E-mail about employing locums and new GPs

Dear Colleagues

We have become aware that some practices may not be fulfilling their obligations when appointing a doctor (including a locum) to work in their practice.  A timely reminder, therefore, seemed appropriate.

Employing any doctor (including a locum) to work in your practice is subject to the NHS regulations and relevant professional and contractual obligations require you to carry out all necessary checks.

Any doctor that you employ must be registered with the GMC to practise medicine in the UK.   It is illegal for doctors to work in clinical practice in the UK Health Service if they are not registered. 

In addition, on 31 March 2006, the GMC introduced a register of doctors who are eligible to work in general practice in the health service in the UK.    From 1 April 2006, all doctors working in general practice in the health service in the UK, other than doctors in training such as GP Registrars should be included on the GMC GP register.

You may check a doctor's registration status at https://webcache.gmc-uk.org/ods/home.do

You should not rely on a locum agency to check a doctor's registration status for you.    If a doctor has previously been employed elsewhere in the UK, you still need to check their registration details, as their registration status may have changed since they were last employed. The due date of an Annual Retention Fee or an Annual Registration Certificate are not evidence that a doctor is currently registered.

Before employing any doctor to work in your surgery you must check:

• That the doctor to be employed is on a Health Authority's Performers List.
• That the doctor has the necessary medical defence cover.
• 2 clinical references* 
• You should always check that a doctor is registered with the GMC as part of your pre-employment checks.Since April 2006 doctors appointed as  GPs should in addition be on the GMC's GP Register

(*   These must relate to a recent post that was held for at least 3 months without a significant break.  If this is not possible a full explanation and alternative references must be followed up.
If a locum is required to work immediately the doctor may be engaged for a single period of up to 14 days while references are followed up and for an additional 7 days if the referee is ill, on holiday or otherwise temporarily unavailable.
If the doctor is employed on more than one occasion in a three month period the employing doctor may rely on the references provided on the first occasion, provided they are not more than 12 months old.)

Further information on the NHS regulations relating to the employment of doctors in your practice is available at;
http://www.opsi.gov.uk/si/si2004/20040291.htm#57c

Please note:
 
A failure to carry out all of the necessary checks may put patients at risk and consequently places your practice at medico legal risk. 

You also risk disciplinary action for breaching the terms of your contract and your professional obligations as a doctor registered with the GMC.

---

Essential Criteria for GP work

The regulations specify that 'the contractor shall take reasonable care to satisfy itself that the person in question is both suitably qualified and competent to discharge the duties for which he is to be employed or engaged.'

It is, therefore, useful to establish a list of essential criteria to assure yourself that applicants are capable of performing the job required.  These should include ;

• good knowledge of current medical practice
• adequate knowledge of how the NHS works in practice
• adequate working knowledge of your practice IT system
• adequate command of medical and colloquial English

Application of these criteria to all applicants would not be discriminatory and you owe a duty of care to your patients to ensure that any doctor working in your practice is competent to do the job.

I hope this helps clarify your obligations and will help you avoid unnecessary problems.

Yours sincerely,

CED