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From locuming to leading a chamber

Richard Fieldhouse


Dr Richard Fieldhouse

Age 48

Location West Sussex

Roles Co-director of Pallant Medical Chambers, locum GP, CEO of the National Association of Sessional GPs and clinical lead for communications and engagement at NHS Coastal West Sussex CCG


What is an average week? 

I work two clinical sessions in surgery and for a day each week at the CCG communications office. For the rest of the time I work from home, on trains or at meetings. This enables me to carry on my CCG role while running the locum chambers where I am co-director and the National Association of Sessional GPs (NASGP). I carry my MacBook Air everywhere. My favourite place to work is the café, at a rate of one americano an hour. Technology and coffee are huge enablers.

What’s the best thing about being a locum GP?

The variety. I’ve worked as a locum in around 100 different practices. I love that I’m helping out practices and patients who would otherwise be struggling. What I lack in terms of providing continuity, 

I make up for in alternative perspective. My career also opens up myriad opportunities, such as commissioning.

What’s the most challenging aspect of your different roles?

The stress when deadlines collide.

What is a locum chamber? 

Each chamber is a co-operative of 10 or so GP locums who combine their resources to work together as one professional unit, alongside other local chambers. We started as one chamber, and now we have around 10, from London to Bristol; more than half of us were partners or salaried GPs before joining the chambers.

How did you get your job?

The NASGP came up with the chambers idea after consulting 30 locum groups on how to enfranchise locum GPs. The idea was to maximise the advantages of working as a team of GPs, without the disadvantages. I tried to sell the idea to PCTs, but ended up setting it up myself with two colleagues. Our PCT agreed to give us 180 sessions to get started and we went from there.

How much remuneration do you get for this work? 

I’m not going to give an exact figure. Instead of a salary, we pay ourselves if there’s any money left over after our costs (such as staff and IT equipment). The chambers has required a substantial amount of risk from its four directors, including me. So when I tell my kids I’ve been working in a café, in terms of getting paid, I might as well have been. Luckily, I’m not doing it for the money. 

What one trait do you most deplore in your colleagues?

I don’t so much deplore as take pity on colleagues who have a fixed mindset. 

The system we work in has led to a sense of learned helplessness. Instead of embracing challenges, creating solutions and finding inspiration in others, they tend to stick with the status quo, complain and feel threatened. We are all the masters of our own destinies.

One living person who inspires you?

At the moment it’s Daniel Kahneman, author of Thinking Fast and Slow. I now realise I know far less than I ever thought I did, and it’s liberating.

What’s the best advice your GP trainer gave you? 

Never underestimate the suffering caused by the death of a pet, and always get a chest X-ray done in a smoker with shoulder pain.

What’s the most common assumption GPs make about your role? 

That I’m a politician. And that the chambers are a way to print money.

How would your patients describe you?

As ‘one of the locums’, ‘Dr Fieldmouse’, or ‘the one with wobbly eyes’. 

What have you given up to have a career as a GP?

Dreams of being a spaceman, detective, architect, scientist, gynaecologist or chef – in that order. I did have a place at university to study brewing, which I was looking forward to, but I took a place at medical school instead.

What makes you angry?

NHS IT. I cannot believe one of the world’s largest employers is still rolling out technology developed in the previous century. It’s hardly surprising the NHS is where it is. In fact, it could be classified as industrial sabotage. 

If you weren’t a medic, what would you like to do for a living? 

If I could get paid to make sourdough bread, I’d do that. Or keep bees and chickens and grow all our own food.