.6 total GP FTE which was
fewer than other GP types. Median locum age was 42 years (IQR, 36–51), and the majority were
UK qualified (660 of 1,034 total locum FTE), were male (642.6 of 1,178.9 locum FTE), and had
long-term employment (834.1 of 1,127.9 total locum FTE). Rurality (IRR=1.250; 95%CI 1.095-
1.428), inadequate CQC ratings (IRR=2.108; 95%CI 1.370-3.246) and single-handed practice
(IRR=4.611; 95%CI 4.101-5.184), were strong predictors of locum use. There was substantial
variation in locum use between regions.
Conclusion: GP locum use remained stable over time. Compared to other GPs, locums are
younger male GPs, a substantial percentage of whom did not qualify in the UK, who serve
underperforming practices in rural areas. This is likely to reflect recruitment or high turnover
challenges in these practices/areas a