Succeeding as a Locum GP

By Dr Surina Chibber, Locum GP and co-founder of MyLocumManager.com – the cloud based locum business toolkit.

 

 

Starting out as a locum GP can be a daunting process but with a few practical insights and tips there are a number of ways that GPs can make this transition a successful one.

Transitioning into a locum career can be a hugely unnerving process whether you are a partner changing the direction of your career, or a newly qualified GP wanting some variety. There are so many reasons why a GP may choose to become a locum. Moving away from the continuity of one practice and regular paid employment has its inherent challenges.

As I approached the end of my GP training I remember the apprehension well. I felt uncomfortable at the thought of walking away from secure employment. However, I wanted to challenge myself by working in different practices. I also wanted to understand how practices adapted to meeting the needs of their patients. Working with different patient populations and on different portfolio roles was also important to me, so, when I finished my GP training, I decided to work as a locum GP.

Below are some steps GPs can take to make the transition to locum  work a success.

Plan Ahead

One of the ways that I succeeded as a locum was by planning ahead. Towards the end of my GP training, I wrote covering letters, and dropped these along with my CV to all the local surgeries. The NHS Choices “Find GP services” website is a great free resource for practices local to you. I followed up with a phone call and email to their practice managers. It wasn’t long before I knew that practice managers needed a number of documents before allowing me to come and work with them.

These include:

  • Documents confirming you’re 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 saved all these documents as a PDF document that could be easily emailed to prospective practice managers. You can also create a dropbox file and send this to your local practices.

It was important to me that I built up good relationships with practices and had a continuity of work and patient care. The alternatives would be to use agencies and third parties to source the work for you. This comes with its own uncertainty, challenges and risks. You will find after the initial introduction to practices you may like to work without a middleman however ensure you are aware of the terms and conditions of booking as you will often be prohibited from working directly with practices if the work is sourced via a third party.

Be Responsive

Practice managers have locum lists to hand, to whom they send their locum requirements on a regular basis. Once you are added to these lists, you will begin to receive offers of work. Many areas have a Whatsapp group on which they post upcoming sessions. To secure work, respond promptly as work is often secured on a first come, first served basis. By far the best way to source work is to contact your local practices directly and build up a local group of practices where you can understand the local policies and pathways and provide good patient care.

Managing Locum Administration

Make sure you keep a diary with all your booked sessions. While this may sound obvious, double booking yourself makes everyone’s life difficult, and does tend to happen. Using a scheduling software like My Locum Manager can simplify the process of booking multiple shifts into your diary.

Additionally, have a system to create invoices, log expenses, track mileage, monitor the number of sessions you are working in line with your indemnity and collect all your work data for your accountant. You may have additional portfolio jobs which contribute to your income. You can do this manually, on excel, or with a bespoke locum business toolkit like My Locum Manager. Ensure you have found a good medical accountant and that you have taken their advice as to whether you set up as a sole trader or limited company. My Locum Manager partners with specialist medical accountants so can help put you in touch if you need help.

Set Terms Beforehand

It is important that both you and the practice understand what work will be undertaken. When I first started working as a locum, I put together a contract setting out my terms, and sent this to practice managers. This had the amount I expected to be paid for my work and included the number of patients I expected to see in a routine surgery, how I wanted my surgery arranged regarding breaks and catch ups, and the number of telephone calls and home visits included in my fee.

I also included a clause regarding cancelling work and the time frame of notice I would give and expect to be given by practices, should my locum work need to be cancelled. These terms and conditions helped to protect me and the practice and ensure each party was clear with their expectations of one another.

You can download a terms and conditions template at MyLocumManager.com/resources and use it as a guide for your own.

When it comes to agreeing a fee, I often ask practices what rate they usually pay and we negotiate from there. Ensure you clarify if this rate is inclusive of your pension contribution.

On the day

Locum work in unfamiliar practices comes with its own risks. Ensure you arrive early to get set up in your room. Introduce yourself to key staff and get their extension numbers so you can access their advice quickly. Ask for the locum pack which will have key information from login details to local prescribing protocols. Ensure you are aware who to speak to if you need a second opinion during the clinic or if you want some additional advice for a patient.

To ensure you are well prepared for your first session at a new practice, here is a list of useful questions to ask:

  • What is the extension number for reception?
  • Where is the panic button?
  • How do I call patients in?
  • How do I request blood tests and where are these done (on site or local hospital)?
  • How do I order X-rays and Ultrasounds?
  • How do I refer for physiotherapy and counselling?
  • Where are MED3, MATB1 and maternity exemption forms kept?
  • Do I dictate or type up referrals?

Mutual support

The patients you see as a locum are your patients and you have a duty of care to them and your colleagues. Do not be tempted to “pass the buck” even if you won’t be working at the practice again. Clear documentation, arranging investigations, reviewing results to assess clinical problems are extremely important from both a clinical and medicolegal point of view.  Ensure you are aware before starting your clinic who in the practice can chaperone alongside you for appropriate examinations and do document if you offered a chaperone but the patient declined.

If you have a regular group of practices where you work continuity of care and reviewing these patients is often easier, however if you are changing practices regularly and you won’t have the chance to follow up a patient, it is helpful to handover to your colleagues and also put a clear plan in the notes so the patients’ regular doctor is able to get all the information they may need. Ensure you document red flags, safety netting advice and follow up arrangements that you have discussed with your patients. To keep up to date about prescribing polices and referral guideline you may find the Red Whale GP Update Locum Essentials Guide useful. You can access this for free online.

I often discuss any queries that I have with the practices’ regular doctors. I also make sure I submit any referrals before I leave for the day.

Returning to Practices

The key to being a successful locum is to ensure you are called back to work at practices.  To help yourself succeed, remember to be flexible in helping meet the needs of the surgery, be punctual, organized, and be equipped with the necessary equipment you’ll need. Developing a relationship between the practices you work at will help you access regular work, support and continuity and become a valued member of your practices wider team.

Locum work can be a fantastic way to gain a wealth of clinical experience and work in different settings. Simplifying all the administration with bespoke locum software like My Locum Manager can save you a huge amount of time and energy. Ensuring you diligently document your consultation notes, handover patients to regular staff and remain up to date with regards to your prescribing and clinical practice are important considerations which will help you thrive as a locum GP.

Dr Surina Chibber is writer of the popular Locum Survival Guide available at www.MyLocumManager.com/resources

www.MyLocumManager.com – the cloud based business software for locum and portfolio GPs.

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Jun 26

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