Agency locums – appraisal and revalidation issues faced by ‘unattached’ doctors

Short for the Latin term “locum tenens”, which translates to “place holder”, locum doctors temporarily fill vacancies in a hospital, clinic, or practice owing to permanent staff being ill or away on leave. This plays a critical role in the continuum of healthcare providers and ensures that the hospitals, clinics and practices can continue to provide healthcare even when key members of their team are absent.  

There are many benefits of being a locum doctor including flexibility in terms of work location and schedule, and the opportunity to create a better work-life balance and higher pay. However, working in short-term placements also poses challenges such as financial uncertainty, lack of sick pay and other employee rights and, importantly for revalidation purposes, it is harder to build longer-term relationships with patients and colleagues. Locum doctors may also find it difficult to source a responsible officer to assist in the appraisal or revalidation process.  

Medical revalidation is the process by which the General Medical Council (GMC) confirms the continuation of a doctor’s licence to practise in the UK, and all doctors need to complete revalidation (normally every five years) in order to continue practising. Similarly, medical appraisal is a process of facilitated self-review supported by information gathered from the full scope of a doctor’s work, and tends to happen annually. 

In January 2022, the GMC commissioned research into the experience of agency locums. One of the key points of the research highlighted that: ‘Many agency locums found it challenging to obtain and gather the evidence needed for appraisal due to the way in which they worked.’ 

The problems faced by locums when gathering colleague and patient feedback  

One key challenge facing locum doctors is obtaining a sufficient number of responses within the given timeframe. A report must contain a standard minimum number of responses to reach a required level of statistical reliability and, therefore, validity. Because locums do not often stay in one post for long, obtaining quality colleague feedback is difficult; it is harder to achieve a good response rate because the act of providing good colleague feedback takes time and is it usually deemed as voluntary, so the lack of established colleague relationships makes it harder to get doctors to commit to completing the questionnaire. 

Interestingly, however, there is evidence supporting the notion that more accurate perceptions do tend to be gathered from less-well established relationships. Eichinger (2004) found that staff who had been at an organisation long enough to get past first impressions (known the subject for one to three years), but not long enough to lose their objectivity (known the subject for more than three years), gave the most accurate ratings. Individuals who knew the subject for less than one year provided the second most accurate ratings. 

How our Doctor 360 solution helps locum doctors and locum agencies to achieve the feedback required for revalidation 

Whether you’re a locum agency revalidation manager, or a medical practitioner, our multi-source feedback (MSF) solutions offer a variety of important benefits: 

1. A wealth of experience. We are extremely experienced at supporting doctors with their revalidation. We have been providing multi-source feedback (MSF) reports since the revalidation process was brought into place by the GMC in 2012 and have 81,000 doctors set up on our system. Our assessment aligns completely with the Four Domains of Good Medical Practice. 
2. A lower minimum threshold of responses. Our minimum number of feedback responses required to generate a report is 17, compared to 34 for the GMC questionnaires. This enables an easier process for collating feedback, which is particularly beneficial for doctors with reduced access to patients and colleagues, such as locums.
3. A dedicated support team. We have a dedicated support team on hand via email or telephone (Monday to Friday) to answer any queries you may have during the process. We also provide step-by-step user-friendly demo videos to help navigate each stage of the process.
4. Easy purchasing. Our Doctor 360 exercises can be purchased easily via our Doctor 360 website. 

For more information on our Doctor 360 feedback exercises, please get in touch. Or, if you’re looking for the full appraisal toolkit package, we partner with Premier IT to provide a reliable and user-friendly appraisal solution. Our partnership with Premier IT enables reports to be integrated from our system into Premier IT’s, ready to be reviewed for appraisal. Premier IT’s blog gives more information.