This article relates to the CQC key question: Is your practice safe?
CQC has been asked how GP practices should ensure the suitability of GP locums including those employed through locum agencies.
Locums can be employed through locum agencies or chambers, via 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, maternity leave or sabbaticals
- provide regular sessions while practice based GPs work outside the practice
- offer specific skills such as minor surgery
- increase GP sessions during busy periods in a practice
General practices have a general obligation to ensure that they only employ individuals, permanent or temporary, who are fit for their role. The practice is responsible for checking that the locum:
- is a GP
- has medical indemnity
- is registered with the GMC, and
- is on the Performers List.
The current regulations regarding recruitment, Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, are clear on the requirements employers must ensure themselves of regarding workers they employ to carry out regulated activities, including locums.
Regulation 19(3) states that:
'The following information must be available in relation to each such person employed –
- the information specified in Schedule 3, and
- such other information as is required under any enactment to be kept by the registered person in relation to such persons employed".
Schedule 3 details the information required in before a person can carry on a regulated activity, including:
- Proof of identity including a recent photograph.
- Satisfactory evidence of conduct in previous employment concerned with the provision of
- health or social care; or
- children or vulnerable adults.
- Satisfactory documentary evidence of any relevant qualification.
- A full employment history, together with a satisfactory written explanation of any gaps in employment.'
How does a provider show they meet Regulation 19?
In our inspections of GP practices, we ask whether staff 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.
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.
Where a locum is supplied by a locum agency, the agency is covered by the Employment Agency Act 1973 and associated Conduct of Employment Agencies and Employment Business Regulations 2003 (amended in 2008).
This regulates the conduct of employment agencies which recruit and manage temporary and permanent labour and requires agencies to check that a locum GP is suitable to work in the position which the practice seeks to fill. This includes obtaining copies of relevant documents such as relevant qualifications and certificates.
When a GP practice is hiring a locum through an agency, they must consider to what extent they 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 and in some cases providers may ask for copies of supporting documents to be sent to them before accepting the locum.
Either way, the CQC expects 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.
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection