Recurring concern
Failure to ensure safe appointment and oversight of locum doctors
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Request correctionFirst reported 13 Apr 2014•Latest report 9 Mar 2020
What this concern includes
Includes failures in the dedicated locum-doctor appointment and oversight process, including competence assessment and sign-off, proportionate supervision or restrictions, monitoring of unresolved remediation or regulatory concerns, and review before subsequent locum employment.
Not included
- Excludes generic staffing shortages or reliance on locum doctors where no appointment or oversight control is deficient.
- Excludes general failures in patient records, referrals or clinical care unless they are directly part of the locum-doctor appointment or oversight process.
- Excludes employment or disciplinary failures concerning permanent staff unless the report explicitly ties them to locum-doctor safety oversight.
- Excludes unrelated regulatory or background-check deficiencies that do not concern the safe appointment or oversight of locum doctors.
- Reports
- 5
- Individual concerns
- 9
- Date range
- 2014–2020
- Stated actions
- 5
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Reluctance to supplement locum references with telephone calls to referees
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Develop a revised reference-validation process covering referee screening, pre-interview checks, recorded clarifications and additional competence or performance validation.
Stated by Betsi Cadwaladr University LHB
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
COVID-19 major incident response delayed approval and implementation of the revised reference-validation process until June 2020.
Stated by Betsi Cadwaladr University LHB
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Concerns raised2
Lack of clear requirements for consultant assessment of locum competence before overnight responsibility
Failure to assess and supervise locum clinicians
This report raised 18 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
The CQC is responsible for deciding and providing further detail on regulatory action concerning the Trust’s maternity-service safety risks.
Stated by Department of Health and Social Care
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Position
The Trust is responsible for setting out and implementing actions to address the identified maternity-service safety risks.
Stated by Department of Health and Social Care
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Concerns raised1
Failure to account for junior doctor unfamiliarity during senior review
This report raised 14 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Remind senior clinicians to exercise extreme caution when reviewing patients assessed by unfamiliar or locum junior staff without personally seeing them.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised2
Lack of regulatory monitoring and review of incomplete remediation referrals before subsequent locum employment
Failure to secure complete employment histories, references and fitness to practise information for long-term locum doctors
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Complete employment and professional registration checks for recruited staff, including verifying GMC registration, restrictions and fitness-to-practise investigations.
Stated by Lewisham and Greenwich NHS Trust -
Action
Review temporary-staff employment-check processes, including medical agency staff, through an internal audit in January 2015.
Stated by Lewisham and Greenwich NHS Trust -
Action
Establish a high-level Secondary Care Locum Doctor Working Group and obtain recommendations to strengthen locum-doctor recruitment and quality assurance.
Stated by Department of Health and Social Care
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
Existing recruitment and revalidation arrangements provide sufficient assurance, so further enquiry into locum doctors’ previous fitness-to-practise concerns is not necessary.
Stated by Lewisham and Greenwich NHS Trust
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Position
Locum agencies and healthcare providers are responsible for checking doctors’ fitness and suitability, with ultimate responsibility resting with the employer.
Stated by Department of Health and Social Care
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Concerns raised3
Failure to provide supervision proportionate to identified competence concerns for locum consultants
Failure to use robust processes for signing off locum consultants as competent for independent practice
Failure to use robust processes for appointing locum consultants
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026