In the UK, there are approximately 15,500 locum GPs according to NASGP. Our locum colleagues are a tremendously important part of our service; a useful and necessary resource. Regardless of whether you need cover for holidays, sickness or CCG meetings, getting a good locum is an all-important task.
Good locums can work like a dream. They know the local care pathways, understands the importance of QOF, and they handover patients safely. Good locums arrive punctually, and they are polite to staff and patients. They refer appropriately, and they don't ask patients to come back unnecessarily.
But how do you find and keep a good quality locum?
In this article, we take a look at five simple steps that you can take to achieve better quality locum bookings.
1. Know the right places to find good locums
The first step is to know where you can find good quality locums. Word of mouth is a great option and you might get some good suggestions from colleagues in neighbouring practices. Locums also advertise themselves from time to time and some practices keep a list so they can contact them as needed.
If you can't find a locum this way, you could of course use a locum agency. Take care though as some agencies send staff that may not have knowledge of your local services and referral pathways. Locum agencies can also work out to be an expensive option as they usually take a substantial commission with every booking.
Make sure you understand what you are paying for, what is included (e.g. home visits, telephone consultation and on-call cover), and if value added tax (VAT) is payable. If you must use a locum agency, make sure you have seen the locum's recent work history and be sure to ask the agency for written feedback from other nearby practices that have used the same locum.
You can also use a locum booking website such as rLocums.com to find locums near you. These sites allow you to browse locum profiles, see who have been recommended by local practices, and then book them directly online.
2. Plan locum cover in advance
It might sound obvious, but good rota management can go a long way in improving the quality of locum bookings. It's worth having ‘holidays and study leave' as an on-going agenda item in your regular practice meetings. This enables you to plan holidays and study leave in advance as a practice, so any internal cross-cover can be coordinated more effectively.
Where external locum cover is needed, it's best to arrange this in advance rather than at the last minute. Good locums tend to get booked up one to three months in advance, though if you do find yourself needing cover at short notice, websites like the one mentioned above can send out SMS text messages to many locums at the same time which can get you quick response.
3. Build relationships with regular locums
Locums are colleagues, just like the rest of us. You'll likely want good locums to come back for more sessions, or they might even become your salaried GP or partner. It goes without saying that you should treat them with the respect and friendliness that you would with any other colleague.
Take the time to introduce yourself, even if it's just popping your head through the door to say ‘hi'. Even if it were just one minute, you'd be amazed at how much the small gesture would be appreciated. An offer of a cup of tea or coffee in the morning can make all the difference between the perception of a welcoming practice, versus a ‘cold' place, where good locums are unlikely to want to come back to work again.
Similarly, if your practice has a mid-morning coffee break, make an effort to invite them so they feel like they are part of the team. You will be rewarded with hard work and plenty of good will.
4. Give locums regular feedback they can use
It's well known that locums can find it difficult to get feedback, as they move from practice to practice, often only staying for short periods at a time. Recent changes, however, have meant that feedback and reflection are now a mandatory part of the appraisal and revalidation process. Feedback therefore, is both appreciated and essential to the locum's professional development.
If you are using a locum booking website, giving feedback is very quick and is probably already part of the process. Some sites will even allow you to give locums a recommendation, which is great for the locum and employer alike, as it gives them an extra incentive to go the extra mile.
When giving feedback, it's helpful to remember that it doesn't have to be time-consuming. It's about the quality, rather than quantity that counts. Remember Pendleton's rules, and discuss things that the locum has done well, with positive reinforcement, before moving on to things that could be done differently. Be clear, concise, objective and constructive. If you would recommend or use the locum again, then say it – otherwise they won't know.
5. Run the 30-second checks
When you book a locum, you have the responsibility of ensuring that they are suitably qualified for the work that they will be doing. You should do some due diligence before appointing a locum, but it doesn't have to be difficult.
A simple check you can do is to check the doctor's registration on the GMC website. Simply enter their name or GMC number and you can check the status of their registration instantly, together with whether they have a license to practise, on the GP register, and the year they were first registered. If a doctor has undertakings or conditions against their registration, this information would be clearly listed on the website and you can then check with the doctor if you have any questions.
With regards to other documents you should ask for, it really depends on what your requirements are. Here are some of the common documents that you might ask for:
- Online GMC registration / GP register check
- Passport or similar proof of identity
- Criminal Records Bureau enhanced disclosure
- Letter of inclusion into a PCT performer's list
- Emergency resuscitation training
- Professional indemnity insurance
- Safeguarding children / vulnerable adults training
Problems with locums can be a time-consuming affair, but if you get it right, a good locum works like a dream. It's well worth taking the time to get things right.
Dr. Steve Leung is a GP in Leicester and medical director of www.rlocums.com
