Credit: Andrew Matthews
More than 8,000 highly paid locum doctors could be putting patients at risk by escaping proper checks on their fitness to practice, a new report warns.
An investigation for the General Medical Council also found hospitals are failing to raise the alarm when they come across stand-in medics whose skill levels are unsafe.
Doctors in the UK are supposed to undergo annual appraisals and must get their licence to practise revalidated every five years.
The system was introduced in 2012, in the wake of Harold Shipman and other NHS scandals.
But the new report finds that for many locums, some of whom demand £155 an hour to work in understaffed hospitals, this is barely more than a tick-box exercise.
Sir Keith Pearson, who led the review, said hospital managers would tell locum agencies “please don’t send that doctor again”, but not give reasons why.
The head of Health Education England also revealed he had found evidence patients were failing to give honest feedback about doctors, which is a critical part of the relicensing process, for fear of being identified and mistreated.
Many doctors are only providing 10 pieces of patient feedback a year for their revalidation reviews, Sir Keith said.
GMC rules also allow doctors to select only the best comments to pass on to their appraiser, although the report found the profession was getting gradually better in this respect.
“The current method of gaining patient feedback needs to be looked at,” he said, adding that there was “no obvious mechanism” for identifying concern about a doctor’s competency.
The Government has introduced an agency cap on how much should be paid to locums, although some hospitals are forced to compete for staff and pay above these rates.
The new report found that more than a third standards appraisals are deferred for agency doctors, more than twice the rate for medics with fixed employment.
“Doctors are under increasing pressure, and it is vital they are given the appropriate time and support for their own learning and wellbeing,” said Charlie Massey, GMC chief executive.
Dr Mark Porter, council chair of the British Medical Association, said the appraisal process must be applied equally to all doctors to avoid “locums falling through the cracks.”