• NED asks United Lincolnshire Hospitals Trust board meeting how it will monitor doctors with GMC restrictions
  • Medical director says trust has agreed not to take on new locums with restrictions, adding it cannot offer the “support they require”
  • Trust has been in special measures for more than two years

A rural trust is rowing back on hiring locum doctors with General Medical Council restrictions, after a non-executive director questioned the “high number” of such staff being employed.

According to minutes from its board meeting last month, United Lincolnshire Hospitals Trust non-executive director Chris Gibson “raised concerns about the high number of doctors in the trust with GMC restrictions and asked how the trust undertake monitoring”.

In response, the trust’s medical director Neill Hepburn said there were nine locum doctors with GMC restrictions. HSJ asked the trust to confirm which specialities the nine doctors were working in but it did not provide a response to this question.

However, Dr Hepburn also told the board an agreement had been made to no longer take on any locums with restrictions and those already in place “would be worked out but consideration would need to be given to fragile services”. He added the trust would put in place a requirement for all locums to be on the speciality register prior to working at the trust.

When approached for more details, Dr Hepburn told HSJ the decision was “not only about making sure our patients are kept safe and have the best experience” but also because the trust “does not have sufficient systems in place to give them the support they require”.

“We are not anticipating that this decision will have a significant impact on our services,” he added. 

The trust has been in special measures for more than two years, having re-entered the regime in 2017. In a recent inspection, the Care Quality Commission found it to be “consumed by operational pressures”. 

The trust also faces recruitment and retention problems. According to its most recent annual report, it spent £37m on agency staff in 2018-19, significantly higher than its NHS Improvement-set £21m cap and an increase on the £29m it spent the year before. 

As of July 2019, there were 811 doctors registered with the GMC who had conditions on their registration.

Restrictions on a doctor’s practice can include interim or substantive conditions. These are designed to keep patients safe, while allowing doctors to remediate and continue to work.

Interim conditions are used when a GMC investigation is ongoing, whereas substantive conditions are used on the conclusion of an investigation. 

United Lincolnshire Hospitals Trust is formed of Lincoln County Hospital, Pilgrim Hospital, Grantham and District Hospital and County Hospital in Louth.