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The key to being a happy and successful locum

Thinking of opting for locum work? In the first of a two-part series, Dr Robbie Coull's survival guide sets out the pros, the cons and the practicalities of working as a GP locum

Locum work is varied, interesting and exciting. Many doctors choose locum work over a formal NHS career because of the flexibility it offers, and because locums avoid much of the bureaucracy and over-management that can make working in the NHS such a trial. Others like the travel, and the fact that you work in so many different environments.

However, locum work is also difficult, and can be lonely. You need to be self-sufficient, have an open mind and be able to make friends quickly and easily. It helps if you are flexible, able to improvise and able to cope with wide variations in normal practice, style and delivery.

You will be called on to treat patients you have never seen before (and may never see again) with the help of staff you don't know in an environment that is unfamiliar.

Starting locum work can be a daunting prospect as there is seldom anyone to show you how it is done (since it is unusual to have more than one locum in the unit or practice at any one time) and many of its elements are not taught in medical school ­ advertising, agreeing/haggling rates, billing etc.

This article, and the one that follows, will answer some of your questions and make locum work easier, less stressful and more rewarding.

How to find locum work

Finding locum work via the internet

Websites such as locum123.com allow you to receive notification of work matching your requirements via SMS text messages, e-mail and/or online noticeboards.

Organising locums yourself

You can send your details to practices in the areas that you are keen to work. A short, well laid out page (single side of A4) with your contact details, availability, and a brief CV is the best format.

Many areas have local locum groups that distribute lists of locums to the practices in their areas (see the NASGP website www.nasgp.org.uk) and most PCOs make the list of locum GPs in their area accessible to practices in their area.

Ask practice managers or other locums in your chosen areas how they find locums, or contact the local dean of postgraduate general practice for advice.

Finding locum work via locum agency

Agencies are the most common route for locum hospital work, but are a much less common route for GPs. Ask around in the area or areas you want to work to see what agencies are popular there.

What rates to charge

You need to agree a rate with the practice before you begin work. This is the part that everyone, including the most hardened haggler, finds most difficult.

You can either charge per 'session' (usually three-four hours) or charge an hourly rate. It is not uncommon for locums to charge an extra fee for home visits (for example £x per visit on top of, or instead of, the normal hourly rate). There are essentially three ways to decide on rates:

·Local rates

Find out what others in your area are charging, and charge the same. This is the most common and least difficult method for setting rates. But it is also produces the lowest profits for locums.

·Market forces

This involves charging 'what the market will bear', and involves applying the principle of supply and demand.

To use this method, choose a starting rate (possibly based on local rates, as above), then increase your rate periodically by a small percentage.

As your rate increases, you will notice there is less demand for your services, but you will be earning more money for the work you are doing. The trick is to find the correct balance where demand is just high enough to produce the desired level of income with the minimum amount of effort.

·Income calculation

Take the amount of money you think you should earn each year ('target income'), add your estimated annual expenses and divide the total by the number of sessions you plan to work. Use this figure as your target rate per session (see the locum income calculator on the locum123.com website).

Locum rates and

the Office of Fair

Trading ruling

In 1999 the Office of Fair Trading decided that BMA and other locum rates breached the Competition Act 1998, which prohibits certain types of anti-competitive behaviour, such as the formation of cartels. A cartel is an agreement between businesses (called undertakings) not to compete with each other on, among other things, price. Locums need to be careful that they do not breach the Act by agreeing between themselves what rates to charge.

Based on the 'Locum Doctor Survival Guide' which can be downloaded free from the locum123.com website

Robbie Coull is a locum with locum123.com

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