Starting out as a locum GP can be daunting. Many doctors have never been self employed before, having transferred from medical school to junior rotations and onto GP training, all within the safe confines of continuous employment. Coming away from this can feel quite uncomfortable.
Enjoy the challenge
I remember well this feeling, but I also wanted to challenge myself by working in different practices. I wanted to understand how practices adapted to fit the needs of their patients, to have an opportunity to care for varying patient populations and to get used working in a variety new teams.
So, at the end of my GP training, I decided to come away from the comparative safety of my training practice for a while and focus on being a locum GP.
Good preparation was key to organising myself enough work. Toward the end of my GP training, I put together a CV and covering letter and dropped these to all the local surgeries. I also called surgeries and asked for the email addresses of their practice managers and sent copies of my letter and CV electronically.
I quickly realised that all practice managers need to see various pieces of documentation before a locum can start work. These include:
- Documents to confirm you are entitled to work in the UK
- Certificate of completion of training
- Confirmation you are on the Performers List
- GMC certificate
- Medical indemnity certificate
- DBS check
- Immunisation status - Hep B
- Child safeguarding training certificate
- Basic life support training certificate
I found it was best to scan all of these documents and save them as a ‘certificate’ document that could be simply emailed to prospective practice managers.
Many practice managers and practice rota co-ordinators have locum lists saved to their address books, to whom they send their locum requirements on a regular basis. Make sure you are added to these lists and you will begin to receive emails offering work.
It is important to regularly checking your inbox and respond promptly to secure sessions, as often there are many locums on an address-book list and work tends to be secured on a first come, first served basis.
Make sure you keep a diary with all your booked sessions. This may sound obvious but I can recall several occasions when a locum had double booked him or herself during my registrar year and the difficulty this caused for the practice.
I also always suggest I arrive an hour early at a practice I am working at for the first time so I can meet the team, have a brief tour, find my room and check that I can successfully log onto and operate the computer systems before patients started to arrive. This helps me feel relaxed and settled when working in so many different places.
When I first started locuming I put together a simple contract setting out my terms and sent this to practice managers.
Most importantly, this laid out the number of patients I would expect to see in a routine surgery, how I would like my surgery arranged in terms of having any break or catch up slots, the number of telephone calls and home visits I would include in the fee I charged and how much I expected to be paid for my work.
It also included a short clause regarding cancelling work and the time frame of notice I would give and expect to be given by practices, bar unforeseen circumstances such as illness, should my locum work need to be cancelled. It may sound quite a formal approach but I felt it removed any room for doubt from the outset.
Sadly, I often hear partners say that locums have a tendency to pass tricky problems back to regular staff to deal with. I try to remember that locum GPs tend to be called to work when the surgery is short of regular doctors so potentially at a time when the team is already under pressure and I aim to ease pressure and not add to it.
For patients who need review, there will likely be an element to 'pass back' to a regular member of staff if you do not know when you will be working at the surgery again, but if it is logistically possible, I try to make a plan to review a patient myself. I also always make a clear record of my plan for follow-up in the notes to help the next clinician looking after the patient I have seen.
This is good medical practice for any patient but is particularly important when handing over care to another doctor. I try to save any systems queries I have during surgery or queries regarding referral pathways for the end of clinic to prevent me needing to regularly interrupt the same person during their morning or afternoon - and I make sure any referrals I chose to make are submitted before I leave.
Get called back
The key to being a successful locum is to make sure you are called back to work at practices. To help yourself to be remembered for good reasons, GP locums can start with obvious and simple things: being punctual and organised, arriving at work looking smart and with all the appropriate equipment to do a GP clinic and by being helpful and approachable and flexible to help meet the needs of a surgery on any given day.
- Dr Cumisky is a GP in Bath