Tips For Making The Most Of Locum GPs

Here’s a really useful article I saw on the GP online magazine,

Dr Simon Wadeaimed more at GPs and practice managers.

I find Judith Harvey often writes candidly  and informatively

 

See what you think………..

 

Locums – How to get the best from locums

By Dr Judith Harvey, 18 January 2012

Dr Judith Harvey says the practice may be the real culprit when a GP locum it hires underperforms.

 GP locums are not going to disappear. If they did, general practice would grind to a halt.

But grumbling about them is almost a sport. It could prove more useful to look at why locums do not always meet the practice’s expectations.

If your locum cannot find a physiotherapy referral form, they have to spend precious time looking for it. If the dictation machine is broken, they cannot dictate letters. If the batteries in the fetal heart monitor are flat, the baby’s wellbeing cannot be checked. If the emergency equipment is incomplete, lives cannot be saved.

It is as simple as that. Locums cannot give of their best with their hands tied behind their back.

So do give some thought to what they have to cope with at your practice before rushing to criticise. This is not to say that locums are never at fault: like the GPs employing them, they are human too.

Consulting in a pig sty
Locums learn to be flexible. They may have to consult in someone else’s pig sty of a consulting room with inadequate patient notes, in a practice with its own way of doing things.

They guard against lack of functioning equipment by bringing their own. But locums are only as good as the environment in which they work.

Enforced underperformance – not giving of your best for reasons outside your control – is a constant threat.

Yet many practices make little effort to meet their legal obligations and to protect their patients, their reputation and their investment, by providing locums with adequate working conditions.

Here is some practical advice that will enable locums working in your organisation to manage your patients as safely and effectively as they can.

The better locums’ working conditions are, the better the job they can do. Everyone pays the price of enforced underperformance and everyone has an obligation to reduce the risks it presents to doctors, the profession and, most of all, to patients.

PRACTICAL TIPS FOR PRACTICES

Tips for GP partners
These also apply to anyone else lucky enough to have their own consulting room.

  • Look at your room with a fresh pair of eyes. Try literally doing this by swapping rooms with a colleague.
  • Could you walk in, sit down and get to work there straight away? As a locum, I may be happy for patients to assume the cute children in your photographs are mine, but dead plants suggest a lack of care.
  • What does that untidy heap of papers say about you? You cannot curse the locum for moving things around if it is the only way to get to the desktop.
  • Could a stranger lay their hands on forms and equipment without an archaeological dig? And if they have to dig, what would they find? Stale biscuits, old love letters, compromising websites?

Tips for Practice Managers
These also apply to the practice’s GPs.

  • For locums, your practice is unknown territory. To work safely they need more time than doctors who work there every day.
  • Locums are not born knowing that a Somali interpreter is available on Thursdays and that you keep the vaginal speculi in the third cupboard on the left.
  • Check the practice’s induction pack. Indeed, check that you have one. If there is no pack, use a standard format, such as a National Association of Sessional GPs’ locum pack.
  • If you have a pack, clear out all that out-of-date information. Wading through information about path labs’ closures over Christmas 2009 wastes locums’ time and your money. Locums know what information they need, so paying a locum to put together a pack, on paper or online, could be a valuable investment.
  • When you engage locums, check how familiar they are with your practice, your IT systems and your referral pathways.
  • Ensure that they have easy access to help when the printer seizes up or when advice on a ‘heartsink’ patient would be useful.
  • How can consulting rooms be set up to make it easy to find things, and to keep them that way? A box file or mobile container specially equipped for locums may be the answer.
  • Are your patients’ records up to scratch? Locums can only brief themselves on patients’ medical histories if those histories are clearly recorded.
  • Look at two high-risk areas: signing repeat prescriptions and handover. A locum who is reassured that you have a robust repeat prescription system will be more confident about signing repeats. Safe systems for handover of information can be, literally, vital.

Tips for others
These apply to primary care organisations (PCOs), clinical commissioning groups (CCGs), the RCGP and the GPC.

  • PCOs are responsible for the standard of healthcare in their area. Locums provide more of that care than many like to admit. Yet locums still complain that PCOs (and CCGs) ignore their existence.
  • Locums can only follow guidelines if they have access to them. They can only attend educational events if they know about them. A statistic that should set alarm bells ringing is that in 2010 only 20% of locums received the flu pandemic cascade. The CCGs and other new organisations must do better.
  • Enforced underperformance could be substantially reduced by ensuring that practices provide adequate working environments as outlined above.
  • The RCGP and GPC have obligations to all GPs. They can ensure that locums receive appropriate training and that their professional role is respected and supported.

 Dr Harvey is a locum GP in central London

Very useful advice. What do you think? Please do leave you comments and views – or start a discussion…

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