RCOG updates, guidance and position statements on safe staffing
Currently there are widespread shortages of suitably-qualified obstetricians and gynaecologists who can safely undertake the role of senior resident doctor out of hours with indirect supervision from a consultant who is non-resident.
Where possible, healthcare providers encourage the use of internal locums, however this is not always possible and external locum doctors are sometimes required.
These locum doctors have not always worked in the unit. Therefore appropriately robust recruitment processes and assessment of their skills and knowledge (with structured feedback and support) are required before they are released to work independently. This is to ensure that there is no compromise in patient safety and quality of care.
Our goals are:
- To improve support for locum doctors in maternity
- To support employers in safely covering gaps in rotas
- To support permanent staff when they are covering gaps
Position statements and guidance:
RCOG guidance on the engagement of short-term locums in maternity care (August 2022)
RCOG has developed this guidance on the engagement of locums in maternity care in collaboration with the NHS. This guidance outlines the roles and responsibilities for healthcare providers, health care organisations and individual doctors undertaking locum positions within the NHS.
For the purposes of this guidance, a ‘locum’ refers to a doctor who is either placed by a locum agency or a locum bank in a healthcare provider organisation or directly engages with healthcare organisations for short-term work. For the purposes of this guidance, ‘short-term’ refers to placements of two weeks or less.
A locum can also be a doctor in a short-term placement who is an employee of the organisation for a short, fixed term. There may also be doctors in training who work as locums outside their training.
- RCOG guidance on the engagement of short-term locums in maternity care (August 2022) (PDF)
- Certificate of Eligibility for short-term locums (CEL) – read about and register
RCOG position statement on ensuring safe out of hours support for complex emergency obstetric and gynaecology surgery (July 2022)
The skills of the O&G consultant workforce, and the complexities of patient care, are evolving and changing. With the increase in specialisation and the reduction in major gynaecological operating, the pool of individuals able to manage both complex gynaecology and obstetric surgical complications is decreasing.
This position statement was developed by the RCOG/HEE Working group following extensive investigation of current workload and practice with Members, Fellows, Trainees, SAS & Locally Employed doctors and other key stakeholders.
In the interests of patient safety, peer support and education, the RCOG recommends that all units have a standard operating procedure for the management of complex gynaecological operating and complex obstetric operating cases out of hours.
Please read the full statement and our recommendation for all Trusts and Health Boards in the UK:
RCOG guidance on the engagement of long-term locums in maternity care in collaboration with NHS England, Scotland and Wales (June 2021)
In this guidance a long-term locum is one where a placement is greater than 2 weeks in duration. This guidance recommends employing organisations offer locums support and supervision including:
- Departmental induction by a consultant on commencement date
- A named consultant supervisor
- Supernumerary clinical duties undertaken with direct supervision prior to commencing OOH duties
- Review of suitability for post and OOH working based on MDT feedback
RCOG guidance on consultants and SAS doctors acting down to cover short-term absence (June 2021)
This guidance includes advice on:
- Measures to avoid acting down
- Covering difficult to recruit to posts
- Managing short notice absence
- Considerations when asking a doctor to act down
- Procedures for requesting a consultant or SAS to act down
- Remuneration and compensation for acting down
RCOG guidance on compensatory rest (June 2021)
There is an increasing need and expectation for consultants to attend overnight whilst non-resident on-call due to increased patient numbers and the rising complexity of cases. RCOG have produced updated guidance on appropriate standards for compensatory rest for consultants and senior SAS doctors following non-resident on call activity.
- Attendance and telephone advice from on call senior clinicians has increased.
- Compensatory rest for consultants should be actively supported and facilitated by the management team.
- It is recommended that the decision to take rest is not left to the individual consultant but agreed via constructive discussion between the manager/clinical director and clinician.
- Job planning should factor in these recommendations for compensatory rest.
Are you currently a locum doctor in the UK?
The RCOG is working with NHS England to develop and launch a certificate of locum eligibility which will be mandatory for any doctor undertaking short term locums (<2 weeks) in maternity.
If you are currently a locum or an employer and would like more information on this scheme as it launches, please register your interest.
For other queries, please contact firstname.lastname@example.org
The tool will describe the summary characteristics and demand for obstetric and anaesthetic staffing on an annual basis in NHS Trusts and Boards providing maternity services across England, Wales and Scotland.