A row has erupted over the competency of foreign locums after an outspoken consultant claimed that some of them are clueless about what is expected of them by the NHS.
Dr John Hutchinson, head of the Department of Anaesthetics at Hereford County Hospital, made his comments in a letter to The Times because he is concerned that locums are falling through the net of regulation.
But Miss Shehnaz Somjee, chair of the Locum Doctors Association (LDA) accuses Hutchinson of unfairly stigmatising locums.
Hutchinson argues that there is an urgent need for locums new to the NHS to undergo a short period of clinical assessment and familiarisation of UK medical practice.
In anaesthetics, there is a shortage of experienced locums to meet demand. This means agencies have to recruit doctors from abroad who are on the medical register and regulated by the GMC, but lack professional support within the UK. These doctors have “absolutely no idea what is expected of them by the NHS” complained Hutchinson.
“Although there are many excellent locum doctors there are some who cannot adjust rapidly to UK practice despite the best efforts of employing NHS trusts,” he said.
If some of these locums were sacked, they could go on to get work at another trust which would be unaware of any previous problems because references are desirable but not essential for employment, he claimed.
Hutchinson is calling for increased monitoring of the clinical workload of locums and for them to be provided with professional support in the same way that UK trainees are. This would have the added benefit of ensuring that locums comply with the 48-hour working week.
But Somjee said locums already face much tougher scrutiny than substantive doctors.
Locums have to undergo Criminal Records Bureau checks for every job and provide recent references. “Locums need references all the time and one small word against them can be enough to destroy their employment prospects,” she said.
Health checks can also be more stringent. Some agencies have been requesting additional tests for HIV and MMR, which are not a requirement for employment.
Most trusts now provide inductions for locums and if posts are longer than three months should be offering appraisals where any problems can be picked up and addressed. Trusts should also ensure that consultants offer support to locums, argued Somjee.
Agencies frequently put on extra courses to update locums’ skills in areas such as advanced life support and the LDA provides additional advice and support.
“The fact is locums are under the microscope from the first minute of the first day that they arrive at a new hospital,” said Somjee.
Tags: Locums
