This chapter considers changes at the four trusts in the employment of locum doctors since the time of Dr Elwood's employment and the current position on the employment of locum consultants at the trusts. CHI has tried to give a picture of the arrangements in place at the time that Dr Elwood worked as a locum at the four trusts. Much has changed at each of them in the years that have elapsed since the period covered by the investigation.
New management is in place at two of the trusts.
Changes in the health service initiated by the Government have also started bedding in. The Government's new clinical governance regime has been a major factor in enhancing performance monitoring and risk assessment for the work of all doctors, including locums. 7.2 One of the more positive consequences of the Dr Elwood case is that it has underlined the importance of robust systems for ensuring that locum doctors provide care of the highest quality. At all four hospitals, improvements in recruitment and performance monitoring procedures were already well underway before the Dr Elwood case received national attention. The incident has helped to emphasise the importance of implementing those procedures.