Life as a Locum GP isn’t always easy – Dr Richard Fieldhouse gives his top tips on getting the most out of the role
CREDIT: This is an edited version of an article that originally appeared on Medscape
Locum work has become much more popular in recent years: between September 2021 and September 2022, locum GP bookings doubled, and membership of the National Association of Sessional GPs (NASGP) increased by 79%.
Here are 11 top tips for anyone who does locum work or is considering it as a career option.
Demonstrate that you meet the requirements of a Locum GP
Keep documentation organised and up to date
Just like other GPs, locum GPs are fully qualified and must have certain documentation to be able to practise in the UK. However, as locum GPs need to prove their status more regularly than their peers, it is particularly useful for them to keep these documents organised and in one place, with both paper and digital copies available.
Other useful documents to keep together and up to date include immunisation cards, an NHS Smartcard, professional references, and a curriculum vitae (CV)—the cornerstone of getting locum work.
Appreciate that Locum GPs are Generally Self-Employed and Practise Independently
Recognise the Differences between GP and Hospital Locums
For the purposes of tax, employment, and NHS pension law, locum GPs are self-employed (unless they work through an agency or their own limited company).Because all GPs, including locum GPs, are licensed by the GMC to practise independently, practices hire locum GPs to cover sessions rather than shifts, and expect them to perform duties across their agreed competencies without direct supervision, as per their privileged place on the GMC GP Register.
Establish Terms and Conditions for Locum Work
Work in the Way that You Choose
When a locum GP sets out clear terms and conditions before agreeing to work, it can protect them from unsafe clinical work and gradual changes in the requirements of, or relationship with, a practice.
It also gives both the GP and the practice a chance to negotiate before a session. When agreeing terms, it is best to be specific and transparent, and practices will generally appreciate the value of having a set of terms and conditions that a locum GP, or the members of a locum chambers, adopt. Topics to cover include:
the amount of work that is expected—this is usually based on workload or time, with a session defined by a maximum number of patient contacts (including whether they are 10- or 15-minute consultations), a fixed amount of time (often around 4 hours), or another standardised measurement
the core work that is expected—including whether it consists of face-to-face, remote, and/or telephone consultations, whether triaged surgeries are involved, and whether supervision of non-GP colleagues is required
Nurture Professional Relationships to Prevent Isolation
Make a Date
Working as a locum GP can be exceptionally challenging, exhausting, and professionally isolating; locums have no fixed workplace, and are often working in rapidly changing, high-pressure environments over which they have little control, and this can lead to burnout.
Peer support can help to counteract this, and can make an active difference to a locum’s professional and social lives. Locum GPs will naturally meet other local locums in the course of their work, and it may be a good idea to set a date for meeting up with one another on these occasions.
Join a Locum Chambers
Being part of a formal group of GPs who work in the same way, such as a locum chambers, is another great way for locum GPs to get support and reduce isolation and stress.
Network, Network, Network
Locum GPs may also benefit from developing relationships with people in the practices in which they work, not just with other locum colleagues. Every day, a locum GP can spend a little time getting to know the people in the practices in which they are working.
Rely on Peer-to-Peer Support in Challenging Times
Share Complaints with Colleagues
When they receive a complaint, locum GPs can only benefit from calling on peer-to-peer support enabled by fostering professional relationships, knowing that their colleagues will listen and empathise having likely experienced similar situations.
After all, a key aspect of being a GP is listening to others and giving support, so doing this with colleagues is second nature. This peer support network is one of the perks of the job.
Be an Agent for Change at the Practices in Which You Work
Pass on Your Concerns to Practices
Passing any concerns on to the practice can be challenging when done as an individual, but as a group—particularly when organised into a locum chambers—it can be powerful. This can be especially effective if simple, anonymised, structured feedback is collected and shared with the practice in a collective voice.
Help Practices to Develop Accessible Practice-Specific Information
One particular challenge of working as a locum GP is the wide variety of methods, procedures, and protocols used by different practices for the same purposes. Blood tests, referrals, and safeguarding measures, for example, are regularly required, but practices organise them in many different ways.
Locum GPs are often not a party to this kind of practice-specific information, and although many practices attempt to bring this together as part of a ‘locum induction pack’, these packs are rarely kept up to date.
Crowdsource Useful Details
A central, easily accessible and updatable electronic pack can work better; hence, the NASGP has built the functionality for practices and locums to share practice-specific information into LocumDeck.
Locum GPs can encourage practices to make sure that they have all the necessary information at their fingertips—be it online or in a useful information pack of some kind—and may achieve more success in prompting them to do this when doing so as a collective.
Tap into the Knowledge of Fellow Locum GPs
Locum GPs will quickly learn that among their local numbers are some real experts in various clinical fields. Some will be newly qualified GPs with special interests, and others will be ex-partners who have run specific services.
Ensure That You Get Paid on Time
Synchronise Invoicing with a Practice’s Routines
Submitting an invoice early, as soon as the month ends if possible, can really help a locum GP to get paid on time. However, invoicing weekly may, counterintuitively, lead to locum GPs getting paid later—it causes extra work for the practice, takes more time, and increases the chance of mistakes.
Invoices are an example of where being part of a locum chambers can make the process easier for everyone involved, as a chamber’s invoices are often arranged and sent at the same time.
This coordination helps the practice to organise its payments more easily and plan its payment run in advance and also allows the locum GPs to be paid more efficiently. Even if not as part of a chambers, it is definitely worth scheduling a regular date for getting invoices organised and sent off.
Embrace the Variety Involved in Being a Locum GP
Working as a locum GP is an exciting opportunity to use the skills and experience gained from being a GP in a different way. Locum GPs need to develop an instant rapport with patients they have never met, providing a different clinical perspective—sometimes at odds with the practice’s other clinicians, who they have also never met—in practices they have never worked for, in places they know little about, navigating unfamiliar clinical pathways.
Locum GPs are a fresh pair of eyes for both a practice and individual patients, potentially picking up on problems that regular staff may miss, and they provide practices with workforce flexibility and variety.
A lot of locum work occurs in understaffed, struggling practices serving disadvantaged communities, as regional deprivation has been linked to greater reliance on locum GPs, and helping patients in these areas to access healthcare can be difficult but especially rewarding. Being a locum can therefore be an exciting and fulfilling career choice for many GPs and, over time, it can create all sorts of career opportunities.
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