A senior doctor is warning today that the heavy reliance of the NHS on locum doctors is leading to a dangerous state of affairs and putting patient safety at risk. The comments come in today’s BMJ from Professor Chris Isles who points to a poorly regulated locum sector in the UK based on his own experiences in trying to fill his medical staff rota.

Professor Isles, from the Dumfries and Galloway Royal Infirmary, says he was dismayed to be offered locum doctors who were inappropriate in terms of experience, qualifications, and fatigue. He believes his experience raises some serious questions for the health service.

The demand for agency locum doctors has increased following the full implementation of the European Working Time Directive and the number of vacancies which are increasingly hard to fill. A recent report by Audit Scotland showed the NHS in Scotland spent 47 million pounds on locums in 2008-9. The Department of Health does not collect figures to show how much English NHS trusts spend on locums. Audit Scotland also found procedures for induction and supervision of locum staff were vague and more likely to be overlooked.

Professor Isles believes responsibility lies with the Working Time Directive and Modernising Medical Careers, but he concludes: “Most of all I rage at the locum agencies whose abject failure to regulate themselves should surely have led to intervention by the GMC by now. We pay lip service to patient safety by allowing this scandalous state of affairs to continue.”